LFT interpretation

Question 1

what individual components make up ‘LFTs’

Answer 1

serum transaminases - ALT/AST
ALP
GGt
albumin
PTT / INR
bilirubin

Question 2

which ones are the liver enzymes

Answer 2

ALT/AST
ALP
GGT

Question 3

what are indicators of intrinsic synthetic liver function

Answer 3

albumin
PTT / INR
bilirubin

Question 4

transaminases are intracellular but are released in the context of __?

Answer 4

hepatocellular injury

Question 5

which is more liver sensitive, AST or ALT

Answer 5

ALT

Question 6

what else (other than the liver) could cause an increase in AST

Answer 6

heart 
pancreas 
skeletal muscle 
brain 
lungs

Question 7

ALT/AST are raised in hepatic/cholestatic injury

Answer 7

hepatic injury

Question 8

what is ALP

Answer 8

alkaline phosphatase

Question 9

where can ALP come from

Answer 9

biliary tree 
bone 
placenta
intestine
kidneys

Question 10

GGT is ‘inducible’, what does this mean

Answer 10

it can be raised from drugs (anticonvulsants, TCA, paracetamol) and alcohol

Question 11

what is bilirubin

Answer 11

a breakdown product from RBC

Question 12

how is bilirubin excreted

Answer 12

in urine as urobilinogen

in faeces as stercobilinogen

Question 13

bilirubin is transported to liver bound to which protein

Answer 13

albumin

Question 14

what clotting factors does the liver produce

Answer 14

factors 2,7,9,10

Question 15

what is prothrombin time

Answer 15

measures the conversion time from prothrombin to thrombin

essentially measures the clotting ability of the liver

Question 16

elevated PTT may reflect elevated/reduced liver synthetic function

Answer 16

reduced function

Question 17

what can cause prolonged PTT

Answer 17

liver disease
warfarin
bile malabsorption
coagulopathies

Question 18

AST/ALT > ALP is indicative of hepatocellular injury/cholestasis

Answer 18

hepatocellular injury

Question 19

ALP > AST/ALT is indicative of hepatocellular injury/cholestasis

Answer 19

cholestasis

Question 20

hyperbilirubinaemia can be conjugated or unconjugated, list unconjugated causes

Answer 20

extra/intravascular haemolysis
impaired uptake by the liver
impaired bilirubin conjugation

Question 21

hyperbilirubinaemia can be conjugated or unconjugated, list conjugated causes

Answer 21

biliary obstruction

liver disease

Question 22

triad for acute liver failure

Answer 22

jaundice
encephalopathy
coagulopathy