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diagnosis hematology differential algorithm management causes clinical treatment pathophysiology liver anemia cirrhosis workup oncology table pharmacology syndrome anticoagulation gastroenterology disease
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury Hepatocellular Liver Injury • AST/ALT elevation
Injury • AST/ALT ... > Alk phos • ALT ... • R value = (ALT ... + ULN ALT) / (alkaline ... #differential #hepatology
Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
kidney, brain ALT ... Alkaline Phosphatase, ALT ... ULN R Value = (ALT ... / ULN ALT) / (ALP ... Transaminitis #diagnosis #hepatology
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
: • Severe - ALT ... • Moderate - ALT ... Others • Mild - ALT ... Pattern (ALP > ALT ... Algorithm #diagnosis #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Algorithm Severe ALT ... HELLP Moderate ALT ... • Others Mild ALT ... Others #LFTs #Hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
R-value: Serum (ALT ... /ULN ALT) / (Alk ... to liver than ALT ... • ALT: Specific ... #differential #Hepatology
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
IU/mL), normal ALT ... IU/mL), normal ALT ... IU/mL), normal ALT ... 2000 IU/mL and ALT ... Indications #management #hepatology
Hepatocellular Liver Injury - Differential Diagnosis Framework: Liver Injury → liver test abnormalities without evidence of liver
increase in AST/ALT ... compared with AST/ALT ... Differential #Diagnosis #hepatology
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism AST and ALT: • AST: liver
Chemistry Tests - AST, ALT ... Metabolism AST and ALT ... cytoplasmic (CAST) • ALT ... AlkPhos #Bilirubin #Hepatology
Clinical Diagnosis of Autoimmune Hepatitis - Onset of jaundice within prior 8 weeks - Ongoing consumption
- AST >50, AST/ALT ... >400 IU/L, AST/ALT ... Hepatitis #Diagnosis #Hepatology
Clinical diagnosis of Alcoholic Hepatitis (AH) • Onset of jaundice within prior 8 weeks • Ongoing
• AST >50, AST/ALT ... >400 IU/L, AST/ALT ... Hepatitis #AH #hepatology
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