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hepatology diagnosis differential management transaminitis treatment function indications interpretation tests aclf aki algorithm ascites causes chemistry chronic failure gap gastroenterology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Tests (LFTs) - ... • NAFLD • Cirrhosis ... Hepatopathy • Acute ... injury) • Ischemic ... Function #Tests #LFTs
Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Indications for Albumin ... Management of Cirrhosis ... ascites removed • Acute ... kidney injury ( ... terlipressin #Albumin
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... injury < 26 weeks ... Production: • Albumin ... hepatitis: < 1 • Cirrhosis ... transaminitis #LFTs
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... Injury Transaminase ... > 20x normal - Acute ... CMV), Alcoholic cirrhosis ... #LFTs #transaminitis
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... Injury (DILI) ... EmoryGastroHep #ACLF #Acute ... #Failure #Cirrhosis
Liver Function Tests (LFTs) - Normal Values and Interpretation Alanine aminotransferase (ALT/SGPT) - Liver, cardiac & skeletal
Liver Function Tests ... (LFTs) - Normal ... hepatocellular injury ... Crigler-Najjar) Albumin ... Function #Tests #LFTs
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Liver Injury: ... Liver Injury: ... Liver Injury: ... hepatitis: < 1 • Cirrhosis
Portal Hypertension - Differential Diagnosis Portal Pressure = the pressure difference between the pressure in the portal
Clues to non-cirrhotic ... INR, bilirubin, albumin ... /acute hepatitis ... sarcoidosis) • Liver ... metastasis • Fatty liver
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
>1.1 g/dl): - Cirrhosis ... ascites - Massive liver ... Veno-occlusive disease - Acute ... fatty liver of ... ascites without cirrhosis
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... injury (INR > 2 ... > 3 mg/dL) or acute ... liver failure
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