LFTs

Question 1

What indicates a hepatic picture in LFTs?

Answer 1

A greater than 10-fold increase in ALT and a less than 3-fold increase in ALP

Question 2

What suggests a cholestatic picture in LFTs?

Answer 2

A less than 10-fold increase in ALT and a more than 3-fold increase in ALP

Question 3

What does an isolated bilirubin rise indicate? (2)

Answer 3

Prehepatic jaundice
Gilbert’s disease

Question 4

What is used to assess the synthetic function of the liver? (2)

Answer 4

Albumin = if liver impaired if decreases
Coagulation studies = if liver impaired then prothrombin time increases

Question 5

What does a 2:1 ratio of AST:ALT indicate?

Answer 5

Alcoholic liver disease

Question 6

What does an isolated ALP rise without a rise in GGT indicate? (3 examples of this)

Answer 6

Bony pathology
Paget’s disease
Vit d deficiency
Bony mets

Question 7

What is an isolated GGT rise associated with?

Answer 7

Alcohol excess

Question 8

What form of bilirubin is extremes by the kidneys?

Answer 8

Conjugated urobilinogen

Question 9

What type of bilirubin is excreted in the stools?

Answer 9

Conjugated stercobilinogen

Question 10

Albumin levels decrease with decreased function of the liver. What are the 2 reasons for this and give 2 examples of each.

Answer 10

• Decreased albumin production: malnutrition, severe liver disease
Increased albumin loss: protein-losing enteropathies, nephrotic syndrome