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1. GI > LFTs > Flashcards

LFTs Flashcards

1
Q

Name some serum transaminases?

A

ALT/AST

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2
Q

What are the enzymes measured in LFTs?

A

Serum transaminases – ALT/AST
Alkaline Phosphatase
Gamma Glutamyl Transpeptidase

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3
Q

What are the indices of intrinsic synthetic function?

A

Albumin
Prothrombin Time
Bilirubin

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4
Q

What are the characteristics of ALT?

A

More sensitive than AST
Predominantly cytosol-located
Predominantly Liver
Short half life – 47hrs

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5
Q

What is more sensitive: ALT or AST?

A

ALT

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6
Q

What are the characteristics of AST?

A

Cytosol and mitochondria

Half life of 17hrs

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7
Q

What are the characteristics of ALP?

A

Half live of a week

Biliary, bone, placenta, intestine following large meals, kidney

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8
Q

What are causes of prolonged thrombin time?

A

Drugs – warfarin
Bile malabsorption
Consumptive coagulopathies

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9
Q

What are the characteristics of prothrombin?

A

Liver is responsible for synthesis of most clotting factors (Factor I - fibrogen, II - prothrombin, V, VII, IX, X, XII, XIII)
PT measures the conversion time from PT-> thrombin and thus reflects a vital component of the liver
Elevated PT may reflect reduced synthetic functionality

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10
Q

Which enzyme must be age adjusted?

A

ALP

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11
Q

What does ALT/AST > ALP & increased Bilirubin indicate?

A

hepatocellular injury

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12
Q

What does ALP> ALT/AST & increased Bilirubin indicate?

A

cholestasis

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13
Q

What does Increased PT/INR indicate?

A

Prolonged jaundice
Vit K malabsorption
Hepatocellular dysfunction

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14
Q

What are the characteristics of Hyperbilirubinaemia Unconjugated?

A
  • Increased bilirubin production
  • Impaired hepatic bilirubin uptake
  • Impaired bilirubin conjugation
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15
Q

What are the characteristics of Hyperbilirubinaemia Conjugated?

A

Extrahepatic Cholestasis

Intrahepatic Cholestasis

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16
Q

What can cause increased bilirubin production?

A

extra/intravascular haemolysis

extravastion of blood into tissues

17
Q

What can cause impaired hepatic bilirubin uptake?

A

heart failure

portosystemic shunt – TIPSS

18
Q

What can cause impaured bilirubin conjugation?

A

Gilbert’s
CN Type II
Advanced liver disease

19
Q

What can cause Extrahepatic Cholestasis?

A

PSC, Cholelithasis, Cholangiocarcioma, HoP Mass, Acute/Chronic Pancreatitis

20
Q

What can cause Intrahepatic Cholestasis?

A

Sepsis/Hypoperfusion states, Cirrhosis, Infiltrative Disease, TPN, Acute Hepatitis, Drugs (Alkylated steroids etc)

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