Liver Function Tests Flashcards
What does significantly raised ALT over ALP suggest?
Hepatocellular injury
ALP over ALT
Cholestasis
Raised GGT & ALP
Biliary epithelial damage & bile flow obstruction. Cholestasis highly likely if both are raised
What are 4 non-liver causes of a raised ALP?
BONE Boney mets/ primary tumour Vitamin D deficiency Recent fracture Renal osteodystrophy
What is renal osteodystrophy
bone disease that occurs when your kidneys fail to maintain proper levels of calcium and phosphorus in the blood. It’s common in people with kidney disease and affects most dialysis patient
What does jaundice with normal ALT & ALP, but isolated raise in bilirubin suggest?
Pre-hepatic cause
Gilbert’s
Haemolysis
What is bilirubin?
Breakdown product of haemoglobin
What happens to bilirubin in the liver?
It is conjugated, making it water-soluble
Why do people get steatorrhoea in post-hepatic jaundice?
Bile & pancreatic lipases are unable to reach the bowel, so fat is not absorbed
Describe urine & stools in someone with:
a) pre-hepatic jaundice
b) hepatic
c) post-hepatic
a) normal & normal
b) dark urine & normal stools
c) dark urine & pale stools
Give 2 causes of conjugated hyperbilirubinaemia
Hepatocellular injurt & cholestasis
What does albumin do?
Helps bind water, fatty acids & bilirubin
Helps maintain oncotic pressire of blood
What is prothrombin time a measure of?
Blood’s coagulation tendency (extrinsic pathway)
What does a ratio of ALT>AST suggest?
Chronic liver disease
What does a ratio of AST>ALT suggest?
Cirrhosis & acute hepatitis
