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Assessing LFTs (Assess ALT and ALP (compare ALT and ALP (Assess hepatic…

- - - - hepatocellular eg non/alcoholic fatty liver, chronic infection HepB/C, biliary cirrhosis
    - - cholestasis
      - check GGT
        
        ++ is biliary epithelial damage and bile flow obstruction.
        Could be alcohol/drugs eg phenytoin
        
        negative - consider bone breakdown eg tumour, vit D deficiency, recent bone fractures.
    - - Bilirubin (+ jaundice)
        
        unconjugated
        
        urine normal colour
        
        drugs, CHF
        
        conjugated
        
        dark urine
        
        cholestasis
        
        stools
        
        pale, bulky, hard to flush
        
        post-hepatic (obstructive)
        
        normal (dark)
        
        pre-hepatic
        
        hepatic
      - albumin
        
        decreased
        
        cirrhosis
        
        inflammation
        
        nephrotic syndrome/loss albumin
      - PT time
        
        increased
        
        check anticoagulants and vit K deficiency
        
        liver disease/dysfunction
      - ALT/AST ratio
        
        ALT>AST
        
        chronic liver disease
        
        AST>ALT
        
        cirrhosis
        
        acute alcoholic hepatitis