Liver Function tests

Question 1

What is more sensitive ALT or AST?

Answer 1

• ALT

Question 2

Where is AST found?

Answer 2

• cytosol and mitochondria of cells

- not specific for the liver

Question 3

AST rise may be subjective of?

Answer 3

• liver damage

- any organ damage

Question 4

High ALT doesn’t always mean a high prognosis?

True or false?

Answer 4

• TRUE

Question 5

What is the function of alkaline phosphatase

Answer 5

• catalyse a number of organic phosphotaste

- found in the biliary cells

Question 6

Is alkaline phosphatase specific to the liver?

Answer 6

• No

- found in bone, placenta, intestine and kidneys

Question 7

What is the function of gamma glutamyl transpeptidase (GGT)

Answer 7

• Enzyme involved in gluthionine metabolism

- transfer of amino acids across cellular membranes and leukortrine metabolism

Question 8

Elevated ALP, and Gamma Glutamyl Transpeptidase (GGT)

Answer 8

• not bone origin

- most likely liver origin

Question 9

Define conjugated?

Answer 9

• water soluble

- can be excreted

Question 10

Elevated bilirubin, normal over liver function tests

Answer 10

• conjugation issue?

Question 11

What does prothrombin time measure?

Answer 11

• measures the conversion time from PT -> Thrombin

- reflects components of the liver

Question 12

Elevated prothrombin time (PT)

Answer 12

• reflects poor PT
• drugs (warfarin)
• bile malabsorption
• Consumptive coagulopathies

Question 13

What drugs may alter liver function tests?

Answer 13

• antibiotics
• antidepressants
• HMG Co A inhibitors (statins)
• NSAIDs
• OTC

Question 14

Cause of

ALT/AST > ALP

Answer 14

• Hepatocellular injury

Question 15

Cause of

ALP> ALT/AST

Answer 15

• Cholestasis

Question 16

Cause of elevated PT/INR?

Answer 16

• Prolonged jaundice

- malabsorbition

Question 17

An AST:ALT ratio >2 may suggest?

Answer 17

• alcohol

Question 18

What other conditions may cause a transaminase rise?

Answer 18

• Coeliac disease
• muscle disorder
• creatine kinase

Question 19

Increased bilirubin (unconjugated) may be caused by what?

Answer 19

• extra/intravascular haemolysis
• extravasarton of blood into tissues
• impaired hepatic bilirubin uptake (heart failure)

Question 20

Increased bilirubin (conjugated) may be caused by what?

Answer 20

• extrahepatic cholestasis
• intrahepatic cholestasis
• drugs

Question 21

Extrahepatic cholestasis may also be called what?

- what causes it?

Answer 21

• biliary obstruction
• may be caused, by pancreatic tumours, pancreatitis,
• cholelithiasis (gall stones)

Question 22

What are some symptoms of acute liver function?

Answer 22

• jaundice
• encephalopathy (altered mental state)
• coagulopathy (bleeding disorder)

Question 23

High AST levels?

Answer 23

• liver damage

- may be from paracetamol