LFTs and jaundice

Question 1

what LTFs are raised in hepatic jaundice

Answer 1

ALT and AST

Question 2

what LTFs are raised in cholestatic jaundice

Answer 2

ALP
bilirubin
slight GGT increase

Question 3

what causes hepatic jaundice

Answer 3

viral hepatitis

NAFLD

Question 4

what causes cholestatic jaundice

Answer 4

obstruction of flow or bile duct disease

gallstones, cancer, PBS, PBC

Question 5

what causes mixed jaundice

Answer 5

alcohol
obstructing tumour
drugs

Question 6

what drugs cause mixed jaundice

Answer 6

flucloxacillin
co-amoxiclav
NSAID

Question 7

what type of jaundice would decreased serum albumin suggest

Answer 7

intra-hepatic jaundice

Question 8

what type of bilirubin is involved in pre-hepatic jaundice

Answer 8

unconjugated

Question 9

what type of bilirubin is involved in intra-hepatic jaundice

Answer 9

unconjugated

Question 10

what type of bilirubin is involved in post-hepatic jaundice

Answer 10

conjugated

Question 11

what LTFs suggest intra-hepatic jaundice

Answer 11

decreased serum albumin

increased AST and ALT

Question 12

what LTFs suggest post-hepatic jaundice

Answer 12

increased ALP

Question 13

what are the causes of pre-hepatic jaundice

Answer 13

haemolytic anaemia
gilbert’s syndrome
newborn

Question 14

what are the causes of intra-heptaic jaundice

Answer 14

cirrhosis
Liver failure
hepatitis

Question 15

what are the cause of post-hepatic jaundice

Answer 15

gallstones
PBC
PSC
cancer

Question 16

what type of jaundice is associated with itching

Answer 16

post-hepatitic

Question 17

what type of jaundice is associated with tender and enlarged liver

Answer 17

intra-hepatic

Question 18

high prothrombin time suggests what

Answer 18

acute or chronic liver disease

Question 19

when are ALT/AST released into the bloodstream

Answer 19

when liver cells are damaged

Question 20

describe the specificity of ALT

Answer 20

specific to the liver

Question 21

describe the specificity of AST

Answer 21

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

Question 22

Very high AST, and slightly high ALT suggests what

Answer 22

alcoholic or drug induced cirrhosis

Question 23

very high ALT and slightly high AST suggests what

Answer 23

viral hepatitis

NAFLD

Question 24

what does normal stool and urine colour suggest

Answer 24

pre-hepatitic

Question 25

what does normal stool and dark urine suggest

Answer 25

intra-hepatitic

Question 26

what does pale stool and dark urine suggest

Answer 26

post-hepatitic

Question 27

what is the general cause for intra-hepatic jaundice

Answer 27

problem within the liver with excretion to conjugation of bilirubin

Question 28

what is the general cause for pre-hepatic jaundice

Answer 28

increase in the breakdown of RBC

Question 29

what is the general cause for post-hepatic jaundice

Answer 29

triggered when the bile duct is damaged, inflamed or obstructed and so can’t escape into the bowel

Question 30

what conditions could cause the following LFTs:

Increased Bilirubin

Answer 30

haemolytic anaemia
malaria
gilberts syndrome

Question 31

what conditions could cause the following LFTs:

Increased Bilirubin
increased AST
increased ALT
decreased serum albumin

Answer 31

cirrhosis
liver failure
hepatitis 
NAFLD
pregnancy (rare)

Question 32

what conditions could cause the following LFTs:

increased bilirubin
increased ALP
increased ALT
increased GGT

Answer 32

gallstones
PBC
PSC
cancer of the bile ducts
stricture of the bile ducts 
pancreatitis

Question 33

what are the causes of jaundice (acronym)

Answer 33

VINDICATE

vascular, infection, neoplasm, drugs, inflammatory, congenital, autoimmune, trauma, endocrine

Question 34

give examples of autoimmune conditions that cause jaundice

Answer 34

autoimmune hepatitis

PBC

Question 35

give examples of congenital conditions which cause jaundice

Answer 35

gilbert’s syndrome
haemochromatosis (iron storage)
wilson’s disease (copper storage)