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diagnosis differential management nephrology neurology dermatology hepatology clinical pediatrics peds hematology cardiology endocrinology obgyn workup acute ddxof gastroenterology ophthalmology primary
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Differential Diagnosis Algorithm ... US - Dilated Bile ... Duct Stone • Biliary ... Differential #Diagnosis #Algorithm ... #Causes
Classification of Jaundice Unconjugated hyperbilirubinemia (predominantly indirect bilirubin) • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
genes coding for bile ... cholestasis, and some cases ... miscellaneous causes ... external pressure on bile ... #differential #causes
Alkaline Phosphatase (ALP) Elevation - Differential Diagnosis Algorithm ALP: - Enzymes that catalyze hydrolysis of organic phosphate
Differential Diagnosis Algorithm ... Intestine - Other causes ... Drugs - Primary biliary ... PSC - Other biliary ... diseases/Bile duct
Alpha-gal Syndrome (AGS) - Diagnosis Algorithm Does patient have recurrent episodes of urticaria, angioedema or isolated GI
AGS) - Diagnosis Algorithm ... - Known tick bites ... irritation at site ... of tick bite • ... AGS #Diagnosis #Algorithm
Diseases of the Biliary Tract Asymptomatic gallstones - Asymptomatic Symptomatic gallstones - Biliary pain Cholesterolosis of gallbladder - Usually
Diseases of the Biliary ... Adenomyomatosis - May cause ... biliary pain Porcelain ... quadrant pain, nausea ... quadrant pain, nausea
Jaundice - Differential Diagnosis Algorithm Pre-Hepatic - Unconjugated Hyperbilirubinemia Increased Production • Hemolysis • Ineffective Erythropoiesis • Hematoma Decreased
Differential Diagnosis Algorithm ... on Ultrasound Biliary ... Gallstones • Biliary ... Differential #Diagnosis #Algorithm ... #Causes #Hepatology
Mechanism of Action of Bile Acid Sequestrants Bile Acid Sequestrants → ↓ Hepatic Bile Acid Pool →
Mechanism of Action of Bile ... Sequestrants Bile ... Sequestrants → ↓ Hepatic Bile ... Pool → ↑ Hepatic Bile ... Plasma LDL-C #biliary
Causes of Severe Acute Liver Injury - Ichemic hepatitis - Acute biliary obstruction - Drug-Induced liver
Causes of Severe ... hepatitis - Acute biliary ... Hemochromatosis - Primary biliary ... Severe #Acute #Causes
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
Primary Biliary ... of intralobular bile ... ducts causes cholestasis ... No extrahepatic biliary ... malignancy #Primary #Biliary
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Differential Diagnosis Algorithm ... • US - Normal Bile ... • US - Dilated Bile ... - CBD stone, Biliary ... Transaminitis #Algorithm
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