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diagnosis differential hepatology transaminitis algorithm chemistry disease function gap globulin hematology hepatitis hepatitisb hepbv indications interpretation laboratory management patterns protein
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... severe liver injury ... > 3 mg/dL) or acute ... liver failure
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Tests (LFTs) - ... • NAFLD • Cirrhosis ... Hepatopathy • Acute ... injury) • Ischemic ... 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
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... > 20x normal - Acute ... normal - Infection (EBV ... CMV), Alcoholic cirrhosis ... #LFTs #transaminitis
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... hepatitis serologies, HCV ... hepatitis serologies, HCV ... hepatitis: < 1 • Cirrhosis ... transaminitis #LFTs
Rheumatology Workup - Laboratories Studies in Rheumatic Diseases • Septic arthritis - Gram stain and culture of
Diseases • Septic arthritis ... Screening Tests for Acute ... Additional tests: HIV ... profile, including liver ... function tests (LFTs
Elevated Globulin - Protein Gap (Total Protein - Albumin > 4) Work-up of an Elevated Globulin Gap: •
Viral infections (acute ... (RA, Temporal arteritis ... Sarcoidosis) • Liver ... disease: Cirrhosis ... inflammation (acute
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