LFTs and Cases

Question 1

Bilirubin synthesis

Answer 1

Red blood cells breakdown releasing heme, iron, and globin

Heme goes on to form bilirubin

Question 2

Which cell in the liver is involved in breaking down RBCs and where is it found?

Answer 2

Lines the sinusoids of the liver - Kuppfer cells

Question 3

What are the best tests of liver synthetic function?

Answer 3

Albumin

Prothrombin time

Question 4

How do AST and ALT rise in alcoholic liver disease?

Answer 4

AST:ALT ratio > 2

AST much more than ALT

Question 5

What does an elevated GGT suggest?

Answer 5

Chronic alcohol use

Bile duct disease + hepatic metastases

Question 6

Where is ALP found in the lvier?

Answer 6

Sinusoidal and canalicular membranes - lining the bile ducts

Question 7

What can be used as a HCC marker?

Answer 7

Alpha fetoprotein

Question 8

What scan is used to look at the biliary tree?

Answer 8

USS

Question 9

What does urobilinogen in the urine suggest?

Answer 9

Haemolysis, hepatitis, sepsis

Question 10

What is the most common cause of drug-induced cholestasis?

Answer 10

Augmentin

Question 11

What are the 3 things that will make ALT rise over 1000?

Answer 11

Toxins - paracetamol
Viruses - hepatitis
Ischaemia