LFTs

Question 1

raised ALT

Answer 1

hepatocellular injury

Question 2

raised ALP

Answer 2

cholestasis

Question 3

what to do after raised ALP

Answer 3

review GGT
raised GGT= epithelial damage, bile flow obstruction, or response to drugs or alcohol = cholestasis
normal GGT= non hepatobillary pathology

Question 4

patient jaundice but normal ALT and ALP

Answer 4

pre-hepatic cause

• giblert’s syndrome
• haemolysis

Question 5

bilirubin

normal urine and normal stools

Answer 5

pre-hepatic cause

Question 6

bilirubin dark urine and normal stools

Answer 6

hepatic cause

Question 7

bilirubin dark urine and pale stool

Answer 7

post-hepatic cause (obstruction)

Question 8

unconjugated hyperbilirubin

Answer 8

haemolysis, impaired heptaic uptake, impaired conjugation (gilbert’s)

Question 9

conjugated hyperbilirubin

Answer 9

hepatocellular injury, cholestasis

Question 10

fall in albumin

Answer 10

liver disease

inflammation triggering an acute phase response - temporary decrease in production

Question 11

increase in prothrombin time

Answer 11

(other than use of anti-coagulants and vitamin K def)

indicates liver disease and dysfunction