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diagnosis management algorithm differential hematology clinical treatment checklist evaluation hepatology causes nephrology anesthesia anesthesiology endocrinology pulmonary peds cardiology intraoperative criticalcare
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)
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis Hepatocellular Pattern (ALT or AST > ALP):
: • Severe - ALT ... >15X ULN ... • Moderate - ALT ... < 5x ULN ... Pattern (ALP > ALT
Standardized Physical Abuse Guideline <6 months of age • Social work consult • Skeletal survey • Head
age • Social work ... Head CT, AST, ALT ... Abdominal CT if AST or ALT ... age if AST or ALT ... Abuse #Guidelines #Workup
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 ... phosphatase + ULN
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Algorithm Severe ALT ... > 15x ULN • Viral ... HELLP Moderate ALT ... 5-15x ULN • Viral ... • Others Mild ALT
Pancytopenia - Differential Diagnosis Algorithm • 12-13 g/dL, • ANC < 1800/uL, • platelet < 150,000/uL Initial
• ANC < 1800/uL ... platelet < 150,000/uL ... Initial Workup ... Algorithm #hematology #workup
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 ... • ALT: Specific
Hypercalcemia Evaluation 1) Clinical clues - Is the patient symptomatic? - Family history? - Have you done
likely - Mid range/ULN ... Hypercalcemia #workup ... elevated #evaluation #workup
Causes of Approach to Altered Level of Consciousness - Workup Clinical Exam - Focal • Trauma •
Consciousness - Workup ... Refer to Blood Work ... Altered #ALOC #Workup ... #diagnosis #workup
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
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