LFTs for Hepatocellular Damage/Injury

Question 1

AST is?

Answer 1

Enzyme released in response to injury of liver, heart, mm, kidney

Question 2

ALT is?

Answer 2

Enzyme released in response to injury of liver or kidney

Question 3

LDH is?

Answer 3

Enzyme released w/ injury or dz of many organs

LDH-5 specific to liver and skeletal mm

Question 4

Elevated AST/ALT most C w/ what conditions? (5)

Answer 4

EtOH
NASH/Fatty liver
Meds
Hepatitis
Hemochromatosis (Fe buildup)

Question 5

NAFLD test results?

Answer 5

↑AST/ALT

Question 6

Hemochromatosis tests? (3)

Answer 6

Serum Fe
TIBC
Ferritin

Question 7

Autoimmune Hepatitis test? (4)

Answer 7

↑AST/ALT
ANA
SMA
IgG

Question 8

α-1 Antitrypsin Deficiency tests? (2)

Answer 8

↑AST/ALT

↓α-1

Question 9

Wilson’s Dz tests? (3)

Answer 9

↑AST/ALT
↓Ceruplasmin
24 hr urine copper

Question 10

Hep A tests? (4)

Answer 10

↑AST/ALT
↑Alk Phos/Bilirubin
IgM anti-HAV + (acute infect)
IgG anti-HAV + (immunity)

Question 11

Hep B tests? (8)

Answer 11

↑AST/ALT
↑Alk Phos/Bilirubin
HBsAg + (active)
anti-HBs + (immun)
IgM anti-HBc + (acute inf)
IgG anti-HBc + (previous inf, now immune)
HBeAg (Infective)
anti-HBe (long term clearance)

Question 12

Hep C tests?

Answer 12

↑AST/ALT
↑Alk Phos/Bilirubin
anti-HCV + (past or ongoing)

Question 13

AST:ALT ratio tells us:

> 2?

< 2?

a/w ↑AST/ALT?

Answer 13

> 2 = liver dz esp if GGT 2x normal

< 2 = acute/chronic viral hep, NASH

a/w ↑AST/ALT = cholestatic dz