Which laboratory pattern best indicates liver dysfunction?

Which laboratory pattern best indicates liver dysfunction?

• A. Elevated albumin, normal INR and bilirubin
• B. Low albumin, high ammonia, elevated INR/PT, increased bilirubin, low platelets
• C. High albumin with low bilirubin
• D. Normal INR and platelets with normal liver enzymes

Answer: (B)

Liver dysfunction disrupts the organ’s ability to synthesize proteins, detoxify ammonia, conjugate and excrete bilirubin, and produce clotting factors. When the liver fails, you see several characteristic lab changes: low albumin reflects reduced synthetic function; high ammonia results from impaired conversion of ammonia to urea; elevated INR/PT signals decreased production of clotting factors; increased bilirubin indicates impaired processing and excretion of bilirubin; and low platelets can occur due to portal hypertension with splenic sequestration or reduced thrombopoietin production. The combination of hypoalbuminemia, hyperammonemia, prolonged INR/PT, hyperbilirubinemia, and thrombocytopenia best indicates significant liver dysfunction. Patterns with normal albumin, INR, bilirubin, platelets, or normal liver enzymes do not convey active hepatic failure.

Liver dysfunction disrupts the organ’s ability to synthesize proteins, detoxify ammonia, conjugate and excrete bilirubin, and produce clotting factors. When the liver fails, you see several characteristic lab changes: low albumin reflects reduced synthetic function; high ammonia results from impaired conversion of ammonia to urea; elevated INR/PT signals decreased production of clotting factors; increased bilirubin indicates impaired processing and excretion of bilirubin; and low platelets can occur due to portal hypertension with splenic sequestration or reduced thrombopoietin production. The combination of hypoalbuminemia, hyperammonemia, prolonged INR/PT, hyperbilirubinemia, and thrombocytopenia best indicates significant liver dysfunction. Patterns with normal albumin, INR, bilirubin, platelets, or normal liver enzymes do not convey active hepatic failure.