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diagnosis hepatology differential algorithm management transaminitis workup acute aih autoimmune biliary calcium causes chemistry cholangitis cirrhosis endocrinology evaluation gastroenterology hepatitis
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Severe - ALT >15X ULN ... Mild - ALT < 5x ULN ... Burak @kwburak #LFTs ... #Elevated #Abnormal
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... Severe ALT > 15x ULN ... Mild ALT < 5x ULN ... disease US — Normal ... • Others #LFTs
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... R-value: Serum (ALT/ULN ... ALT) / (Alk phos/ULN ... specificity to elevated ... transaminitis #LFTs
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 ... endocrinology #calcium #elevated
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
IgG typically elevated ... upper limit of normal ... ALT + AST > 10x ULN ... ALT + AST > 5x ULN ... AND IgG > 2x ULN
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
• ALT & AST normal ... or slightly elevated ... • Bilirubin - Normal ... early on but elevated ... • ALP > 1.5 x ULN
Acute Pancreatitis - Diagnosis and Management - GrepMed Handbook Presentation: • Epigastric abdominal pain (90%, characteristically
2) Lipase > 3x ULN ... Lipase, Ca2+, LFTs ... diagnosis, can be normal
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