LFTS

Question 1

What does ALT stand for?

Answer 1

Alanine aminotransferase

Question 2

What does AST stand for?

Answer 2

Asparate aminotransferase

Question 3

What does ALP stand for?

Answer 3

Akaline Phosphatase

Question 4

What does GGT stand for?

Answer 4

Gamma Glutamyl transferase (gamma GT)

Question 5

What are the 6 common things tested in a liver function test?

Answer 5

ALT, AST, ALP, GGT, Bilirubin, Albumin

Question 6

If your ALT or AST are raised, what 6 pathologies is this suggestive of?

Answer 6

• Liver damage/disease
• Biliary disease
• Alcohol
• Muscle damage
• MI
• Pancreatitis

Question 7

If your ALP is raised, what 5 pathologies is this suggestive of?

Answer 7

• Biliary disease/damage
• Liver disease
• Alcohol
• Bone disease (pagets)
• Pregnancy

Question 8

If your GGT is raised, what 2 pathologies is this suggestive of?

Answer 8

• Biliary or liver disease

* Alcohol

Question 9

If your Bilirubin is raised, what 2 pathologies is this suggestive of?

Answer 9

• Jaundice

* Giberts syndrome

Question 10

If your Albumin is raised, what kind of pathology is this suggestive of?

Answer 10

• Dehydration

Question 11

If your Albumin is low, what 4 pathologies is this suggestive of?

Answer 11

• Inflammation
• Cirrhosis
• Malnutrition
• Pregnancy

Question 12

If your ALT or AST is low, what kind of pathology is this suggestive of?

Answer 12

•Possibly decreased vitamin B6

Question 13

If a patient presents with clinical features of liver disease yet returns a normal LFT test, what should not be discounted?

Answer 13

Liver disease. Normal LFTS do not discount this.

Question 14

Raised AST and ALT indicate what kind of disease?

Answer 14

Hepatocelular disease

Question 15

Raised ALP and GGT indicate what kind of disease?

Answer 15

Cholestatic diseadse

Question 16

In results that have AST and ALT that are moderately raised to approx. 5 times normal lvls, what are 5 pathologies that spring to mind?

Answer 16

• Chronic Hep B + C
• Autonimmune Hepatitis
• Heamochromatosis
• Alcoholic hepattis
• Fatty liver disease

Question 17

In results that have AST and ALT that are extremely raised approx. 10 times normal lvls, what are 4 pathologies that spring to mind?

Answer 17

• Acute Hep A, B, E
• Toxic drugs/fungi
• Ischaemic Hepatitis
• Sever acute autoimmune

Question 18

In results that have ALP and GGT that are extra-hepatic in origin what are 5 pathologies that spring to mind?

Answer 18

• Stones
• Ca. pancreas/bile duct
• Biliary stricture
• Sclerosing cholangitis
• Pancreatitis

Question 19

In results that have ALP and GGT that are intra-hepatic in origin what are 6 pathologies that spring to mind?

Answer 19

• Viral
• Alcoholic hepatitis
• Cirrhosis
• Primary biliary cirrhosis
• Pregnancy
• Drugs

Question 20

What can a raised ALP alone signify?

Answer 20

infiltration such as metastasis or cirrhosis

Question 21

What is cholestasis?

Answer 21

Impaired hepatic excretion

Question 22

What is an obstructive cholestatic LFT picture?

Answer 22

• ALP in the 1000’s
• ALT/ASt mildly elevated
• ↑ Bilirubin

Question 23

What is an chronic hepatic picture LFT picture?

Answer 23

• ALT/AST in the 100’s

* ↓ Bilirubin

Question 24

What is an acute hepatic picture LFT picture?

Answer 24

• ALT/AST in the 1000’s

* ALP mildly raised

Question 25

What diseases are associated with Cholestasis?

Answer 25

• Primary biliary cirrohsis → Autoimmune destruction of the common bile duct
• Primary sclerosing cholangitis → common and hepatic bile ducts shrink due to infection and scarring
• Drugs → Flucloxacilin, Fusic acid, co-amoxiclav, nitrofurantoin, steroids, Prochlorperazine, Chlorpromazine, Sulfonylureas
• Gallstones
• CA. pancreas, cholangiocarcinoma
• Mirzzis → Cystic duct stopne impaction causing common bile duct obstruction.