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Liver function tests and diagnosis
Fichas del conjunto (15)
- 1Give three reasons for requesting a liver function testWell 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 - 2Do LFTs indicate underlying severity of disease?No - nor how long the person has had it for
- 3What steps would you take with someones who has abnormal LFTs?Step 1 - clinical history
Step 2 - physical examination
Step 3 - reassessment of initial LFTs - 4How 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? - 5What 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 - 6What other tests would you perform on someone with abnormal LFTs?Synthetic function tests - albumin and PT time
Full blood count - 7Decreased albumin in hepatocellular injury (increased ALT or AST) means what?Chronic hepatitis
- 8Normal albumin in hepatocellular injury (increased ALT or AST) means what?Acute hepatitis
- 9Decreased albumin in cholestatic disease (increased ALP and GGT) means what?Chronic cholestasis
- 10Normal albumin in cholestatic disease (increased ALP and GGT) means what?Acute cholestasis
- 11What 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
- 12Increased ALP independent of GGT means what?Possible bone disease
- 13What are possible causes of cholestatic disease (with dilated ducts)Gallstones
Strictures
Space-occupying lesions
Cancer of the head of the pancreas
Sclerosing cholangitis - 14What are possible causes of cholestatic disease (with undilated ducts)Biliary cirrhosis
Sclerosing cholangitis - 15What does a positive anti-mitochondrial antibody test with non-dilated ducts (in possible cholestatic disease)Primary biliary cirrhosis
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- Fichas sobre Liver function tests and diagnosis, creado por Isobel Setford el 28/11/2015.
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- Isobel Setford
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