LFTs Flashcards
What are the true liver function tests?
Albumin
PT
What are the liver enzymes?
Alk Phos
ALT / AST
Gamma-GT (GGT)
Bilirubin
Wha does increased ALT mean?
Damage to liver cells
Marked increase in ALT indicates?
Hepatitis
Liver ischaemia
Between ALT and AST; which is specific to the liver?
ALT
A raised AST indicates the same thing as a raised?
ALT
If ALT > AST = ?
Chronic liver disease
If AST > ALT = ?
Cirrhosis, alcoholic liver disease
Increased ALP indicates`
Damage to liver cells
Marked increase in ALP indicates?
Gallstones, PBC; PSC, pancreatic Cancer, drugs
GGT mirrors?
ALP
GGT is raised in?
Alcohol misuse and enzyme-inducing drugs
Unconjugated hyperbilirubinaemia indicates?
Drugs
Physiological neonatal jaundice
Conjugated hyperbilirubinaemia?
Hepatocellular dysfunction
Imparied hepatic secretion
What is the difference between unconjugated and conjugated hyperbilirubinaemia?
Conjugate = water-sobuble --> excreted in urine Unconjugated = insoluble --> not excreted in urine
How long does it take for albumin to be affected?
20 days
What does decreased albumin and decreased protein indicate?
Advanced cirrhosis
Alcoholism
Malnutrition
What does decreased albumin and normal protein indicate?
Infection
What LFT changes does hepatitis show?
Predominant rise in ALT/ AST
What is the ULN for ALT?
55
What LFT changes are shown in NAFLD?
Modest elevation in ALT (unlikely if > 250)
What LFT changes are shown with Cholestasis?
ALP and Bili (with some GGT) rise
ALT middle elevated or normal
The ULN for ALP is dependent on?
Age and sex
ULN for Bili is approx?
22
What LFT changes would PBC show?
May have slightly elevated ALP and slightly high Bili (if more advanced)
What is the most common cause of a mixed LFT pattern (hepatic & cholestatic)
Alcohol Obstructing parenchymal tumours Drug induced (flucloxacillin, co-amoxiclav & NSAIDs)
