LFTs

Question 1

What LFTs would you expect to see in a person with acute hepatitis?

Answer 1

ALT/AST in 1000s

ALP mildly raised

Question 2

What LFTs would you expect to see in a person with chronic hepatitis?

Answer 2

ALT/AST in 100s

Drop in albumin

Question 3

What LFTs would you expect to see in a person with a biliary obstruction?

Answer 3

ALP in 100s
ALT/AST mildly raised
Increase in bilirubin

Question 4

What LFTs would you expect to see in an alcoholic?

Answer 4

Increase in gamma GT

Increase in MCV

Question 5

What do liver enzymes reflect?

Answer 5

Liver injury (not function)

Question 6

Where is ALT found?

Answer 6

Liver

Question 7

Where is AST found?

Answer 7

Liver, heart, skeletal muscle, kidneys, pancreas

Question 8

If ALT is higher than AST, what does this show?

Answer 8

Chronic liver disease

Question 9

If AST is higher than ALT, then what does this show?

Answer 9

Established cirrhosis

Alcoholic liver disease

Question 10

Where can ALP be found?

Answer 10

Biliary ducts

Bone

Question 11

What is used to confirm whether ALP is of hepatic origin?

Answer 11

Gamma GT

Question 12

If there is a large increase in ALP (>4 x normal) what does this suggest?

Answer 12

Cholestasis

Question 13

If there is a moderate increase in ALP ( <3 x normal) what does this suggest?

Answer 13

Hepatitis

Cirrhosis

Infiltration

Question 14

What is the half life of albumin?

Answer 14

20 days

Question 15

If there is a drop in both albumin and protein, what does this suggest?

Answer 15

advanced cirrhosis, alcoholism, protein malnutrition, chronic inflammation, renal/gut/skin loss

Question 16

If there is a drop in albumin, but normal protein, what does this suggest?

Answer 16

Infection

Question 17

If there is a drop in albumin and an increase in protein, what does this suggest?

Answer 17

Myeloma

Question 18

What is prothrombin time/INR dependant on?

Answer 18

Vitamin K-dependant clotting factors and fibrinogen

Question 19

What does a raised INR suggest?

Answer 19

Liver disease

Vitamin K deficiency

Question 20

What does macrocytosis suggest?

Answer 20

Alcohol

Question 21

What test do you do if someone is suspected to have fatty liver disease?

Answer 21

Fasting glucose and lipids

Question 22

When is anti-mitochondrial testing done?

Answer 22

Primary biliary cirrhosis suspected

Question 23

When is anti-nuclear testing done?

Answer 23

Autoimmune hepatitis type 1

Question 24

What blood test can be done to test for coeliac disease?

Answer 24

TTG

Question 25

What test can confirm pancreatitis?

Answer 25

Abdominal CT