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diagnosis hepatology management differential transaminitis algorithm hepatitis indications acidosis aclf aih aki albumin autoimmune bloodsmear borrelia causes chemistry chronic classification
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-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... months without treatment ... Injury (DILI) ... #Failure #Cirrhosis
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
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Interpretation of LFTs ... Mixed - Check Acute ... injury < 26 weeks ... hepatitis: < 1 • Cirrhosis ... transaminitis #LFTs
Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ascites removed • Acute ... kidney injury ( ... Indications #Management #Cirrhosis ... #treatment #hepatology
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
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
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Injury (DILI) - ... involvement, Kidney injury ... non-essential drug/HDS treatments ... dechallenge • Acute ... #Injury #Diagnosis
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
Torsemide) • Acute ... cirrhosis, chronic ... cirrhosis, and ... hyperaldosteronism • Acute ... Tolvaptan) • Treatment
Acute Kidney Injury (AKI) - Management Principles Prerenal - Correct hemodynamic derangements: • If low preload →
Acute Kidney Injury ... Treat underlying liver ... → No specific treatment ... #Kidney #Injury ... #treatment #management
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