Liver Function Tests (LFTs) Flashcards
What processes is the liver responsible for?
Gluconeogenesis
Glycogenolysis
Glycogenesis
Detoxification
Synthesising amino acids/fats/proteins
What is bile responsible for?
Breaking down fat during digestion
What is bilirubin, and where is it found?
It is found in the bile, and is a waste product of haemoglobin
What drugs should you be careful with if a patient has low albumin levels (hypoalbuminaemia)?
Phenytoin
Warfarin
Calcium
This is because they are all protein (albumin)-binding drugs
What can high bilirubin levels indicate?
Obstruction in system
Cholestasis - stoppage/blockage of bile flow
Gallstones
What are the symptoms of high bilirubin levels (Gilberts syndrome)?
Itchiness
Jaundice
N+V
Abdominal pain
What can high AST/ALT levels indicate?
Acute liver damage, e.g. hepatitis, or injury
What should the ratio of AST/ALT always be?
<1
What can high ALP levels indicate?
Cholestasis
Tumour
Cirrhosis
Is ALP specific to the liver?
No
What can high GGT levels indicate?
Alcohol
Enzyme inducing drugs - phenytoin, carbamazepine, rifampicin, st johns wort
What 2 indicators which when high, can indicate cholestasis in the body?
GGT + ALP
What is a patient at risk of if their PT level is high?
Risk of bleeding, because the liver cannot produce clotting proteins
What condition can contribute to a high PT level?
Vitamin K deficiency, as it is needed to produce clotting factors
How is a high PT level reversed?
By giving IV vitamin K
What is ascites?
A condition associated with hypoalbuminaemia/low oncotic pressure.
This causes an increase in sodium/water retention, and portal hypertension
What specific drugs should you avoid in people with ascites, and why?
NSAIDs and steroids, because they increase sodium/water retention
What are some treatment options for ascites?
Bed rest
Lower salt intake/fluid restriction
Spironolactone +/- furosemide
K+ sparing diuretics
B-blockers for portal hypertension
What antibiotic is given to reduce the risk of infection associated with ascites?
Floxacillin
What are oesophageal varices?
Enlarged veins in the oesophagus due to portal hypertension
What is the treatment for oesophageal varices?
B-blocker to reduce portal hypertension
Elastic bands to tie off bleeding veins
Terlipressin (vasoconstrictor on V1 receptors)
What is spider naevus?
Enlarged blood vessels due to absent oestrogen metabolism
Which indicator is mostly present in foetal liver?
AFP
What can high levels of AFP indicate?
Cancer
Neural tube defects
Tumour
What is hepatic encephalopathy?
Reversible altered mental function due to high levels of ammonia from liver impairment
What is the treatment for hepatic encephalopathy?
Lactulose + neomycin
What specific drugs should a patient with hepatic encephalopathy avoid?
Constipating drugs, e.g.
Opioids
Diuretics
Antidepressants
Sedative drugs
What is Wernickes encephalopathy?
Neurological symptoms caused by thiamine depletion (e.g. alcohol, prolonged vomiting)
How is wernickes encephalopathy treated?
Pabrinex (vit. B/C)
