S1E35 Liver Labs Decoded: What LFTs Really Tell You

Think a high AST or ALT means your patient’s liver is failing? Think again. Liver function tests are one of the most misunderstood panels in clinical practice — often called "function" tests, yet many don’t measure function at all.

In this episode, we break down the real meaning behind LFTs, explore the different patterns of liver injury, and help you interpret these labs like a pro. Whether it’s differentiating between cholestasis and hepatocellular injury, or figuring out when to worry about that isolated bilirubin bump, we’ve got you covered with pathophysiology, clinical reasoning, and nursing implications.

🧠 Key Topics Covered:

• Why “LFT” is often a misnomer

• True measures of liver function: Albumin, PT/INR

• Injury patterns:

  • Hepatocellular (↑ AST/ALT)

  • Cholestatic (↑ ALP/GGT)

  • Mixed patterns

  • Isolated hyperbilirubinemia

• What each test actually tells you:

  • ALT/AST – hepatocellular enzymes

  • ALP/GGT – biliary obstruction clues

  • Bilirubin – excretory function vs hemolysis

  • Albumin, PT/INR – synthetic function markers

• Common causes of abnormal labs:

  • Medications, alcohol, viral hepatitis, fatty liver, hemolysis, specimen error

• How to link lab patterns to clinical conditions

• When to escalate care or consult hepatology