LFTs

Question 1

what cells produce AST and ALT

Answer 1

hepatocytes

Question 2

what will an isolated rise in ALT indicate

Answer 2

fatty liver disease

Question 3

where is GGT produced

Answer 3

hepatocytes and bile ducts

Question 4

what will an AST:ALT ratio of >2 indicate

Answer 4

alcoholic liver disease

Question 5

what will cause a rise in GGT

Answer 5

inc in chronic alcohol use, bile duct disease, hepatic mets

Question 6

where is ALP produced

Answer 6

bile ducts (also bone and placenta)

Question 7

what will cause an inc in ALP

Answer 7

obs jaundice, bile duct damage
pregnancy
bone disease

Question 8

what zone of the liver is damaged more by hapatoxic substances

Answer 8

z1 (periorbital)

Question 9

what zone of the liver is damaged by substances that require bioactovation

Answer 9

z3 (centrilobular)

Question 10

what will cause a drop in albumin

Answer 10

CLD
malnutrition
sepsis
nephrotic syndrome

Question 11

what will cause a raise in albumin

Answer 11

acute pancreatitis

Question 12

what do dilated biliary ducts indicate

Answer 12

gallstones, cancer

Question 13

when is AFP raised

Answer 13

pregnancy
hepatic damage
hepatocellular carcinoma

Question 14

what will cause a drop in urobilinogen on a urine dipstick

Answer 14

obs jaundice

Question 15

what will cause a spike in urobilinogen on a urine dipstick

Answer 15

haemolysis, sepsis, hepatitis

Question 16

what dye tests are used to assess liver function

Answer 16

indocyanine green

bromosulphaline

Question 17

what aspects of liver function are dye tests measuring

Answer 17

excretory capacity

hepatic blood flow

Question 18

what markers are raised following a MI

Answer 18

CLAMT

Ck, LDH, AST, Myoglobin, Troponins

Question 19

what can you say about the ALT:AST in viral hep

Answer 19

ALT > AST

Question 20

what can you say about the ALT:AST in alcoholic hep

Answer 20

AST:ALT >2

Question 21

what will a very raised urea level indicate

Answer 21

kidney failure/dehydration

Question 22

what will a be raised in chronic liver failure

Answer 22

very high creatinine

Question 23

what is a shorter term marker for glucose control than HbA1c

Answer 23

fructosamine (3w)

Question 24

what are some differentials if ALP is raised <5x normal levels

Answer 24

bone tumour/fracture
hepatitis
pregnancy

Question 25

what are some differentials if ALP is raised >5x normal levels

Answer 25

Pagets, Osetomalacia

cholestasis, cirrhosis

Question 26

when is faecal elastase measured

Answer 26

chronic pancreatitis

Question 27

what is the marker for inflammatory bowel disease

Answer 27

faecal calprotein

Question 28

when should you measure troponins after chest pain

Answer 28

6hrs after onset and again at 12-24hrs

Question 29

how long will troponins remain high for after an exacerbating event

Answer 29

2 weeks

Question 30

what is brain NP and how is it used

Answer 30

natriuretic peptide secreted by ventricles

very sensitive used to exclude heart failure in a clinical setting