ASGE Annual GI Advanced Practice Provider Course (On-Demand) - Clinical Case-Based Learning (Day Two) | March 2024-Evaluation of Abnormal Liver Function Tests LFTs

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This document discusses the evaluation of abnormal liver function tests (LFTs). The objectives of this evaluation are to define liver tests, categorize different types of liver tests, discuss the implications of abnormalities in specific liver tests, and determine how to work up patients with abnormal liver test results. The document presents polling questions to test knowledge about specific liver tests such as alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, γGT (gGT or gGTP), and 5’-nucleotidase. It then provides a list of disorders associated with abnormal liver test results, including viral hepatitis, alcoholic hepatitis and cirrhosis, autoimmune hepatitis, primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC). The document explains that liver tests can provide information about liver injury, liver function, the liver's ability to synthesize proteins, serum proteins, clotting proteins, and the ability to conjugate and transport bilirubin. It categorizes liver tests as liver injury tests, liver synthetic function tests, liver enzymes, and liver function tests (LFTs). The document explains that liver injury tests include AST and ALT, while liver synthetic function tests include albumin and prothrombin time. Liver enzymes encompass AST, ALT, ALP, γGTP, and 5’-nucleotidase, while LFTs include albumin, prothrombin time, and bilirubin. The document clarifies the distinction between cholestatic liver tests and cholestatic liver enzymes. It also discusses patterns of abnormality in liver test results and provides a clinical approach to evaluating and managing patients with abnormal liver tests. The document concludes with practice pearls and contact information for the author.

Asset Subtitle

John Martin, MD, FASGE

Keywords

abnormal liver function tests

evaluation

liver tests

specific liver tests

disorders

viral hepatitis

liver injury

liver synthetic function

cholestatic liver tests

clinical approach