liver function tests

Question 1

Which 2 values reflect Liver Function?

Answer 1

Albumin: Low albumin suggest chronic damage

Prothrombin time/INR: abnormal coagulation in acute and chronic damage

Question 2

ALT, Marker of?
AST, from?
These liver enzymes reflect what?

Answer 2

Specific for Liver ONLY (most specific for cell death)
Liver, Heart, Muscle, Brain
Reflects RATE of cell death, NOT SEVERITY of liver damage

Question 3

AST:ALT ratio - 2:1

Answer 3

Almost diagnostic of

Alcoholic Liver Disease

Question 4

AST : ALT > 1

Answer 4

Cirrhosis

WIlson’s disease

Question 5

Factors for abnormal Bilirubin (5)

Answer 5

Production rate (Haemolysis, Ineffective Erythropoiesis, Megaloblastic Anaemia)
Liver Uptake Impaired
Conjugation problem (Hepatocyte DMG)
Blockage transport to bile duct
Excretion issue

Question 6

GGT: produced where?

serum levels reflect?

Answer 6

bile duct epithelial cells
Specific for biliary tree
1) Hepatocyte destruction - due to liver insult
2) Induction of bile duct cell division - biliary pressure increase

Question 7

SAP (alkaline phosphatase)

Produced where?

Answer 7

Liver, Bone, Placenta, Kidney, Small intestine

Question 8

GGT increased, SAP increased = ?

Answer 8

Biliary tree issue

Question 9

SAP increased, GGT same = ?

Answer 9

Non-liver source

Bones, Pagets disease, Osteopenia, Metastasis

Question 10

SAP same, GGT increase =?

Answer 10

Excessive Alcohol Intake

Drug Therapy

Question 11

Albumin is decreased in: (3)

Answer 11

Cirrhosis
Gastrosis
Nephrosis

Question 12

4 Main LFT scenarios

Answer 12

Hepatocellular Injury
Obstruction
Jaundice
Infiltration

Question 13

ALT and AST in the 1000s, what does it mean?

Answer 13

Acute Viral Hepatitis
Ischaemic Hepatitis
Paracetamol

Question 14

ALP&raquo_space; GGT = ?

Answer 14

Bone disease

Pregnancy

Question 15

GGT&raquo_space; ALP = ?

Answer 15

Alcohol

Medications

Question 16

Bilirubin, what does it reflect with elevated liver enzymes?

Answer 16

Reflective of Liver disease or Biliary obstruction

Question 17

Bilirubin, what does it reflect without elevated liver enzymes?

Answer 17

Haemolysis
Gilbert’s Syndrome
Severe liver Disease

Question 18

Coagulation is a test of liver function. Why does it reflect immediate liver status?

Answer 18

They have short half lifes

Question 19

Globulins, when is it elevated?

Answer 19

Inflammatory conditions

Question 20

Globulins elevated with other Elevated LFT, what to consider?

Answer 20

Immune Liver Disease 
(Chronic active hepatitis)
(Chronic drug injury)
(Sclerosing cholangitis)
(Primary biliary cirrhosis)