189 results
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
(ALT or AST > ALP ... Wilsons, Pregnancy - AFLP ... Cholestatic Pattern (ALP ... - CBD stone, Biliary
Alkaline Phosphatase (ALP) Elevation - Differential Diagnosis Algorithm

ALP:
 - Enzymes that catalyze hydrolysis of organic phosphate
Alkaline Phosphatase (ALP ... - Increased ALP ... Drugs - Primary biliary ... PSC - Other biliary ... #Phosphatase #ALP
Liver Function Test (LFTs) Elevation
AST - Cardiac and skeletal muscle, kidney, brain
ALT - More specific for
for the liver ALP ... - Biliary tree ... Transaminase, ALP ... / ULN ALT) / (ALP ... / ULN ALP)
Acute Fatty Liver of Pregnancy (AFLP)
Pathophysiology:
 • Defect in fetal free fatty acid metabolism products →
of Pregnancy (AFLP ... infiltrates maternal hepatocytes ... iMedEducation #AFLP
Classification of Jaundice
Unconjugated hyperbilirubinemia (predominantly indirect bilirubin)
 • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
Dysfunction - Biliary ... epithelial and hepatocyte ... certain drugs, biliary ... Choledocholithiasis, biliary ... , carcinoma of biliary
Liver Chemistry Tests - AST, ALT, Alkaline Phosphatase and Bilirubin Metabolism
AST and ALT:
 • AST: liver
Synthesis: in hepatocyte ... accumulation in hepatocyte ... from albumin upon hepatocyte ... conjugation in hepatocyte ... reuptake into hepatocyte
Pathology - Hepatocyte Pigments

Lipofuschin (H&E) 

Alpha-I-antitrypsin globules (PAS-D) 

Mallory's hyaline / Mallory Denk Bodies 

Giant Mitochondria
Pathology - Hepatocyte ... bilirubinostasis (H&E) #Hepatocyte
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Extrahepatic - Biliary ... Choledocholithiasis, Biliary ... - Obstruction: Biliary ... • AST/ALT > ALP ... disease - If ALP
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
• Pregnancy - AFLP ... Duct Stone • Biliary
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Elevated ALP 2. ... #PBC #Primary #Biliary