MBChB 2023 Liver Blood Tests PDF

Report Course MBChB 2023 Cohort - MBChB 2023 Cohort Lesson B1 CTB Liver Blood Tests Email [email protected] Liver blood tests Can you work out which tests form part of the basic liver panel? Drag the test to the appropriate column (need help? Click here to access the Coventry an...

Report Course MBChB 2023 Cohort - MBChB 2023 Cohort Lesson B1 CTB Liver Blood Tests Email [email protected] Liver blood tests Can you work out which tests form part of the basic liver panel? Drag the test to the appropriate column (need help? Click here to access the Coventry and Warwick Pathology Services - see p35 or p48 ) Liver panel Other Alanine aminotransferase (ALT) Activated Partial Thromboplastin Activated Partial Thromboplastin Time (aPTT) Time (aPTT) Albumin Conjugated bilirubin Alanine aminotransferase (ALT) Alkaline phosphatase gamma-glutamyl transferase Albumin Total bilirubin (GGT) Alkaline phosphatase Total protein Aspartate aminotransferase (AST) Aspartate aminotransferase (AST) Conjugated bilirubin Fibrinogen Fibrinogen Prothrombin time (PT) gamma-glutamyl transferase Urobilinogen (GGT) Prothrombin time (PT) Total bilirubin Total protein Urobilinogen Why might you see normal liver blood tests even when there is pathology? There may be compensation by other parts of the liver. Blood tests - Protein Total protein measures all protein within the sample. Albumin is the most abundant protein found in the blood and is a storage protein (it is used to regulate the osmotic pressure of the blood - you'll come back to this in Block 2). What is the other principal type of protein measured in a total protein test? Enzymes Hormones Immunoglobulins Transport proteins Try this!... A patient has raised levels of protein but normal levels of albumin. What disorder are they most likely to have? (Need help? Consider which of the following situations might lead to increased cellular production of substances). Bone marrow failure Multiple myeloma Immunode ciency Chronic Liver disease Blood tests - Bilirubin What is bilirubin a breakdown product of? Click here to nd out about bilirubin. Bacteria Blood Bile Cholesterol Why would you expect to see small amounts of bilirubin in blood under normal conditions? Bilirubin is blood being broken down so in normal conditions, a small amount would be normal - normal red blood cell turnover. Blood tests - GGT Try this!... A patient has raised levels ALP but normal levels of GGT. They also have abnormal calcium levels. What organ is most likely to have pathology? (Need help? Think about where these two substances play a key role in homeostasis). Bone GI Liver Lung Mr Hunter's Blood tests Can you circle/mark the elements of Mr Hunter's blood tests that are abnormal? Click the annotate button to access the drawing tools. What do these results tell you? Can you explain why? That the liver is struggling - damage to the liver, and that there may be some sort of infection/immune system not fully functioning. Popup - Notebook Notebook There are two aminotransferases that form a key part of liver blood tests: Alanine aminotransferase (ALT) Aspartate aminotransferase (AST) Both indicate cell damage, due to in ammation or cell death. High levels of both most likely indicate liver damage, however these enzymes are also produced in other systems. If creatine kinase levels are also increased, you're probably looking at muscle damage; if troponin is raised, it's more likely to be a problem with the heart. ALT is generally higher in acute liver damage. Some clinicians use higher AST levels over time as indicative of cirrhosis. In the liver, sugars are added to bilirubin to give conjugated bilirubin, which is a soluble form that can be excreted in bile. Conjugated bilirubin is not normally found in blood. If present this suggests a blockage of the bile duct or liver dysfunction. Gamma-glutamyl transferase (GGT) is an enzyme found mainly in the liver. If the liver or bile ducts are damaged this enzyme increases. GGT is also elevated in people with chronic alcohol use. It is a useful way of monitoring whether a patient is staying abstinent after withdrawal. Even small amounts of alcohol used within 24 hours of the test can result in a temporary increase in GGT, so repeated GGT measurements may be required to determine chronic use.