LFTs and Liver serum markers.

Question 1

ALT and AST are the transaminases used in which cycle?

When are they most helpful?

Answer 1

Urea cycle.

Helpful in detecting acute and aggressive hepatitis. Detect rate of destruction rather than functionality.

Question 2

What toxicity is routinely responsible for raging hepatitis with extremely high levels of Transaminases?

Answer 2

APAP toxicity.

Question 3

Viral hepatitis most often responsible for acute inflammation.

Answer 3

Hepatitis B (which can also be chronic) followed by Hepatitis A. Hepatitis C has more of a slow burn.

Question 4

In most liver pathologies, which transaminase is more elevated? What is the exception?

Answer 4

ALT is normally higher than AST except in alcoholic hepatitis.

Question 5

If Alkaline Phosphatase is significantly elevated more than ALT and AST, what should be suspected?

Answer 5

Some sort of biliary obstruction.

Question 6

What other conditions will have elevated Alkaline Phosphatase?

How is GGT helpful in this case?

Answer 6

Anything with high bone cell turnover or metastatic prostate cancer is osteoblastic.

GGT has nothing to do with bone so if it is concurrently elevated, you can isolate to a biliary problem.