LFTs Flashcards

1
Q

what are aminotransferases (AST, ALT) associated with

A

hepatocellular damage

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2
Q

what is more specific for liver damage ALT or AST

A

ALT

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3
Q

what is the ratio of AST:ALT useful for

A

DDx

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4
Q

raised aminotransferases

AST:ALT is 1

A

associated with ischaemia
1 CCF
2 ischaemic necrosis
3 hepatitis

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5
Q

raised aminotransferases

AST:ALT is >2.5

A

associated with alcohol

e.g. alcoholic hepatitis

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6
Q

raised aminotransferases

AST:ALT is <1

A

high rise in ALT (which is most specific for hepatocellular damage)
may indicate paracetamol overdose with hepatocellular necrosis
viral hepatitis may also cause this

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7
Q

what do raised ALP and GGT normally indicate

A

cholestasis (blockage with gallstone)

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8
Q

what is ALP associated with

A

cholestasis and malignant hepatic infiltration

it is also a marker of rapid bone turnover and extensive bone metastasis

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9
Q

what is GGP associated with

A

alcohol ingestion
non-specific marker of hepatocellular damage
very sharp rise with biliary and hepatic obstruction

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10
Q

what is indicated if AST is >20times normal range

A

acute viral hepatitis
toxic hepatitis
ischaemic hepatitis (CCF)

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11
Q

what is indicated if AST is 10-20time normal

A
alcoholic cirrhosis
infectious mononucleosis (glandular fever)
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12
Q

what is indicated if AST is 5-10times normal

A

liver (chronic hepatitis)

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13
Q

what do very high levels of ALT indicate

A

hepatocellular injury
1 viral hepatitis
2 toxic hepatitis
3 ischaemic hepatitis

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14
Q

what do moderately raised levels of ALT indicate

A

infection (infectious mononucleosis - glandular fever)

liver (chronic hepatitis)

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15
Q

what are slightly raised levels of ALT suggestive of?

A

often suggestive of AST:ALT >2.5

which is commonly alcoholic liver disease (hepatitis or cirrhosis)

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16
Q

what is seen first in biliary obstruction (raised ALP or raised bilirubin)

A

raised ALP

17
Q

what are causes of raised ALP

A
pathological
liver
bone
non-pathological
pregnancy
blood type O + B
18
Q

what causes raised ALP in pregnancy

A

comes from placenta

19
Q

what causes raised ALP in blood types O + B

A

usually due to a small meal, ALP is released from the small intestine

20
Q

what are causes of raised ALP (liver)

A

usually indicates cholestasis or obstruction

21
Q

what are causes of raised ALP (bone)

A

osteomalacia
bone metastasis
pagets

22
Q

what produces GGT

A

renal tubules, liver, biliary tract, pancreas,

23
Q

what is the benefit of GGT

A

sensitive marker of hepatocellular damage (more so than ALP + AST) but much less specific

24
Q

what are causes of raised GGT

A

liver (hepatocellular damage)

pancreatitis

25
Q

what are causes of a rapid increase in GGT

A

obstructive jaundice

26
Q

what is LDH (LD1 and LD2) commonly found in

A

heart, RBCs, kidneys

27
Q

what is LDH (LD3) commonly found in

A

lungs

28
Q

what is LDH (LD4 and LD5) commonly found in

A

liver and skeletal muscle