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diagnosis differential algorithm liver workup alcoholic ascites chemistry cholangitis classification congenital conjugated criteria hyperbilirubinemia hypertension inherited injury interpretation liverenzymes pbc
Classification of Jaundice Unconjugated hyperbilirubinemia (predominantly indirect bilirubin) • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
Classification of Jaundice ... hepatocyte damage (eg, hepatitis ... , hepatic cirrhosis ... cirrhosis, sepsis ... miscellaneous causes
Clinical diagnosis of Alcoholic Hepatitis (AH) • Onset of jaundice within prior 8 weeks • Ongoing
(AH) • Onset ... of jaundice within ... IU/L • Serum total ... bilirubin >3.0 ... #AH #hepatology
Portal Hypertension - Differential Diagnosis Portal Pressure = the pressure difference between the pressure in the portal
to non-cirrhotic ... function: INR, bilirubin ... /acute hepatitis ... pregnancy • Primary biliary ... #hepatology
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
intralobular bile ducts causes ... hyperpigmentation • Jaundice ... slightly elevated • Bilirubin ... Diagnosis: • Viral hepatitis ... diagnosis #workup #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
• Alcoholic hepatitis ... Infiltrative • Cirrhosis ... Duct Stone • Biliary ... • Others #LFTs ... #Hepatology #LiverEnzymes
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... Check Acute viral hepatitis ... : < 1 • Cirrhosis ... #differential #Hepatology ... transaminitis #LFTs
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Algorithm Vascular Causes ... Extrahepatic - Biliary ... - Obstruction: Biliary ... : < 1 • Cirrhosis ... diagnosis #algorithm #hepatology
Inherited Non-hemolytic Disorders of Hyperbilirubinemia == Disorders of Conjugation == Gilbert Syndrome: • 5-10% of the population
of about 30% of normal ... breastfeeding jaundice ... and stress may cause ... #hepatology #diagnosis ... #gastroenterology
Ascites - Diagnostic Approach and Differential Diagnosis The most common causes: cirrhosis, malignancy and heart failure. Approx
The most common causes ... more than one cause ... brown: elevated bilirubin ... concentration (bowel or biliary ... Differential #Diagnosis #hepatology
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