12 results
diagnosis hepatology algorithm lfts management autoimmune biliary hepatitis liver primary transaminitis treatment workup aih ascites calcium causes chemistry cholangitis endocrinology
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Tests - Differential ... Ducts - PBC ... Congenital, Others, Cirrhosis ... kwburak #LFTs #Elevated
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... - Differential ... disease US — Normal ... Bile Ducts • PSC ... Infiltrative • Cirrhosis
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
Primary Biliary Cirrhosis ... or slightly elevated ... early on but elevated ... • ALP > 1.5 x ULN ... bile ducts Differential
Peritonitis - Spontaneous vs Secondary vs Peritoneal Dialysis Associated Peritonitis Spontaneous Bacterial Peritonitis • Cirrhosis (high SAAG)
Peritonitis • Cirrhosis ... ) + ascites w/ PMN ... glucose < 50, LDH ULN ... > 100 WBC, >50% ... Peritoneal #diagnosis #differential
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
R-value: Serum (ALT/ULN ... ALT) / (Alk phos/ULN ... specificity to elevated ... hepatitis: < 1 • Cirrhosis ... chemistry #diagnosis #differential
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Liver Injury - Differential ... specificity to elevated ... function may be abnormal ... hepatitis: < 1 • Cirrhosis ... injury #hepatitis #differential
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
reported (eg AIH-PBC ... IgG typically elevated ... upper limit of normal ... ALT + AST > 5x ULN ... AND IgG > 2x ULN
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 ... endocrinology #calcium #elevated
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
(>10^6 IU/mL), normal ... Presence of CP or PC ... Family history of cirrhosis ... IU/mL and ALT > ULN ... or fibrosis • Cirrhosis
Primary Biliary Cirrhosis - Management A. Initiate therapy - Initiate 1st line therapy with UDCA (13-15
Primary Biliary Cirrhosis ... if ALP > 1.5x ULN ... and/or abnormal ... survey disease #PBC ... Primary #Biliary #Cirrhosis
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