LFTs

Question 1

LFTs test names:

Answer 1

• Bilirubin (total & direct/conjugated)
• ALP
• GGT
• ALT
• AST
• Total Protein
• Albumin
• Globulins

Question 2

Functions of the liver

Answer 2

Fat metabolism, Glycogen & glucose metabolism, drug metabolism, bilirubin conjugation, protein synthesis - albumin & clotting factors.

Question 3

Raised unconjugated bilirubin alone

Answer 3

Haemolysis, Gilbert Syndrome

Question 4

How to test for haemolysis (3)

Answer 4

Anaemia, reticulocytes, haptoglobulin

Question 5

Haptoglobin

Answer 5

binds haemoglobin and is used up even in mild haemolysis

Question 6

Isolated elevated ALP (2)

Answer 6

Bone formation
Pregnancy - placenta secretes

Question 7

Elevated ALP bony causes (4)

Answer 7

Young & Growing
Vit D deficiency - osteomalacia
Metastatic disease
Pagets disease

Question 8

Isolated raised GGT causes (4)

Answer 8

Alcohol, phenytoin, metabolic syndrome, obesity

Question 9

Raised ALP & GGT

Answer 9

Biliary Disease

Question 10

Mildly elevated transaminases (ALT & AST, GGT)

Answer 10

Fatty liver disease, chronic hep C or hep B, haemochromatosis, autoimmune.

Question 11

Fatty liver disease

Answer 11

steatosis - hepatic manifestation of metabolic syndrome.
high risk of cirrhosis

Question 12

Marked elevated transaminases

Answer 12

Paracetamol Overdose
Acute viral hepatitis

Question 13

Paracetamol overdose treatment

Answer 13

<2 hrs - activated charcoal
2-8 hrs - measure serum paracetamol & ALT - nomogram
>8 hrs - acetylcystein

Question 14

Isolated AST

Answer 14

MI

Question 15

Elevated Globulins causes

Answer 15

Chronic inflammation esp RA
Myeloma or lymphoma
HIV

Question 16

Elevated globulins next investigations

Answer 16

Protein electrophoresis

Question 17

Total Bilirubin RR

Answer 17

2-20

Question 18

Conjugated bilirubin RR

Answer 18

<5

Question 19

ALP RR

Answer 19

30-150

Question 20

GGT RR

Answer 20

10-50

Question 21

ALT RR

Answer 21

0-30/40

Question 22

AST RR

Answer 22

10-50

Question 23

Total protein RR

Answer 23

64-83

Question 24

Albumin RR

Answer 24

32-48

Question 25

Globulins RR (by subtraction)

Answer 25

25-41