LFTs

Question 1

ALT is a measure of ….

Answer 1

hepatitis- liver inflammation

Question 2

ALP is a marker of… when else may it be increased?

Answer 2

cholestasis, can also be increased in bone growth and heart damage

Question 3

GGT is a marker of… and can be used in conjunction with…

Answer 3

cholestasis, used with ALP to determine whether a high ALP is because of the liver.

Question 4

Bilirubin is marker of… and often implies…

Answer 4

jaundice

often implies obstruction to the drainage of bile, synthetic dysfunction of the liver or acute severe injury

Question 5

Describe a hepatic pattern, what sort of conditions have a hepatic pattern?

Answer 5

Predominant rise in ALT compared with other analytes most commonly seen in conditions causing a hepatitis:
NAFLD/ NASH (non-alcoholic…)
AIH (autoimmune hepatitis)
HBV, HCV (hep B or C virus)

Question 6

Describe a cholestatic pattern, what sort of conditions have a cholestatic pattern?

Answer 6

Predominant rise in ALP +/- gGT=/- bilirubin
Most commonly seen in conditions associated with cholestasis
Obstructive conditions e.g. stones or tumours
PBC (primary biliary cholangitis)

Question 7

Describe a mixed pattern, what sort of conditions have a mixed pattern?

Answer 7

Both ALT and ALP/gGT/Bilirubin rise
No clear predominant analyte deranged
Can occur in any liver condition
Most common examples include alcohol, DILI, systemic causes of LFT derangement

Question 8

What other organ can be assessed to determine state of liver?

Answer 8

Kidneys- they are very closely linked

Question 9

What will increase with a failing liver?

Answer 9

Bilirubin

Question 10

What will reduce with a failing liver?

Answer 10

Albumin

and glucose in very late stages

Question 11

What will happen to PT (INR)?

Answer 11

It will prolong