ال alpha fetoprotein الsensitivity بتاعته مش عالية اوي يعني لو جاي عيان و انا شاكك عنده المرض و عملته ال test و طلع نورمال يبقى مقدرش استبعد المرض
و علشان يكون specific و عملته لازم يكون فوق 400ng/ml يبقى علطول احلف انه عنده HCC
عشان كدا normal alpha fetoprotein which do not exclude HCC

● السؤال ده برضو ي شباب :

ممكن albumin يقل فعلا في حالة واحدة الا اذا acute liver faliure  لو كان subacute ساعتها هيقل albumin  غير كدا في acute &  hyperacute ميلحقش ينقص لانه life half بتاعته طويلة
برضو كمعلومة hypoalbuminemia is a marker of chronic liver disease

■ السؤال ده تفسيره يا شباب :-
●GGT   ده بيعلى في  حالات
Biliary tract obstruction as obstructive jaundice

●و ALP ده بيعلى برضو في أي liver disease 
و عشان
to confirm increase ALP due to liver disease not bone disease  لازم associated with increase GGT & Abdominal US

■ بكرا بإذن الله يا شباب هنزل ليكم notes on the liver function tests لأنه الأغلب تايه فيهم لازم تفهم الدرس ده أولاً بعد كدا تحفظ النقط المهمة
تاني حاجة بالنسبة لل ENT في اسكيمه نزلت فيها كل حاجة ما عدا ttt أنا عملت اسكيمه ليها برضو

مساء الخير يا شباب دلوقتي هنزل ليكم اسكيمه شابتر ال pharynx كلها

■ Notes on liver function tests :-

● sr.albumin & PT are consiedered for a marker of synthetic function of the liver

● hypoalbuminemia is a marker of chronic liver disease

● Albumin is initially normal in Acute liver disease but decrease later , especially in subacute liver cell failure

● PT is prolonged in case of LCF & OJ

● A rising INR in patients with liver disease that is not corrected by vit K

● ALT is present only in the liver & it is more specific for the liver disease than AST

● ALT is elevated only in active liver disease such as Acute hepatitis as viral hepatits

● AST is present in brain & kidney & liver

● AST is elevated in AMI , myositis , liver disease

● ALP & GGT is formed normally in the liver & excreted in the bile

● ALP is elevated in liver & bone disease

● ALP & GGT is elevated in case of biliary obstruction ( cholestasis)

● ALP is marked elevated > 1000IU/L in case of metastases & PBC

● confirm that increase in ALP due to liver disease not bone disease : shoulde be associated increase GGT & Abd US

● Increase GGT in case of OJ & Alcoholic hepatitis & drug hepatitis

● Normal level of alpha fetoprotein do not exclude HCC

● alpha fetoprotein is more than 400ng/ml is more spedific for HCC

● in PBC : IgM is increased , AIM : IgG is raised

●igG4 is raised in case of Autoimmue pancreatitis & cholangitis 

● Globulin is increased in case of Acute & chronic liver disease

● Reversed A/G ratio in chronic liver disease

● Direct bilirubin is increased in OJ

● indirect bilirubin is increased in hemolytic jaundice

● both types of bilirubin are increased in hepatocellular jaundice

● in chronic liver failure : there is hypoalbuminemia & hyperglycemia & Increased liver enzymes

● Acute liver faliure :

♤ albumin is initially normal then decreased later esp . In subacute Liver faliure

♤ hypoglycemia

♤ serum transaminases is increase at the first then decrease d.t massive necrosis

لا تنسوهم من دعواتكم فهم الآن بأمس الحاجة للدعاء لهم بالصبر و الثبات و التمكين

■ Notes on Liver function tests :

https://t.me/med_Notes2/534

■ MCQ on Liver function tests:

https://t.me/med_Notes2/517

■ أهم أسئلة الباطنة في مديول GIT :-

● Enumerate the precipitating factors of HE

●investigation & symptoms of HE

● Enumerate common causes of gastritis