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Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
disease US — Normal Bile ... US - Dilated Bile ... Ducts • Common Bile ... Diagnosis #Algorithm #Causes
Primary Biliary Cirrhosis (PBC) - Summary PBC Epidemiology: • Female:Male 9:1 • Common European descent • Age:
small intralobular bile ... of intralobular bile ... ducts causes cholestasis ... of interlobular bile ... related disease, Bile
Classification of Jaundice Unconjugated hyperbilirubinemia (predominantly indirect bilirubin) • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
genes coding for bile ... cholestasis, and some cases ... miscellaneous causes ... external pressure on bile ... #differential #causes
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Algorithm Vascular Causes ... ALP - Surface of bile ... - Cholestasis/Bile ... Unconjugated Bili ... > 90% of Total Bili
IBD - Assessment of Lack of Response (sLOR) - Differential Diagnosis Non-inflammatory mechanisms: • IBS • Fibrostenotic
Malignancy • Other (bile ... Differential #Diagnosis #Causes
What the Color of Urine Can Tell You - Differential Diagnosis by Urine Color Clear: excess water Pale
dehydrated, liver/bile ... differential #diagnosis #causes
Limy Bile Syndrome on POCUS You are performing a POCUS GB exam on elderly woman and notice
Limy Bile Syndrome ... Milk of calcium bile-also ... known as limy bile ... stasis.Rarely known to cause
Alkaline Phosphatase (ALP) Elevation - Differential Diagnosis Algorithm ALP: - Enzymes that catalyze hydrolysis of organic phosphate
Intestine - Other causes ... biliary diseases/Bile
Causes of Green Colored Urine - Differential Diagnosis Drugs/Ingestion: • Cimetidine, Promethazine, Indomethacin, Metoclopramide, Flutamide, Methylene
Causes of Green ... Miscellaneous: • Bile ... Differential #Diagnosis #Causes
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
Causes of Ascites ... Pancreatic ascites - Bile ... peritonitis #Ascites #Causes
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