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Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
Liver Function Test ... specific for the liver ... Value = (ALT / ULN ... ALT) / (ALP / ULN ... SinaiBmoreIMRes #Liver
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury Hepatocellular Liver Injury • AST/ALT elevation
Liver Enzymes (LFTs ... and Cholestatic Liver ... Hepatocellular Liver ... value = (ALT + ULN ... phosphatase + ULN
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... Severe ALT > 15x ULN ... Moderate ALT 5-15x ULN ... Mild ALT < 5x ULN
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
Liver Chemistries ... R-value: Serum (ALT/ULN ... ALT) / (Alk phos/ULN ... Identify Acute Liver ... - Specific to liver
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Severe - ALT >15X ULN ... Moderate - ALT 5-15X ULN ... Mild - ALT < 5x ULN
HAS-BLED Score - Hypertension: Baseline SBP > 160mmHg - Renal disease: Cr > 2.6mg/dL, on HD,
transplant - Liver ... bilirubin > 2x ULN ... ALT/alkphos > 3x ULN
Acute Fatty Liver of Pregnancy (AFLP) Pathophysiology: • Defect in fetal free fatty acid metabolism products →
Acute Fatty Liver ... hepatocytes → Liver ... malaise) → Acute liver ... AST/ALT (5-10x ULN ... Transfer to a liver
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
disease to acute liver ... hepatocellular pattern of liver ... ALT + AST > 10x ULN ... ALT + AST > 5x ULN ... AND IgG > 2x ULN
HAS-BLED Score - Risk of Major Bleeding in 1 Year Characteristics (1 point each) • Hypertension: Baseline
transplant • Liver ... bilirubin > 2x ULN ... /Alk phos > 3x ULN
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
IU/mL and ALT > ULN ... infection with severe liver ... mg/dL) or acute liver
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