LFTs Flashcards
What are the 6 values found in an LFT
ALT, AST, ALP, GGT, Bilirubin, Albumin
What are each of the LFTs
ALT and AST: enzyme found in liver and heart
GGT: enzyme found mostly in liver
ALP: enzyme found in liver and bones
Albumin: non specific marker of synthetic liver function
Bilirubin: marker of severity of cholestatic and hepatocellular damage
What do each of the LFTs indicate
High ALT & AST= hepatocellular injury eg cirrhosis, hepatitis, paracetamol overdose, carcinoma. AST being twice as high as ALT suggests alcohol liver disease
High ALP & GGT= biliary system flow dysfunction
High GGT alone= alcohol excess
High ALP= obstructive liver disease, vitamin D deficiency
Low albumin= severe liver disease, nephrotic syndrome
High Bilirubin= Gilberts (if only bilirubin is high in an LFT), damage to hepatocytes (normally with high ALT/AST), anaemia, pancreatitis, viral hepatitis
Which LFTs are related to cholestasis and which are related to hepatocellular damage
ALT, AST= hepatocellular damage
GGT, ALP= cholestasis
What is the general structure for LFT chronic disease management 7
- Ask about patient’s PC
- Checking patient’s understanding
- Ask about patient’s condition
- Ask the patient about their medication
- Effect of condition on patient’s life
- PMH, DH, FH, SH
- ICE
What does checking patient’s understanding mean regarding LFTs 4
- explain patient’s condition if they don’t understand
- explain what LFTs are (a test that measures enzymes that are released from your liver into your blood and they indicate how healthy your liver/ GB is)
- Why we encourage LFTs to be low (reduce damage to your liver/ GB which can worsen their condition)
- Do they know what their test results mean
What does checking patient’s condition mean regarding LFTs 4
- how long have they had this condition
- how well do they think their condition is being managed
- risk factor check: diet, alcohol, IVDU, recent infections
- any symptoms (RUQ pain, fever, jaundice, weight loss, fatigue, pruritis)- ask about progression if so
What does checking patient’s medication mean regarding LFTs 4
- when did they start taking it
- do they take it regularly, if not why and how often
- any side effects/ adverse reactions?
- how effective has the medication been at controlling their condition
What does checking the EFFECT of the condition on the patient mean regarding LFTs 5
- mood
- sleep
- diet
- ADL
- affecting work/ personal life
What is relevant PMH for LFTs 4
- cancer
- surgeries
- previous gallstones
- IBD/IBS
What is relevant social history regarding LFTs 7
- recent travel
- smoking
- alcohol
- recreational injected drugs
- diet
- recent sexual activitiy
- VACCINATIONS
What is one thing that needs to be checked throughout the LFT chronic disease management
ICE
