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differential lfts transaminitis dili management aclf chemistry congenital conjugated direct drug druginduced failure function hepatitis idiosyncratic induced inherited interpretation patterns
Approach to Conjugated Hyperbilirubinemia - Differential Diagnosis Algorithm 1. Definition: T.bili elevation + >20% conjugated 2. Obtain RUQ
Algorithm 1. ... MRCP, ERCP, liver ... #direct #bilirubin ... #Algorithm #gastroenterology ... #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... Injury (DILI) ... #Chronic #Liver ... #Hepatology #gastroenterology ... #management #diagnosis
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... - Differential Diagnosis ... Algorithm Vascular ... hepatitis: < 1 • Cirrhosis ... #algorithm #hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
• NAFLD • Cirrhosis ... • Chronic Viral ... Hepatopathy • Acute ... injury) • Ischemic ... #hepatology #transaminitis
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
> 2 • NASH, Chronic ... hepatitis: < 1 • Cirrhosis ... 3 • Chronic muscle ... #chemistry #diagnosis ... #differential #Hepatology
Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury (DILI) DILI Types: • Intrinsic - predictable, dose dependent
Diagnosis and Management ... presentation • Chronic ... #differential #Diagnosis ... #algorithm #gastroenterology ... #hepatology
Inherited Non-hemolytic Disorders of Hyperbilirubinemia == Disorders of Conjugation == Gilbert Syndrome: • 5-10% of the population
common hereditary hyperbilirubinemia ... of hemolysis or liver ... injury ... #hepatology #diagnosis ... #gastroenterology
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
> 20x normal - Acute ... CMV), Alcoholic cirrhosis ... 5-10x normal - Chronic ... #Injury #hepatology ... #differential #diagnosis
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis ... Algorithm DILI ... dechallenge • Acute ... #Injury #Diagnosis ... #Algorithm #hepatology
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