Labs basics

Question 1

ALT and AST assesses

Answer 1

liver cell death or damage

Question 2

ALP and GGT assesses

Answer 2

assess for impairment of bile flow

Question 3

If ALP and GGT elevated

Answer 3

If elevated, and extra-hepatic biliary obstruction ruled out by ultrasound,

test anti-mitochondrial
antibody.

Any positive titer is significant and is highly specific for primary biliary cholangitis (which
affects ~1:1000 women over the age of 40). If positive, consider referral to hepatology.

Question 4

CBC with platelets when suspecting

Answer 4

CBC with platelets (to assess liver function and enable FIB-4 score calculation)

o Platelets are included in the FIB-4 calculation as thrombocytopenia can be an initial sign of
cirrhosis.

Question 5

Assess liver function - suspecting cirrhosis

Answer 5

If cirrhosis is suspected, also test INR, bilirubin, albumin (to assess liver function)