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diagnosis hepatology differential algorithm causes ascites management transaminitis disease laboratory rheumatology syndrome abnormal aflp function gastroenterology injury interpretation obstetrics pbc
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... , Toxic Hepatitis ... CMV), Alcoholic cirrhosis ... #Patterns #Liver ... Injury #hepatology #LFTs
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Tests (LFTs) - ... • NAFLD • Cirrhosis ... Chronic Viral Hepatitis ... • Acute Viral Hepatitis ... Function #Tests #LFTs
Clinical Examination for Liver and Biliary Diseases 1) Hands: Clubbing, Dupuytren's contracture, Leuconychia, Bruising, Flapping tremor (hepatic
Examination for Liver ... and Biliary Diseases ... Xanthelasma and jaundiced ... #physicalexam #cirrhosis ... #liver #disease
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... • Alcoholic hepatitis ... Infiltrative • Cirrhosis ... Duct Stone • Biliary ... • Others #LFTs
Common Etiologies of Cirrhosis Inflammation - Hepatitis B (15 percent) - Hepatitis C (47 percent) - Schistosomiasis
Etiologies of Cirrhosis ... Inflammation - Hepatitis ... 15 percent) - Hepatitis ... congenital - Primary biliary ... Nonalcoholic fatty liver
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 Portal Hypertension - Differential Diagnosis Portal Pressure = the pressure difference between the pressure in the portal
Clues to non-cirrhotic ... /acute hepatitis ... sarcoidosis) • Liver ... metastasis • Fatty liver ... pregnancy • Primary biliary
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
Primary Biliary ... /Liver failure ... hyperpigmentation • Jaundice ... or higher • Liver ... Diagnosis: • Viral hepatitis
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 ... postoperative jaundice
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Non-Malignant • Fatty Liver ... Infectious • Hepatitis ... • Alcoholic Hepatitis ... Cholangitis • Primary Biliary ... Cirrhosis #Hepatomegaly
Ascites - Differential Diagnosis Chronic liver disease (cirrhosis or chronic hepatitis) - 80% Underlying malignancy - 10% Congestive heart
Diagnosis Chronic liver ... disease (cirrhosis ... or chronic hepatitis ... failure - 3-5% Cirrhosis ... Failure, Pancreatic, Biliary
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