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 misnomerTrue measures of liver function: Albumin, PT/INRInjury patterns:Hepatocellular (↑ AST/ALT)Cholestatic (↑ ALP/GGT)Mixed patternsIsolated hyperbilirubinemiaWhat each test actually tells you:ALT/AST – hepatocellular enzymesALP/GGT – biliary obstruction cluesBilirubin – excretory function vs hemolysisAlbumin, PT/INR – synthetic function markersCommon causes of abnormal labs:Medications, alcohol, viral hepatitis, fatty liver, hemolysis, specimen errorHow to link lab patterns to clinical conditionsWhen to escalate care or consult hepatology