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diagnosis neurology hepatology algorithm lfts causes management transaminitis weakness workup atrophy biliary calcium cardiology chemistry cholangitis cirrhosis endocrinology evaluation flaccid
Upper Motor Neuron (UMN) lesions are lesions occurring anywhere in the CNS from the brain up
pathology and muscle disorders ... disorder and form ... part of the differential ... However, in UMN ... and a positive Babinski
Generalized Weakness - Differential Diagnosis Framework "l feel weak": • Infectious: Influenza, EBV, PNA, Bacteremia, Sepsis •
Generalized Weakness - Differential ... : CHF, valves, COPD ... Infection • Neuro: UMN ... stroke, tumor), LMN ... Polyneuropathy, ALS), NMJ disorder
Spinal Cord Disorders - Differential Diagnosis Framework Spinal cord neurological lesion: Clinical findings: • Symptoms and signs below
Spinal Cord Disorders ... - Differential ... injury • Gait is abnormal ... : Areflexia UMN ... plantar response LMN
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 ... kwburak #LFTs #Elevated
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... - Differential ... Severe ALT > 15x ULN ... disease US — Normal ... #LiverEnzymes #Differential
Weakness - Differential Diagnosis Framework Approach To Weakness: • Non-neuromuscular disorder (Cardiac, pulmonary etc) • CNS ->
Weakness - Differential ... Non-neuromuscular disorder ... of the spinal cord ... Gravis - Lack of UMN ... /LMN signs - Lack
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
Transverse Myelitis Overview Focal inflammatory disorder of the spinal cord resulting in rapid onset of weakness, sensory
Focal inflammatory disorder ... CSF pleocytosis, elevated ... Sjogren's • CSF: - Abnormal ... infectious myelitis - Elevated ... management #neurology #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 ... - If both are normal ... chemistry #diagnosis #differential
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
• ALT & AST normal ... or slightly elevated ... early on but elevated ... • ALP > 1.5 x ULN ... bile ducts Differential
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