LFTs Flashcards
Where is albumin synthesised?
The liver
If albumin is low, what may it indicate?
That synthetic function is impaired but protein loss is elsewhere
Where is AST found?
Mitochondrial enzyme which is found in the liver, heart, muscle, kidneys and brain
When is AST raised?
Hepatic necrosis, MI, muscle injury and congestive cardiac failure
What is ALT?
Cytosol enzyme produced by hepatocytes
Which is more specific to the liver - AST or ALT?
ALT - raised in liver disease
Where is Alkaline phosphatase produced?
In the biliary cells
When may ALP be raised?
In the presence of biliary injury e.g. obstruction, tumours
What does ALP suggest?
Obstructive jaundice formation
In which situation, other than the liver, may ALP be raised?
Produced in bone so in growing children or bone metastases
what does a raised GGT suggest?
Biliary injury related to alcohol abuse or related to fatty liver disease
What does raised bilirubin and raised ALP suggest?
Hepatocellular injury - liver metastasis and hepatitis
When does the prothrombin time become deranged?
Acute hepatic failure - fails to synthesis clotting factors
When is alpha feta protein values used?
To diagnose patients with focal lesions of the liver
In which disease is alpha feta proteins used as a screening test?
Cirrhotic patients at risk of developing hepatocellular carcinomas
What is ceruloplasmin?
A protein which binds to copper
When is ceruloplasmin low?
Typically in Wilson’s disease - also raised urinary copper
Typical LFT in alcohol abuse?
AST double ALT value and raised GGT
What is raised in acute liver damage?
ALT, AST and bilirubin
What is raised in chronic liver disease?
Bilirubin, ALT, AST and ALP
What is raised in cirrhosis?
AST is higher than ALT, bilirubin increases in late stages and PTT is prolonged
What is raised in bile duct obstruction?
Bilirubin, ALT, AST and ALP is greatly increased
What is raised in metastatic liver disease?
ALP greatly increased
What is decreased in autoimmune conditions of the liver?
Albumin
What does albumin do?
Regulates osmotic gradient and transports nutrients and waste products
What does a significantly raised ALP and raised GGT suggest?
Duct blockage
