Liver Function Test (by StatPearls | P)

It is located in the right upper quadrant of the body and below the diaphragm

1) Primary detoxification of various metabolites 2) It fxns in synthesizing proteins 3) It fxns in producing digestive enzymes 4) It has a significant role in metabolism 5) It has a fxn in terms of regulation of RBCs 6) It fxns in glucose synthesis 7) It fxns in for storage

1) Alanine transaminase (ALT) 2) Aspartate transaminase (AST) 3) Alkaline phosphatase (ALP) 4) Gamma-glutamyl transferase (GGT) 5) Serum bili 6) Prothrombin Time (PT) 7) International normalized ratio (INR) 8) Albumin

1) These tests can be helpful in determining the area of hepatic injury 2) These tests can be helpful in determining the pattern of elevation 3) These tests can help organize a differential dx

True, because many of the tests do not comment on the fxn of the liver but rather pinpoint the source of the damage

Hepatocellular disease

Cholestatic pattern

Based on its ability to produce: 1) Albumin 2) Vitamin K dependent clotting factors

Elevated LFTs are found in approx 8%

These elevations may be transient in pts w/out symptoms w/ up to 30% elevations resolving after 3 wks

Care should be taken when interpreting these results to avoid unnecessary testing

1) Hepatocellular pattern a. ALT-predominant b. AST-predominant 2) Cholestatic pattern a. Hepatobiliary causes b. Non-Hepatic causes of elevated alkaline phosphatase

Elevated aminotransferases out of proportion to ALP

1) Acute or chronic viral hepatitis 2) Steatohepatitis 3) Acute Budd-Chiari syndrome 4) Ischemic hepatitis 5) Autoimmune 6) Hemochromatosis 7) Medications / toxins 8) Autoimmune 9) Alpha1-antitrypsin deficiency 10) Wilson disease 11) Celiac disease

1) Alcohol-related 2) Steatohepatitis 3) Cirrhosis 4) Non-hepatic a. Hemolysis b. Myopathy c. Thyroid disease d. Exercise

Elevated ALP + GGT + bili out of proportion to AST and ALT

1) Bile duct obstruction 2) Primary biliary cirrhosis 3) Primary sclerosing cholangitis 4) Medication-induced 5) Infiltrating diseases of the liver a. Sarcoidosis b. Amyloidosis c. Lymphoma 6) Cystic fibrosis 7) Hepatic metastasis 8) Cholestasis

1) Bone disease 2) Pregnancy 3) Chronic renal failure 4) Lymphoma or other malignancies 5) Congestive heart failure 6) Childhood growth 7) Infection or inflammation

1) AST 2) ALT

1) They are the markers of hepatocellular injury 2) They participate in gluconeogenesis

By catalyzing the transfer of amino grps from aspartic acid or alanine to ketoglutaric acid to produce oxaloacetic acid and pyruvic acid respectively aspartic acid -> ketoglutaric acid = oxaloacetic acid alanine -> ketoglutaric acid = pyruvic acid

1) It is present in cytosolic and mitochondrial isoenzymes 2) It is found in the: a. Liver b. Cardiac muscle c. Skeletal muscle d. Kidneys e. Brain f. Pancreas g. Lungs h. Leukocytes i. RCs 3) It is not as sensitive or specific for the liver 4) Elevation in AST may be seen as 2ndary to nonhepatic causes as well

It is a 1) cytosolic enzyme that is 2) found in high concentrations in the liver

Hepatocellular injury and not necessarily cell death