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diagnosis management hepatology algorithm lfts neurology biliary causes elevated pbc primary sclerosis transaminitis workup acute aih als amyotrophic ascites atrophy
Upper Motor Neuron (UMN) lesions are lesions occurring anywhere in the CNS from the brain up
form part of the differential ... However, in UMN ... UMN lesions are ... and a positive Babinski ... @DharSaty #UMN
Amyotrophic Lateral Sclerosis (ALS) Summary ALS: combination of the clinical examination finding of amyotrophy with the pathologic
combination of UMN ... sclerosis with pure UMN ... combination of UMN ... conditions listed in differential ... diagnosis column Treatment
Peritonitis - Spontaneous vs Secondary vs Peritoneal Dialysis Associated Peritonitis Spontaneous Bacterial Peritonitis • Cirrhosis (high SAAG)
Peritonitis • Cirrhosis ... ) + ascites w/ PMN ... > 250 • Treatment ... glucose < 50, LDH ULN ... Peritoneal #diagnosis #differential
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Tests - Differential ... Severe - ALT >15X ULN ... Mild - ALT < 5x ULN ... Congenital, Others, Cirrhosis
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Liver Enzymes - Differential ... Severe ALT > 15x ULN ... disease US — Normal ... Infiltrative • Cirrhosis ... #LiverEnzymes #Differential
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
(>10^6 IU/mL), normal ... (<2000 IU/mL), normal ... Family history of cirrhosis ... IU/mL and ALT > ULN ... or fibrosis • Cirrhosis
Spinal Cord Disorders - Differential Diagnosis Framework Spinal cord neurological lesion: Clinical findings: • Symptoms and signs below
Cord Disorders - Differential ... injury • Gait is abnormal ... dysfunction • Abnormal ... : Areflexia UMN ... plantar response LMN
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
Primary Biliary Cirrhosis ... cholestasis → Cirrhosis ... • ALP > 1.5 x ULN ... bile ducts Differential ... Primary #Biliary #Cirrhosis
Hypercalcemia Evaluation 1) Clinical clues - Is the patient symptomatic? - Family history? - Have you done
likely - Mid range/ULN ... FeCa <1 %) - Low normal ... • If all normal ... Hypercalcemia #workup #differential
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
upper limit of normal ... ALT + AST > 10x ULN ... ALT + AST > 5x ULN ... AND IgG > 2x ULN ... regarding need for treatment
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