Liver Function/Hepatitis Flashcards
Describe the following common liver function tests:
- ALT/AST
- PT/Albumin
- Bilirubin/ALP
ALT/AST: Measures liver integrity
- Liver enzymes housed in hepatocytes
- Levels increase when hepatocytes die
PT/Albumin: Measures synthetic activity of liver
Bilirubin/ALP: Measures excretory function of liver
List potential differential diagnoses for elevations in ALT/AST.
- Liver injury
- Hepatitis
- Acute liver failure
- NAFLD (Non-Alcoholic Fatty Liver Disease)
What is currently the most common cause of liver transplants?
NAFLD (Non-Alcoholic Fatty Liver Disease)
List potential differential diagnoses for elevations in ALP.
- Bone disease*
- Liver disease*
- Obstructed bile ducts
*NOTE: Tests for isoenzymes of ALP can differentiate between liver (ALP1) and bone (ALP2) disease
List potential differential diagnoses for elevations in bilirubin.
- RBC desctruction
- Liver disease
- Bile duct obstruction
- Gilbert’s Disease (~ 7% of population have benign bilirubin elevations)
List potential differential diagnoses for PT elevations in the setting of abnormal LFTs).
- Cirrhosis
- Cancer originating in the liver
List potential differential diagnoses for elevations in albumin.
Usually normal in liver disease
What is indicated by ALT results being greater than AST results?
ALT > AST = Viral hepatitis
In other words:
The ratio of ALT/AST > 1 = Viral hepatitis
What are the Hepatitis A markers and what do their positive/negative results signify?
+ Anti-HAV IgG:
- Recovered from Hepatitis A &
- Immune to Hepatitis A
+ Anti-HAV IgM:
- Acute Hepatitis A infection &
- Immune to Hepatitis A
- Anti-HAV IgG & - Anti-HAV IgM:
- Not infected with Hepatitis A &
- Not immune from Hepatitis A
(offer this patient Hepatitis A vaccination)
HINT:
IgM = Minute = positive the minute infected
IgG = Gone = positive when infection is gone
What is HBsAg and what does its positive result signify?
HBsAg = Hepatitis B Surface Antigen
+ = past infection or
current infection
What is Anti-HBs and what does its positive result signify?
Anti-HBs = Hepatitis B Surface Antibody
+ = Immunity from:
- vaccine or
- past disease
What is Anti-HBc and what does its positive result signify?
Anti-HBc = Hepatitis B Core Antibody
+ = Infection:
- current or
- previous
What is IgM Anti-HBc and what does its positive result signify?
IgM Anti-HBc = IgM Antibody to Hepatitis Core
Antigen
+ = Acute Hepatitis B infection (≤ 6 months)
Who should be screened for chronic Hepatitis C infection?
Universal one-time screening
Adults aged 18+
What test/s is/are performed for chronic Hepatitis C infection?
HCV antibody:
- initial screening
HCV-RNA:
- Confirm + HCV antibody
- If exposure < 6 months
- If exposure is unknown
