Liver Function Tests

Question 1

What are transaminases?

Answer 1

→ aminotransferase enzymes used in protein metabolism

AST:ALT ratio >2 = acute liver disease

Question 2

Alkaline phosphatase (ALP)

Answer 2

→ found in abundance in cells lining bile duct

→ so good indicator of cholestatic damage

These enzymes hydrolyse organic phosphatase esters.

Question 3

Gamma-Glutamyltransferase (GGT):

Clinical Significance

Answer 3

→ found in biliary ducts and its activity can be induced by alcohol metabolism in hepatocytes

→ more specific marker for cholestatic disease than ALP

5’nucelotidase can be used to decide if raised ALP is due to billiary or extrabilliary origin (elevated levels show billiary obstructuion)

Question 4

What causes raise ALP?

(Alkaline phosphatase)

Answer 4

→ bone tumours
→ primary hepatitis
→ osteomylitis
→ hepatic tumours
→ infiltritive hepatic disease
→ hepaptitis
→ IBD
→ cirrhosis
→ Cholestasis

Question 5

What causes raised ALT/AST?

Answer 5

→ pancreatitis
→ alcohol abuse
→ cholestasis
→ chronic hepaptis
→ autoimmune hepatitis

Question 6

What causes raised GGT?

Answer 6

→ excess alcohol
→ cirrhosis
→ pancreatitis
→ alcoholic liver disease
→ cholestasis

Question 7

Types of jaundice

Answer 7

Pre-Hepatic Jaundice:
→ raised Biliverdin in blood
→ raised Urobilinogen

Hepatic Jaundice:
→ raised conjugated Bilirubin

Post-Hepatic Jaundice
→ raised conjugated Bilirubin in blood
→ urine, less Urobilin formed