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Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Liver Enzymes - Differential ... Algorithm Severe ALT ... > 15x ULN • Viral ... HELLP Moderate ALT ... #LiverEnzymes #Differential
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury Hepatocellular Liver Injury • AST/ALT elevation
Injury • AST/ALT ... > Alk phos • ALT ... • R value = (ALT ... + ULN ALT) / (alkaline ... Transaminitis #diagnosis #differential
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
Function Tests - Differential ... : • Severe - ALT ... >15X ULN ... • Moderate - ALT ... < 5x ULN
Liver Function Test (LFTs) Elevation AST - Cardiac and skeletal muscle, kidney, brain ALT - More specific for
kidney, brain ALT ... ≥ 3x ULN Cholestatic ... R Value = (ALT ... / ULN ALT) / (ALP ... / ULN ALP)
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
R-value: Serum (ALT ... /ULN ALT) / (Alk ... phos/ULN ALP) ... to liver than ALT ... chemistry #diagnosis #differential
Acute Fatty Liver of Pregnancy (AFLP) Pathophysiology: • Defect in fetal free fatty acid metabolism products →
Findings: • ↑AST/ALT ... (5-10x ULN), ↑Tbili ... Cr, ↓Glucose, ↓PLT ... infiltration) Differential
HAS-BLED Score - Hypertension: Baseline SBP > 160mmHg - Renal disease: Cr > 2.6mg/dL, on HD,
bilirubin > 2x ULN ... , or AST/ALT/alkphos ... > 3x ULN - History
Autoimmune Hepatitis Clinical Presentation - Highly variable clinical presentation, from subclinical disease to acute liver failure. -
immunosuppressive tx: - ALT ... + AST > 10x ULN ... - ALT + AST > ... 5x ULN AND IgG ... > 2x ULN - Certain
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
IU/mL), normal ALT ... IU/mL), normal ALT ... IU/mL), normal ALT ... 2000 IU/mL and ALT ... 2000 IU/mL and ALT
Pancytopenia - Differential Diagnosis Algorithm • 12-13 g/dL, • ANC < 1800/uL, • platelet < 150,000/uL Initial
Pancytopenia - Differential ... • ANC < 1800/uL ... platelet < 150,000/uL ... studies, PT/aPTT Differential ... #Pancytopenia #Differential
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