Post on 10-Apr-2015
Clinical Case A 65 year-old man came to his GP with visible jaundice which he had noticed to be
deepening in colour. He had no pain but had noticed some weight loss and that his stools were pale. He was a moderate drinker and was not on any drug therapy.
Table Of LFT
What is the differential diagnosis? Comment on any useful investigations
Parameter Test Value Normal range
Bilirubin (μmol\L)
250 3-22
AST(IU\L)
87 12-48
ALT(IU\L)
92 3-55
ALKP(IU\L)
855 80-280
Objectives:Bilirubin metabolismLiver Function testsClinical case
Liver Function Tests
Liver Function Tests
True LFT
Investigate the metabolic function of the liver.
True LFT
Albumin
Bile salts
AmmoniaBilirubin
PT
Parameter
PT •Cholestasis (due to Vit. K def.)•Warfarin therapy
Bilirubin •Hepatitis•Cholestasis•Malaria•Liver cancer
-
Ammonia
Bile salts
Albumin •Renal disease•Hepatocell-ular damage
Routine LFTIndicative of liver damage or biliary tract disease.
Routine LFT
ALT
AST
Albumin
γGT
Bilirubin
ALKP
Parameter
ALKP •Cholestasis•Cirrhosis•Cholangitis•Hepatitis
ALT •Liver cancer•Cirrhosis•Hepatitis
AST •Hepatitis•Cirrhosis•Cholestasis
Albumin
γGT •Alcohol toxicity•Cholestatic damage
Bilirubin •Hemolytic anemia•Cirrhosis•Hepatitis
Clinical Case A 65 year-old man came to his GP’s with visible jaundice which he had noticed to be
deepening in colour. He had no pain but had noticed some weight loss and that his stools were pale. He was a moderate drinker and was not on any drug therapy.
Table Of LFT
What is the differential diagnosis? Comment on any useful investigations
Parameter Test Value Normal range
Bilirubin (μmol\L)
250 3-22
AST(IU\L)
87 12-48
ALT(IU\L)
92 3-55
ALKP(IU\L)
855 80-280
Differential Diagnosis of Obstructive Liver disease:
Obstructive Liver disease
Intrahepatic
Alcoholic liver
disease
Drug toxicity(e.g.
Acetaminophen phenytoinAllopurinol
Liver Cancer
Extrahepatic
Gallstones Pancreatic cancer
Gall bladder
carcinoma
Diagnosis of Obstructive Liver DiseaseArteriography
Nuclear LiverScans
Liver Ultrasound