Liver function test

Question 1

What do liver function tests measure?

Answer 1

• Alanine aminotransferase
• Albumin
• Bilirubin
• Alkaline phosphatase
• Gamma glutamyltransferase
• Asparatate aminotransferase
• Globulin or total protein

Question 2

Which components of a blood test measure liver injury?

Answer 2

ALT, AST, alk phos, gamma-GT

Question 3

What does albumin measure

Answer 3

liver synthesis

Question 4

What does bilirubin measure?

Answer 4

Liver excretion

Question 5

Jaundice

Answer 5

• Pre-hepatic: haemolysis
• Hepatic: hepatocyte impairment
• Post-hepatic: biliary stasis
• Unconjugated bilirubin is indirect, conjugated is direct
• Unconjugated bilirubin is protein-bound so shouldn’t appear in urine

Question 6

Hepatitis C

Answer 6

• Blooc-blood contact (needle sharing)
• Majority will not clear virus and develop infection
• Leads to cirrhosis or hepatocellular carcinoma
• Liver function test and ascites indicate cirrhosis
• Raised gamma GT suggest alcohol is additional factor
• Management involves monitoring extent of injury and consider antivirals
• AST>ALT
• Increased gamma GT