LFT Lecture

Question 1

What are the True LFTs?

Answer 1

Albumin, Clotting (INR/Prothrombin), Glucose Status

Question 2

What are the ‘non-true’ LFTs?

Answer 2

Bilirubin, ALP, ALT(AST), GGT

Question 3

What is ATA1?

Answer 3

Alpha 1 anti-trypsin

Question 4

What is ATA1 …….. clinically associated with?

Answer 4

Deficiency ….. Lung emphysema + impaired liver function

Question 5

What is Caeruloplasmin?

Answer 5

Copper carrier molecule

Question 6

What condition is low Caeruloplasmin most associated with?

Answer 6

Wilson’s disease

Question 7

What are the 3 main patterns of LFT derangement?

Answer 7

Hepatitis, Cholestasis, mixed

Question 8

What is the main LFT change in a Hepatic pattern?

Answer 8

Predominant rise of transaminases (ALT, AST)

Question 9

What is the main LFT change in a cholestatic pattern?

Answer 9

Predominant rise in ALP & Bilirubin with some GGT. ALT tends to be normal or mildly elevated.

Question 10

What antibody is PBC associated with?

Answer 10

AMA

Question 11

What antibody is AIH associated with?

Answer 11

ASMA

Question 12

Is ALP rise always pathological?

Answer 12

Can be physiological as it is not specific to the liver, can be found in skeletal muscle, breast tissue, bone marrow. Will be elevated in puberty.

Question 13

LFT change in AIH?

Answer 13

ALT elevation of 100 to 800 mainly

Question 14

LFT change in HCV?

Answer 14

Elevated ALT but need clinical suspicion

Question 15

LFT change in NAFLD?

Answer 15

Can have asymptomatic elevation of ALT. Usually ALT elevated around 100. ALT >250-330 unlikely.

Question 16

LFT change in PBC?

Answer 16

Elevated ALP & slightly high Bili/ALT.

Question 17

Mixed Pattern

Answer 17

Mixture of hepatitis & cholestasis pattern.

Question 18

ALP ULN

Answer 18

Age & Sex dependent ~100-120

Question 19

ALT ULN

Answer 19

55

Question 20

ULN Bilirubin

Answer 20

~22