LFTs interpretation

Question 1

markers of liver injury

Answer 1

ALT
AST
alkaline phosphatase
bilirubin

Question 2

markers of hepatocellular function

Answer 2

albumin
bilirubin
prothrombin time

Question 3

serum bilirubin measures

Answer 3

the livers ability to detoxify metabolites and transport organic anions into bile

Question 4

serum aminotransferases

Answer 4

alanine aminotransferase ALT
aspartate aminotransferase AST

Question 5

AST is present

Answer 5

in the liver, cardiac muscle, kidney and brain

Question 6

ALT is present

Answer 6

primarily in the liver - is a more specific marker of hepatocellular injury

Question 7

alkaline phosphatase is derived from

Answer 7

predominantly the liver and the bones
elevated alkaline phosphatase can be confirmed to be originating from the liver based on the presence of simultaneous elevation of other measures of cholestasis, eg. GGT

Question 8

other reasons alkaline phosphatase may be high

Answer 8

women in the third trimester of pregnancy have elevated serum alkaline phosphatase due to an influx of placental alkaline phosphatase into blood.
individuals with type O or B can have elevated serum alkaline phosphatase levels after eating a fatty meal due to influx of intestinal alkaline phosphatase.
infants and toddlers occasionally display transient marked elevations of alkaline phosphatase in the absence of detectable bone or liver disease.
benign familial occurrence of increased alkaline phosphatase

Question 9

GGT is found in

Answer 9

hepatocytes and epithelial cells, as well as in the kidney, seminal vessicles, pancreas, spleen, heart and brain.

Question 10

tests of hepatic synthetic function include

Answer 10

serum alumin
prothrombin time/INR

Question 11

things to identify in the history

Answer 11

alcohol
hepatotoxic medications
risk of viral hepatitis
recreational expsosure to hepatotoxins eg. mushroom picking,

Question 12

risks for hepatitis

Answer 12

IV drug use
travel to areas where hepatits is endemic
exposure to patients with jaundice
hep B and C are transmitted parenterally
A and E are transmitted from person to person via faecal oral route

Question 13

stigmata of liver disease

Answer 13

spider naevi, palmar erythema, gynecomastia, and caput medusae

Question 14

stigmata of decompansated cirrhosis

Answer 14

ascites or hepatic ecephalopathy

Question 15

stigmata of advanced alcoholic corrhosis

Answer 15

dupuytren’s contractures, parotid gland enlargement, and testicular atrophy

Question 16

increased JVP may indicate

Answer 16

hepatic congestion and right heart failure

Question 17

hepatocyte injury pattern

Answer 17

raised serum aminotransferases disproportionate compared to alk phos
serum bilirubin may be elevated
tests of synthetic function may be abnormal

Question 18

cholestasis pattern

Answer 18

elevated alkaline phosphatase disproportionate compared to aminotransferases
serum bilirubin may be elevated
tests of synthetic function may be abnormal

Question 19

isolated hyperbilirubinaemia

Answer 19

these patients have elevated bilirrubin level wth normal serum aminotransferases and alk phos