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Blood Studies Liver function test (LFT) Group of biochemical tests

Blood Studies Liver function test (LFT) Group of biochemical tests Uses of liver function test (LFTs) Differential diagnosis & prognosis of jaundice To assess the extend of liver damage To follow the progress of liver damage. Liver function test (LFT) Serum Bilirubin

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Blood Studies Liver function test (LFT) Group of biochemical tests

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  1. Blood Studies Liver function test (LFT) • Group of biochemical tests Uses of liver function test (LFTs) • Differential diagnosis & prognosis of jaundice • To assess the extend of liver damage • To follow the progress of liver damage

  2. Liver function test (LFT) • Serum Bilirubin • Hepatic enzymes – AST, ALT, Alkaline Phosphatase • Prothrombin time • Serum proteins (with albumin & globulin ratio A/G ratio)

  3. 1. Serum Bilirubin 2. Serum Enzymes Serum Aminotransferase - AST (SGOT), ALT (SGPT) Elevated levels usually indicate cellular damage to the liver ALT – alanineamonitransferase • Cytosol enzyme • It is more specific than AST for the liver AST – asparateamninotransferaase • Mitochondrial enzyme • Also present in heart, brain, kidney & musles • High levels are seen in hepatic necrosis, myocardial infarction, muscle injury

  4. Alkaline phosphatase • Present in canalicular membranes of hepatocyte • Secreted in bile, Blockage of Alkaline Phosphatase excretion (via bile) will induce more synthesis, leading to high blood levels. • Raised in cholestatic jaundice (4-6 times normal) • Also raised in Metastatis & cirrhosis • Present in liver, bone , intestine & plasma Gamma glutamyltransferase (γGT) • Raised value is good guide to alcohol intake

  5. ProthrombinTime (PT) • Time required for a firm fibrin clot to form • It is a sensitive indicator of both acute & chronic liver disease • Prolonged PT occurs due to Vit K deficiency, which is excluded by giving 10mg of Vit K IV • In liver dysfunction, increase clotting time with increased risk of bleeding

  6. Protein Studies • Serum albumin • Low levels indicates severity of chronic liver disease • Falling serum albumin is a bad prognostic sign liver disease • Serum globulin • Hyperglobulinaemia occurs in chronic liver disease due to immunological mechanisms High globulin & low albumin is a characteristic feature of CLD

  7. Ammonia • Liver converts ammonia to urea. Ammonia rises in liver failure Tumor Marker • Alpha-fetoprotein (AFP) • Increased levels are seen with hepatic carcinoma Liver Biopsy • Used to obtain a specimen of liver tissue • Done under local anesthesia

  8. Imaging • USG of Liver

  9. Imaging • CT of Liver • MRI of Liver

  10. Cholangiography X-ray examination of the biliary system, using a radiopaque dye given intravenously or orally, as contrast medium Types • Oralcholecystography /OCG • Intravenous cholangio graphy/ICG • Endoscopic Retrograde Cholangio – Pancreatography /ERCP • Percutaneous transhepatic cholangiography /PTC • Operative cholangiography • Operative T tube cholangiography Dr S Chakradhar

  11. Magnetic Resonance cholangio-pancreatography/MRCP Dr S Chakradhar

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