4138593
Descripción
Fichas por Isobel Setford, actualizado hace más de 1 año
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Creado por Isobel Setford
hace más de 8 años
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| Pregunta | Respuesta |
| Give three reasons for requesting a liver function test | Well person screening To investigate unexplained symptoms To investigate signs and symptoms of indicative of liver disease For pre-op baseline assessments To monitor progress of established liver disease and response to treatment |
| Do LFTs indicate underlying severity of disease? | No - nor how long the person has had it for |
| What steps would you take with someones who has abnormal LFTs? | Step 1 - clinical history Step 2 - physical examination Step 3 - reassessment of initial LFTs |
| How would you take a clinical history from someone with abnormal LFTs? | When did the symptoms start and for how long they been happening? Exposure to epatotoxins? Family history? Possible viral exposure? |
| What physical things would you look for in someones with abnormal LFTs? | BMI, nutritional status Jaundice Signs of CLD (spider nevi, liver palm) Acites, pleural effusion, oedema Hepato/splenomeagly |
| What other tests would you perform on someone with abnormal LFTs? | Synthetic function tests - albumin and PT time Full blood count |
| Decreased albumin in hepatocellular injury (increased ALT or AST) means what? | Chronic hepatitis |
| Normal albumin in hepatocellular injury (increased ALT or AST) means what? | Acute hepatitis |
| Decreased albumin in cholestatic disease (increased ALP and GGT) means what? | Chronic cholestasis |
| Normal albumin in cholestatic disease (increased ALP and GGT) means what? | Acute cholestasis |
| What further tests does suspected cholestatic disease require, and what will these show? | Ultrasound or percutaneous cholangiography will show whether the blockage is intra- or extra-hepatic |
| Increased ALP independent of GGT means what? | Possible bone disease |
| What are possible causes of cholestatic disease (with dilated ducts) | Gallstones Strictures Space-occupying lesions Cancer of the head of the pancreas Sclerosing cholangitis |
| What are possible causes of cholestatic disease (with undilated ducts) | Biliary cirrhosis Sclerosing cholangitis |
| What does a positive anti-mitochondrial antibody test with non-dilated ducts (in possible cholestatic disease) | Primary biliary cirrhosis |
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