OnlineMedEd: Intern Content - "Liver Function Tests"

Question 1

Give the fishbone diagram for LFTs.

Answer 1

Total protein | Albumin

Total bili | Direct bili

AST | ALT

     /      Alk phos   \

Question 2

What things can cause a protein gap (>4)?

Answer 2

• Autoimmunity
• Sepsis
• MM
• HIV
• HCV

Question 3

Three disease states can cause low albumin: ________________.

Answer 3

nephrosis, gastrosis, and cirrhosis

Question 4

List five things that can cause transaminitis in the 1000’s.

Answer 4

• Budd-Chiari
• Autoimmune hepatitis
• HAV/HBV
• Acetaminophen toxicity
• Shock liver

Question 5

Infiltrative liver diseases –like Wilson’s disease –present with what lab pattern?

Answer 5

Elevated alkaline phosphatase with a normal or only mildly elevated direct bilirubin

If you see this, go straight to biopsy.