Lab Case 30 – Interpretation

1. Describe the relevant biochemical abnormalities

Elevated bilirubin – jaundice (require direct vs indirect)

Markedly elevated ALT >> GGT/ALP – transaminitis, indicating hepatocellular damage

Normal Albumin – marker of synthetic function Normal FBC/UEC

2. What is the most likely diagnosis?

Acute hepatitis (obstructive picture/ similar not acceptable)

3. Give 4 most likely causes

Infection – Viral especially Hepatitis A, B, C, other EBV, HSV, CMV, HIV

Alcohol

Toxins/ Drugs – Paracetamol, antibiotics

Autoimmune

4. What are the markers of synthetic function of the liver?

Albumin

Bilirubin

Prothrombin time – measures Vit K dependant clotting factors (II, VII, IX, X)

Ammonia – does not correlate well and is not a good marker of synthetic function

5. List 3 immediate complications of acute liver failure

At least two of:

Encephalopathy

Coagulopathy

Shock

Accept one of:

hyponatraemia

ascites

cerebral oedema

haematemesis/ malaena