LFTs / liver biochemistry Flashcards Preview

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Flashcards in LFTs / liver biochemistry Deck (16)
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1
Q

what are ‘true’ liver function tests that reflect the synthetic function of the liver ?

A

albumin
PT - prothrombin time
bilirubin

2
Q

what are transaminases

A

AST/ALT - they are intracellular hepatic enzymes which convert aspartate and alanine into ketoglutarate

3
Q

what are markers of liver biochemistry and what do they show

A

AST/ALT
ALP
GGT
- they give a clue to underlying liver pathology and should be validated by clinical findings and investigations

4
Q

if AST/ALT is higher than ALP - what does this suggest ?

A

hepatitis

5
Q

if ALP is more elevated than AST/ALT wha does this suggest ?

A

obstruction

6
Q

what does an acute rise in GGT suggest

A

alcohol consumption

7
Q

what is the function of alkaline phosphatase

A

ALP - catalyses the hydrolysis of phosphate esters

8
Q

what is pre hepatic jaundice, and its findings

A

> due to excess heme production as a result if haemolysis
have raised total bilirubin, normal conjugated bilirubin, raised unconjugated bilirubin, normal LFTs, normal urine and stool colour

9
Q

what is intra hepatic jaundice, and its findings

A

> hepatocellular damage leading to intrahepatic cholestasis
>caused by hepatitis, drugs, cirrhosis, pregnancy
raised total bilirubin, raised both unconjugated and conjugated bilirubin, hepatic LFTs, dark and pale urine/stool

10
Q

what is post hepatic jaundice, and its findings

A

> obstruction to bile outflow from the liver (ie it leaks into blood)
>causes include gallstones, cholangiocarcinoma, head of pancreas cancer, biliary structure, PSC, PBC
raised total bilirubin, raised conjugated bilirubin, normal unconjugated bilirubin and obstructive LFTs, dark urine and pale stools

11
Q

what are the clinical signs of jaundice and what are they due to ?

A

yellowing of the sclera/skin, itch, dark urine, pale stools (signs of liver disease)

due to hyperbilirubineamia (>40 mmol/L)

12
Q

viral hepatitis - acute

-what are the clinical features

A

nausea/vomitting, diarrhoea, flu like symptoms, hepatosplenomegaly - rarely becomes fulminant hepatitis; encephalopathy, coagulopathy, jaundice, ascites, raised AST/ALTs and slight elevation of ALPs

13
Q

viral hepatitis - acute

-characteristics

A

Hep A –> RNA virus transmitted by faeco-oral route

>has a short incubation period and does not cause chronic disease

14
Q

viral hepatitis - acute

-treatment

A

support and vaccination

15
Q

viral hepatitis:

Hep D

A

is an incomplete RNA virus needing concomitant HepB infection in order to complete its life cycle

Tx - interferon

16
Q

viral hepatitis:

Hep E

A

very similar to A ie faeco-oral route spread via animals but extremely more deadly in pregnant women