Liver Function Tests Presentation

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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

Transcript of Liver Function Tests Presentation

Page 1: Liver Function Tests Presentation

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

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Objectives:Bilirubin metabolismLiver Function testsClinical case

Liver Function Tests

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Liver Function Tests

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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

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Ammonia

Bile salts

Albumin •Renal disease•Hepatocell-ular damage

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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

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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

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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

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Diagnosis of Obstructive Liver DiseaseArteriography

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Nuclear LiverScans

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Liver Ultrasound

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