Liver Enzymles and LFTs Flashcards
What other organs does ALT also is present?
much lower levels lin
* muscle
* kidnes
* brain
* and pancreas
What does the ALt and AST signify?
Usually
* ALT goes up more than AST with liver damatge
* in cirrhosis
* if ration > 2– without alcohol indicates cirrhosis
What is the AST:ALT ratio?
What does it usually signify?
Usually ALT goes up more than AST with liver damage
But in certain instances AST is higher than ALT
- AST: ALT ratio >2.0 in alcohol suggests advanced disease (especially if GGT)
- In absence of alcohol AST:ALT ratio >1.0 ? advanced fibrosis or cirrhosis
What is ggt usually clinicallsy used for?
alcohol
Might also be increased in bile duct disease and hepatic metastasis
What does an relative more increase in alk phos in LFTs indicate?
Usually bile duct obstruction /obstructive jaundice or bile duct damage
Other tissues: Bone
Physiologically goes up with pregnancy
What is the half life of albumin?
about 20 days
–> better marker for chronic liver disease
What is the half life of clotting factors?
usually hours –> marker of acute liver function (PT/INR)
What if the best blood test for acute liver synthic function?
Clotting (due to much shorter half life than albmumin)
(PT/INR)
What are the differentials for a raised AFP?
- hepatocellular carcinoma
- pregnancy
- testicular cancer
What testa are included in a liver panel?
- fastingn lipids+fasting glucose (fatty liver)
- coeeliac serology
- hepatitis serology
- alpha-1-antitrypsin
- caeruloplasmin (if under 50 years) - low indicated wilson
- liver Antibodies (LKM, aSMA, AMA)
- immunoglobulin
- ferritin
- ANCA screen
What are some differenatiols for a cholestatis picture on LFTs without dilation of bile ducts?
Augmentin can cuase drug-induced cholestasis
What are the 3 only things that cuase very high transaminases (ALT over 1000)
- Toxins
- viruses
- ischaemia
Explain the rationale how to differentiate between different causes of jaundice on LFTs
