Liver Function Tests (LFTs) Flashcards
What are the 5 things tested for in a Liver Function Test?
Albumin
ALT
AST
ALP
Bilirubin
What can low levels of albumin indicate in a LFT?
Impaired synthetic function of liver
However not always since nephrotic syndrome or kidney disease can be cause of low albumin
Which 2 LFT components are released when Hepatocyte are damaged?
ALT (Alanine Transaminase)
AST (Aspartate Transaminase)
Which of ALT and AST are more specific to the liver /Hepatocyte damage?
ALT (L in ALT can be used to remember more Liver specific)
Where is AST also present in the body?
Cardiac muscle
Skeletal muscle
Red cells
What produces ALP that’s related to the liver?
Cells lining bile duct
What pathology may be indicated with an elevated ALP?
Damage or obstruction to the bile duct (cholestasis)
Where else and what other situations may ALP be high expect for bile duct pathology?
Children with growing bones
Bone malignancies
What other marker can be measured to confirm whether an elevated ALP is due to liver issues (bileduct) or elsewhere?
GGT
Its elevated when there’s damage to bile ducts too
Why are high levels of UNCONJUGATED bilirubin concerning?
Can cross Blood Brain Barrier and accumulate in brain
What are the functions of LFTs?
Provide a measure of baseline liver function which can be used as a comparator later on to assess potential med Side effects
Monitor liver function with disease
Asses potential suspected liver pathology
What maybe causing this child’s jaundice with these LFT results:
-ALT: Normal
-AST: Normal
-ALP: Normal
-Bilirubin: Raised
-Albumin: Normal
Normal ALT and AST indicates normal liver function (no hepatocyte damage)
Normal ALP indicates normal Biliary function
Synthetic function of liver normal due to albumin normal
Indicates must be an increased amount of Hb to break down
So Pre-hepatic Jaundice likely due to increased haemolysis so a haemolytic anaemia
What may be causing this patients LFT results:
-ALT: Raised
-AST: Raised
-ALP: Normal
-Bilirubin: Normal
-Albumin: low
Indicates Hepatocellular damage
So potentially a Paracetamol overdose
What condition is the LFT results of this patient suggesting:
What further blood test could be done to support this diagnosis?
-ALT: Normal
-AST: Normal
-ALP: Raised
-Bilirubin: Raised
-Albumin: Normal
Normal ALT and AST suggest normal hepatocyte health/function
Raised ALP indicative of biliary pathology which is reinforced by elevated bilirubin (jaundice)
Can do a plasma amylase and lipase test
If elevated likely Acute Pancreatitis (Post-hepatic jaundice cause)
What type of pain is experienced in a patient with acute pancreatitis?
How does the patient present?
Epigastric pain radiating to back
Jaundiced (post-hepatic jaundice)
Vomiting
