LFTs and jaundice Flashcards

1
Q

what LTFs are raised in hepatic jaundice

A

ALT and AST

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2
Q

what LTFs are raised in cholestatic jaundice

A

ALP
bilirubin
slight GGT increase

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3
Q

what causes hepatic jaundice

A

viral hepatitis

NAFLD

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4
Q

what causes cholestatic jaundice

A

obstruction of flow or bile duct disease

gallstones, cancer, PBS, PBC

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5
Q

what causes mixed jaundice

A

alcohol
obstructing tumour
drugs

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6
Q

what drugs cause mixed jaundice

A

flucloxacillin
co-amoxiclav
NSAID

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7
Q

what type of jaundice would decreased serum albumin suggest

A

intra-hepatic jaundice

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8
Q

what type of bilirubin is involved in pre-hepatic jaundice

A

unconjugated

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9
Q

what type of bilirubin is involved in intra-hepatic jaundice

A

unconjugated

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10
Q

what type of bilirubin is involved in post-hepatic jaundice

A

conjugated

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11
Q

what LTFs suggest intra-hepatic jaundice

A

decreased serum albumin

increased AST and ALT

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12
Q

what LTFs suggest post-hepatic jaundice

A

increased ALP

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13
Q

what are the causes of pre-hepatic jaundice

A

haemolytic anaemia
gilbert’s syndrome
newborn

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14
Q

what are the causes of intra-heptaic jaundice

A

cirrhosis
Liver failure
hepatitis

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15
Q

what are the cause of post-hepatic jaundice

A

gallstones
PBC
PSC
cancer

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16
Q

what type of jaundice is associated with itching

A

post-hepatitic

17
Q

what type of jaundice is associated with tender and enlarged liver

A

intra-hepatic

18
Q

high prothrombin time suggests what

A

acute or chronic liver disease

19
Q

when are ALT/AST released into the bloodstream

A

when liver cells are damaged

20
Q

describe the specificity of ALT

A

specific to the liver

21
Q

describe the specificity of AST

A

non-specific, produced by heart, muscles, kidneys, and brain

22
Q

Very high AST, and slightly high ALT suggests what

A

alcoholic or drug induced cirrhosis

23
Q

very high ALT and slightly high AST suggests what

A

viral hepatitis

NAFLD

24
Q

what does normal stool and urine colour suggest

A

pre-hepatitic

25
what does normal stool and dark urine suggest
intra-hepatitic
26
what does pale stool and dark urine suggest
post-hepatitic
27
what is the general cause for intra-hepatic jaundice
problem within the liver with excretion to conjugation of bilirubin
28
what is the general cause for pre-hepatic jaundice
increase in the breakdown of RBC
29
what is the general cause for post-hepatic jaundice
triggered when the bile duct is damaged, inflamed or obstructed and so can't escape into the bowel
30
what conditions could cause the following LFTs: Increased Bilirubin
haemolytic anaemia malaria gilberts syndrome
31
what conditions could cause the following LFTs: Increased Bilirubin increased AST increased ALT decreased serum albumin
``` cirrhosis liver failure hepatitis NAFLD pregnancy (rare) ```
32
what conditions could cause the following LFTs: increased bilirubin increased ALP increased ALT increased GGT
``` gallstones PBC PSC cancer of the bile ducts stricture of the bile ducts pancreatitis ```
33
what are the causes of jaundice (acronym)
VINDICATE vascular, infection, neoplasm, drugs, inflammatory, congenital, autoimmune, trauma, endocrine
34
give examples of autoimmune conditions that cause jaundice
autoimmune hepatitis | PBC
35
give examples of congenital conditions which cause jaundice
gilbert's syndrome haemochromatosis (iron storage) wilson's disease (copper storage)