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ORGAN FUNCTION TESTS – LIVER,
THYROID, KIDNEY, PANCREAS

Organ Function Tests (00:00:48) Please Note

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Liver Funtion Test (00:01:40)

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Set of viochemal investgao done to liagnose and
monitr disea of liver and the bilary trac
Based on nature of the clina problem, they should tes
difernt aspect of liver functio

Indication of LFT (00:04:02)

Diferntial diagnos of aundiceJ

Suspectd liver metasi
Alvohlic liver disea
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Follow up of Chronic cases during out breack of infective Please Note
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pepatitis
All trigh s are er serev d. These notes are the o c tyrighp of Nusr ing
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C agulation disorders Next eLiv . eR o pr duction of these notes in any o f rm or any means
electo r nic or mechaanic l including, scer enshot, photocoyingp,
Follow up of therapy with hepatotoxic drugs tprin out, scanig, or culir ating and sharing yb any means
electo r nic liek emailing, WhatsAp, eT legar m, aF cebook,
Instagar m and yb any mechaanic l means will be treated as
Classification of LFT (00:05:35) violation of Cotyrighp Act. Sharing or culir ating these Notes
in any o f rm, edir ctly or eindr ctly, is a punishable ofef nce. The
ofef nder will be o pr secuted.
eT sts for synthetic function
eT st for detoxifcation
eT st for hepatic excretory function
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eT st for metabolic function
eT st for liver injury/cholestasis
Special tests

Plasma proteins
Prothromlin time

All plasma proteins, exept y–globulins are synthesized

liver
In o m st hepatic disorders, impaired synthesis of these
molucules occure, resulting in hypoproteinemia and
hypoalbuminemia
Allrumin globulin (A:G) ratio is a more reliable of hepatic
dysfunction than total protein concentrotion

Prothrombin Time
→ Liver synthesizer most coagulation factors, including
factor II (prothrombin)
→ In liver diseases, prothrombin time may get reduced
Prothrombin Time – Which Tube will you use?
→ Sodium citrate vail (blue to tube)
PT–INR
PT test
INR = ISI
PT normal
→ INR → International normlized ratio
→ PT test → Tested prothrombin time
→ PT normal → Normal prothrombin time
→ ISI → International sensitivity index
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Please Note
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Next Live. Reproduction of these notes in any form or any mea
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Tests for Detoxification Function (00:14:15) Please Note
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→ Hippuric acid escretion test
Test for Hepatic Excretory Function (00:16:00)
→ Serum bilirubin
Conjugated
Unconjugated
→ Urine – bile salt, bile pigments
→ Bromsulphtalein excretion test
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Bromsulphtalein Excretion Test

→ Dye used to assess excretory function of the liver

→ Non – toxic compound exclusively excreted through bile
→ Dose: 5 mg/kg body weight
→ Administration: Intravenously
→ Procedure: Serum concentration is measured at 45 min
and at 2 hours
→ Result >5% of dye retained abnormality in excretory
function of the liver

Jaundice (00:18:37)

→ Jaundice is the commonest mode of presentation in

patients with liver disease
→ Jaundice is the yellowish discoloration of the skin and
mucous membrane, sclera, palate and nail brals, caused
by deposition of bilirubin in the tissues
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Total Bilirukin Please Note

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→ Normal 0.3–1 mg/dl All rights are reserved. These notes are the copyright of Nurs
Next Live. Reproduction of these notes in any form or any mea
→ Direct 0.2–0.7 mg/dl electronic or mechanical including, screenshot, photocopying
printout, scanning, or circulating and sharing by any me
→ Indirect 0.1–0.4 mg/dl electronic like emailing, WhatsApp, Telegram, Facebook
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Van Den Bergh Reaction (00:21:40)

→ Traditional methods of measuring bilirubin are based on

the reaction of bilirubin with a diazo reagent to form
the colored compound azobilirubin

Enzymes Level for Liver Injury/Cholestasis (00:23:16)

→ Enzymes eleveted in serum in pepatocyte injury

→ Alanine transaminase (ALT/SGPT)
→ Aspartate transaminase (ALT/SGPT)
→ Enzymes elevated in serum in cholestasis
→ Alkaline phosphatase
→ S' Nucleotidase
→ Gamma glutamyl trasferase

Types of Jaundice (00:24:38)

1. Hemolytic
2. Hepatocellular
3. Obstrucive
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Lives Function Tests–Reference Interval (00:26:04) Please Note
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All rights are reserved. These notes are the copyright of Nurs
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Difference between hemolytic, heoatocellular, obstructive

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Special Tests (00:29:40) Please Note

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All rights are reserved. These notes are the copyright of Nurs
→ Alpha fetoprotein – tumor markers Next Live. Reproduction of these notes in any form or any mea
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Renal Function Tests (00:30:02) electronic like emailing, WhatsApp, Telegram, Facebook
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→ Serum urea in any form, directly or indirectly, is a punishable offence. T
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→ Serum creatinine
→ Serum electrolytes
→ Sodium
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→ Potassium

Glomeular Filtration Rate (GFR) (00:31:11)

→ The amount of ultrafiltrate formed per minute when

plasma posses through the kidney
→ It is a useful general index for the assessment of the
severity of kidney damage

Couses of Decreased GFR

→ Pre–renal causes:
→ Decreased renal blood flow due to haemorrhage
dchydration, cardiac failure, etc.
→ Renal causes
→ Acute and chronic glomerulonephritis, polycystic
kidney, etc.
→ Post–renal causes:
→ Obstruction to wine flow in the urinary tract e.g.
renal stones, prostate enlargement, etc.
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Creatinine Clearance (00:35:40)
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Cockcroft–Gault Formula
(140–age) × Lean Body Weight (kg)
GCL (mL/min) = (× 0.85 if female)
Serum Creatinine × 72

Pancreatic Function Tests (00:38:45) Please Note

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Direct Tests Indirect Tests

→ Secretin/CCK → Fat absorption test
stimulation test → C13 – MTG test
→ Faecal enzyme assays → Fluorescein dilauryl test
→ Faecal elastase → NBT–PABA test
assay
→ Pancreatic schilling test
→ Chylomicron
→ Serum enzyme assays

→ Direct tests involve the stimulation of the pancras with

a meal as hormonel secretagogues after which duodenal
fluid is collected and analysed to quantity normal
pancreatic secretory content (ie enzymes, HCO3–)
→ Indirect tests measure the consequences of pancreatic
insufficiency

Secretin Stimulation Test

→ Invasive test that requires passage of a triple lumen tube

through radilogical guidance
→ Nonabsorbable markers like polyethyle glyconl or
bromsulphthalein is used
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Please Note

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→ 50 gm per kg of body weight of secretin per hour is

administered by continuous infusion
→ Duodenal juice is collected by gravity drainage in iced
tubes at 15 minute intervals for 1.5 hours after the
stimulation
→ Considered as the gold standard test for pancreatic
insufficiency
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Fecal Elastase Assay

→ Elastase–1 is a pancreatic specific enzyme

→ It is not degraded in the gut and excreted as such in
faces
→ Concentration of elastase in faces is 5–6 times that of
concentration in pancreatic juice
→ It can be quantified by EUSA. Thus, it server as a useful
indicator of exocrine pancreatic insufficiency
→ As this is non – invasive, this test is suitable for paediatric
patients

Schilling Test

→ Help to determine/differentiate the etiology of vitamin

B12 malabsorption
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Thyroid Function Test (00:44:55)
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→ Thyroid stimulating hormone (TSH), Free T3 and T4 are
the three most commonly perfomed TFTs.
→ Autoantibodies like thyroperoxidase autoantibodeis (anti
TPO) and thyroglobulin autoantibodies (anti Tg) are
measured when autoimmune etiology is suspected.
→ TRTs are done by immunoassay like EUSA and chemilumi
nescence immunoassay. The latter is superior to the former.
Please Note
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