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see patient .co.uk
''bilirubin''
breakdown of haem, binds to albumin, conjugated by liver, lost in urine
''albumin''
chronic marker
''total protein''
albumin + globulin (as one rises, other falls)
high in chronic active or alcoholic hepatitis
''ALT/AST''
show hepatocellular damage esp ALT
AST also in skeletal muscle (Creatinine Kinase) or Heart (troponin)
high ALT (>1000) - PCM, acute hep A/B, ischaemia, autoimmune
ratio can be useful
''GGT''
helps show specific to liver damage but raised in many liver diseases
''Alk Phos''
from bile duct and bone
so if GGT also high - then cholestasis, if normal then bone
Check ... travel, transfusion, alcohol
Exam - liver stigma, hepatosplenomegaly, ascites, obesity