LFTs

Question 1

ALT

Answer 1

Raised in liver damage or inflammation

Question 2

AST

Answer 2

Usually liver damage if raised but also heart and skeletal muscle

Question 3

ALP

Answer 3

suggestive of gall bladder but can be bone as well

Question 4

Albumin

Answer 4

decreased in chronic liver damage

Question 5

Billirubin

Answer 5

High levels of conjugated bili is suggestive of gall stones - ie an obstructive picture. Can also suggest pancreatic tumour, hepatitis, alcohol abuse. Unconjugated is red blood cell breakdown

Question 6

GGT

Answer 6

Suggestive of obstructive picture ie gall stones

Question 7

Pre hepatic jaundice

Answer 7

Malaria / sickle cell / thalassaemia / Crigler Najar (enzyme for bili removal from blood absent) / hereditary spherocytosis (increased haemolysis)

Question 8

Intrinsic jaundice

Answer 8

Hepatitis / Alcoholic liver disease / ecstasy or paracetamol OD / 1 biliary cirrhosis (progressive liver damage) / Gilbert’s (unable to break down bilirubin at normal rate) / liver cancer / autoimmune / 1 sclerosing cholangitis / Dubin Johnson (can’t combine bili and bile to get out of liver

Question 9

Post hepatic jaundice

Answer 9

Gallstones / Ca head of pancreas / Biliary cancer / pancreatitis

Question 10

Pancreatitis

Answer 10

Iatrogenic / Gall stones / ERCP / Trauma / Steroids / mumps / autoimmune / scorpions / hypercalcaemia / Ethanol / Drugs

Question 11

Pancreatitis treatment

Answer 11

Fluids - need loads!! Oxygen and nutrition needed and find the underlying cause - often need painkillers too

Question 12

Gallstones treatment

Answer 12

Nothing! if no symptoms. Laparoscopic cholecystectomy if there are - life without gallbladder = possible need to change diet. Made of cholesterol so lose weight

Question 13

What does the gall bladder do?

Answer 13

STORES bile

Question 14

Where is bile made

Answer 14

Liver