Liver Function Tests

Question 1

What are isolated causes of ALP?

Answer 1

• Boney mets
• Vit D deficiency
• Recent fractures
• Renal osteodystrophy

Question 2

What is the difference between conjugated and unconjugated billirubin?

Answer 2

Unconjugated - not water soluble
Conjugated - water soluble so will make urine dark (remember liver conjugates bilirubin)

Question 3

What are the causes of unconjugated hyperbilirubinaemia

Answer 3

• Haemolysis,
• Impaired hepatic uptake
• Impaired conjugation (gilberts)

Question 4

What are some causes of low albumin?

Answer 4

• Liver disease
• Inflammation (triggers acute phase response which decreases liver production of albumin)
• Excess loss of albumin

Question 5

If ALT is greater than AST then what is this associated with?

Answer 5

Chronic liver disease (T for time)

Question 6

If AST is greater than ALT then what is this associated with?

Answer 6

Cirrhosis or Acute alcoholic hepatitis

Question 7

What are some causes of acute hepatocellular injury?

Answer 7

Poisoning (paracetamol overdose)
Infection (Hep A/B)
Liver ischaemia

Question 8

What are causes of chronic hepatocellular injury?

Answer 8

AFLD, NAFLD, Chronic hepatitis infection, primary billiary cirrhosis. Less common causes include Alpha-1 antitrypsin, Wilson’s disease, haemochromatosis