LFTs

Question 1

What occurs in liver failure to intermediary metabolism

Answer 1

Reduction in blood sugar (lack of glycogen)
Lactic acidosis
Increased ammonia

Question 2

What are the four serum markers of liver cell damage?

Answer 2

ALT
AST
ALP
GGT

Question 3

What are the markers of liver synthetic funcrtion

Answer 3

Albumin
PT

Bilirubin

Question 4

Where are ALT and AST usually found

Answer 4

Within cytoplasm of hepatocytes

Question 5

When are ALT and AST released

Answer 5

Upon hepatocyte death

Question 6

What other organs are ALT and AST found in

Answer 6

Muscle, heart, kidney, bone

Question 7

What AST ALT ratio indicates liver disease

Answer 7

2:1 AST:ALT

Question 8

What does elevated GGT indicate

Answer 8

Chronic alcohol abuse

Question 9

Where is ALP normally found

Answer 9

In the bile ducts

Question 10

When is ALP raised

Answer 10

Obstructive jaundice / bile duct damage

Question 11

What other conditions other than liver can cause increased ALP

Answer 11

Bone disease

Pregnancy

Question 12

What is the half life of albumin

Answer 12

20 days

Question 13

When is albumin low?

Answer 13

LOW PRODUCTION

• chronic liver disease
• malnutrition

INCREASED LOSS
- gut, kidney

SEPSIS
- third spacing

Question 14

What is ALP raised in?

Answer 14

hepatocellular carcinoma
Pregnancy
Testicular cancer

Question 15

What are pale stools / dark urine a feature of?

Answer 15

OBSTRUCTIVE jaundice

Question 16

How much urobilinogen is present in the urine of a healthy person

Answer 16

Very small amounts

Question 17

How much urobilinogen is present in urine of pt with obstructive jaundice

Answer 17

NONE

Question 18

How much urobilinogen is present in someone with haemolytic , hepatitis, sepsis

Answer 18

TOO MUCh

Question 19

What is the liver panel

Answer 19

Liver USS
AST
CK
TFT
Fasting lipids
Coeliac serologi
Hepatitis serology (B surface antigen, C antibody) 
Alpha 1 antitiripsin 
Ceruloplasmin 
Ferritin