LFTs and jaundice Flashcards
what LTFs are raised in hepatic jaundice
ALT and AST
what LTFs are raised in cholestatic jaundice
ALP
bilirubin
slight GGT increase
what causes hepatic jaundice
viral hepatitis
NAFLD
what causes cholestatic jaundice
obstruction of flow or bile duct disease
gallstones, cancer, PBS, PBC
what causes mixed jaundice
alcohol
obstructing tumour
drugs
what drugs cause mixed jaundice
flucloxacillin
co-amoxiclav
NSAID
what type of jaundice would decreased serum albumin suggest
intra-hepatic jaundice
what type of bilirubin is involved in pre-hepatic jaundice
unconjugated
what type of bilirubin is involved in intra-hepatic jaundice
unconjugated
what type of bilirubin is involved in post-hepatic jaundice
conjugated
what LTFs suggest intra-hepatic jaundice
decreased serum albumin
increased AST and ALT
what LTFs suggest post-hepatic jaundice
increased ALP
what are the causes of pre-hepatic jaundice
haemolytic anaemia
gilbert’s syndrome
newborn
what are the causes of intra-heptaic jaundice
cirrhosis
Liver failure
hepatitis
what are the cause of post-hepatic jaundice
gallstones
PBC
PSC
cancer
what type of jaundice is associated with itching
post-hepatitic
what type of jaundice is associated with tender and enlarged liver
intra-hepatic
high prothrombin time suggests what
acute or chronic liver disease
when are ALT/AST released into the bloodstream
when liver cells are damaged
describe the specificity of ALT
specific to the liver
describe the specificity of AST
non-specific, produced by heart, muscles, kidneys, and brain
Very high AST, and slightly high ALT suggests what
alcoholic or drug induced cirrhosis
very high ALT and slightly high AST suggests what
viral hepatitis
NAFLD
what does normal stool and urine colour suggest
pre-hepatitic
what does normal stool and dark urine suggest
intra-hepatitic
what does pale stool and dark urine suggest
post-hepatitic
what is the general cause for intra-hepatic jaundice
problem within the liver with excretion to conjugation of bilirubin
what is the general cause for pre-hepatic jaundice
increase in the breakdown of RBC
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
what conditions could cause the following LFTs:
Increased Bilirubin
haemolytic anaemia
malaria
gilberts syndrome
what conditions could cause the following LFTs:
Increased Bilirubin
increased AST
increased ALT
decreased serum albumin
cirrhosis liver failure hepatitis NAFLD pregnancy (rare)
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
what are the causes of jaundice (acronym)
VINDICATE
vascular, infection, neoplasm, drugs, inflammatory, congenital, autoimmune, trauma, endocrine
give examples of autoimmune conditions that cause jaundice
autoimmune hepatitis
PBC
give examples of congenital conditions which cause jaundice
gilbert’s syndrome
haemochromatosis (iron storage)
wilson’s disease (copper storage)
