Notes · Gastrointestinal · 6 min read

Interpreting liver tests

Hepatocellular or cholestatic, and what very high numbers mean.

Key points

Hepatocellular pattern: ALT and AST rise more than ALP.
Cholestatic pattern: ALP and GGT rise more than the transaminases.
ALT above 1000 U/L: ischaemic hepatitis, paracetamol toxicity or acute viral hepatitis.
An AST:ALT ratio above 2 suggests alcohol-related liver disease.
Albumin, INR and bilirubin reflect liver function; the enzymes reflect injury.

Lobules, acini and why the zones matter for injury patterns.

Map each coronary artery to the myocardium and ECG leads it supplies.

A repeatable ABCDE read so you never miss the second finding.