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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
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
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
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 Thrombocytopenia and Platelet Disorders - Differential Diagnosis and Workup History: - Prior platelet count, family
Diagnosis and Workup ... for decreased PLT ... for decreased PLT ... Diagnosis #Causes #Workup
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
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