LFTs Flashcards
What LFTs would you expect to see in a person with acute hepatitis?
ALT/AST in 1000s
ALP mildly raised
What LFTs would you expect to see in a person with chronic hepatitis?
ALT/AST in 100s
Drop in albumin
What LFTs would you expect to see in a person with a biliary obstruction?
ALP in 100s
ALT/AST mildly raised
Increase in bilirubin
What LFTs would you expect to see in an alcoholic?
Increase in gamma GT
Increase in MCV
What do liver enzymes reflect?
Liver injury (not function)
Where is ALT found?
Liver
Where is AST found?
Liver, heart, skeletal muscle, kidneys, pancreas
If ALT is higher than AST, what does this show?
Chronic liver disease
If AST is higher than ALT, then what does this show?
Established cirrhosis
Alcoholic liver disease
Where can ALP be found?
Biliary ducts
Bone
What is used to confirm whether ALP is of hepatic origin?
Gamma GT
If there is a large increase in ALP (>4 x normal) what does this suggest?
Cholestasis
If there is a moderate increase in ALP ( <3 x normal) what does this suggest?
Hepatitis
Cirrhosis
Infiltration
What is the half life of albumin?
20 days
If there is a drop in both albumin and protein, what does this suggest?
advanced cirrhosis, alcoholism, protein malnutrition, chronic inflammation, renal/gut/skin loss
If there is a drop in albumin, but normal protein, what does this suggest?
Infection
If there is a drop in albumin and an increase in protein, what does this suggest?
Myeloma
What is prothrombin time/INR dependant on?
Vitamin K-dependant clotting factors and fibrinogen
What does a raised INR suggest?
Liver disease
Vitamin K deficiency
What does macrocytosis suggest?
Alcohol
What test do you do if someone is suspected to have fatty liver disease?
Fasting glucose and lipids
When is anti-mitochondrial testing done?
Primary biliary cirrhosis suspected
When is anti-nuclear testing done?
Autoimmune hepatitis type 1
What blood test can be done to test for coeliac disease?
TTG
What test can confirm pancreatitis?
Abdominal CT
