LFTs

Question 1

Main components

Answer 1

ALT - Alanine Aminotransferase
AST - Aspartate Aminotransferase
Bilirubin
Albumin
GGT - Gamma GT
INR
ALP - Alkaline Phosphatase

Question 2

What raises ALT?

Answer 2

Liver problems, less so wiht bile duct issues

A very high ALT indicates hepatitis

Question 3

What changes AST?

Answer 3

High levels - Liver/heart/muscle problems

AST changes more quickl basd on current acute damage/necrosis, so is good for monitoring progression/recovery.

Raised AST:

• Viral Hep
• Alcoholic Cirrhosis
• Chronic Cirrhosis

Mildly raises could be:

• Liver mets
• Steatosis

Question 4

What changes ALP?

Answer 4

Found largely in cells lining bile duct
So bile duct blockage rises it alot
Minorly raised in liver disease

Question 5

What affects Gamma GT?

Answer 5

OBstruction of bile ducts raises GGT, good for confirming that a raised ALP is related to Liver damage

Question 6

What does bilirubin tell you?

Answer 6

ITs raised in jaundice, mostly in obstructive jaundice

Question 7

What could reduce Albumin?

Answer 7

• Diarrhoea
• Liver disease
• Poor diet
• Fe Deficiency
• Infection

Question 8

ALP raised & ALT slightly raised?

Answer 8

Bile duct problem

Question 9

ALT raised & ALP slightly raised?

Answer 9

Liver problem

Question 10

Very high ALT & slightly high AST?

Answer 10

Necrosis of liver:

• Viral
• Drug induced
• Severe

Question 11

AST raised and ALT slightly raised?

Answer 11

Alcoholic or drug induced cirrhosis

Question 12

Pattern of obstructive LFTs?

Answer 12

• High bilirubin
• High ALP
• Normal ALT

Question 13

Pattern of heaptic LFTs?

Answer 13

Acute liver inflammation:

• Very High ALT
• Variable Bilirubin (higher = more damage)
• Slightly raised ALP
• Increased PTT