LFT interpretation Flashcards
what individual components make up ‘LFTs’
serum transaminases - ALT/AST ALP GGt albumin PTT / INR bilirubin
which ones are the liver enzymes
ALT/AST
ALP
GGT
what are indicators of intrinsic synthetic liver function
albumin
PTT / INR
bilirubin
transaminases are intracellular but are released in the context of __?
hepatocellular injury
which is more liver sensitive, AST or ALT
ALT
what else (other than the liver) could cause an increase in AST
heart pancreas skeletal muscle brain lungs
ALT/AST are raised in hepatic/cholestatic injury
hepatic injury
what is ALP
alkaline phosphatase
where can ALP come from
biliary tree bone placenta intestine kidneys
GGT is ‘inducible’, what does this mean
it can be raised from drugs (anticonvulsants, TCA, paracetamol) and alcohol
what is bilirubin
a breakdown product from RBC
how is bilirubin excreted
in urine as urobilinogen
in faeces as stercobilinogen
bilirubin is transported to liver bound to which protein
albumin
what clotting factors does the liver produce
factors 2,7,9,10
what is prothrombin time
measures the conversion time from prothrombin to thrombin
essentially measures the clotting ability of the liver
elevated PTT may reflect elevated/reduced liver synthetic function
reduced function
what can cause prolonged PTT
liver disease
warfarin
bile malabsorption
coagulopathies
AST/ALT > ALP is indicative of hepatocellular injury/cholestasis
hepatocellular injury
ALP > AST/ALT is indicative of hepatocellular injury/cholestasis
cholestasis
hyperbilirubinaemia can be conjugated or unconjugated, list unconjugated causes
extra/intravascular haemolysis
impaired uptake by the liver
impaired bilirubin conjugation
hyperbilirubinaemia can be conjugated or unconjugated, list conjugated causes
biliary obstruction
liver disease
triad for acute liver failure
jaundice
encephalopathy
coagulopathy
