LFTs Flashcards
what does a 10x fold increase in ALT suggest?
hepatocellular
what does a 3x increase in ALP suggest?
cholestasis if GGT raised as well
ALT > AST
chronic liver disease
ALT < AST
alcoholic hepatitis/ cirrhosis
jaundice cause if normal stools and urine?
pre-hepatic
jaundice cause if normal stools and dark urine
hepatic cause
jaundice cause if dark urine and pale stools
post-hepatic cause
common causes of acute hepatocellular injury
poisoning (paracetamol overdose)
HBV or HAV
liver ischaemia
chronic hepatocellular injury causes
NAFLD alcohol fatty liver disease HBV HCV PBC alpha-1 antitrypsinogen deficiency Wilson's haemochromatosis
what can you check to assess liver function?
serum albumin
bilirubin
PT (INR)
LFTs in alcoholic liver disease
high AST more than ALT with raised GGT and macrocytosis
LFTs in obstruction
AST, ALT and ALP raised
indications for upper GI endoscopy
haematemesis melaena dysphagia dyspepsia persistent vomiting iron deficiency treatment of bleeding lesions banding sclerotherapy stenting
indications for colonoscopy
rectal bleeding iron deficiency anaemia persistent diarrhoea faecal occult blood test +ve IBD suspicion colonic cancer surveillance bleeding lesions volvulus decompression pseudo-obstruction
