LFTS Flashcards
best liver function test
trick questions! none!!
most informative if used as a group and looking for patterns of abnormalities
damage to bile duct seen in which LFT (3)
- alkaline phosphatase
- 5’nucleotidase
- bilirubin- severe
damage to hepatocyte seen in which LFT (6)
- AST/ALT
- protein synthesis
- immunoglobins
- removal of ammonia- severe
- clotting factors- severe
- glucose homeostasis- severe
increase in unconjugated bilirubin (2)
- hemolysis
2. UGT1A1 deficiency: (a) Gilbert’s (b) crigler-najjar
increase in conjugated bilirubin (2)
- Dubin-Johnson syndrome (MRP-2)
2. Hepatocyte injury
which bilirubin is soluble in water and excreted in urine
conjugated
serum ammonia used to diagnose
hepatic encephalopathy or urea cycle disorders
hypoalbuminemia can be due to
chronic liver disease. protein malnutrition
liver produces all clotting factors except for
Factor VIII
what is the single best measure of hepatic synthetic function
factor VII
AST and ALT are indicators of
hepatocyte injury
which is more specific for the liver ALT or AST
ALT
relative levels of ALT and AST
what about in alcoholic liver disease
- ALT > AST
2. alcohol-induced deficiency of pyridoxal phosphate which impairs synthesis of ALT more than of AST
what if the GGT are elevated?
less specific and both ER or bile duct cells might be affected
diffuse polyclonal increases sin IgG seen in
autoimmune hepatitis
elevated alpha-fetoprotein
since it is produced by hepatocytes sit might be an indication of hepatocellular carcinoma or hepatic injury or liver regenetation
what can we see in hepatocellular
- ALT, AST elevations
2. hepatitis, vascular injury, drugs
what can we see in cholestatic
- alkaline phosphatase elevation
2. bile duct obstruction, PBC, PSC, tumor
what can we see in severe liver disease acute/chronic
- low albumin
2. elevated bilirubin
what can we see in liver failure
- elevated PT
2. low glucose
