SlideShare a Scribd company logo

Approach to the patient with abnormal LFTs

•
•
S
salaheldin abusin

The document provides an overview of approach to evaluating abnormal liver function tests (LFTs). It defines relevant liver enzymes and tests. Epidemiology studies show most abnormal LFT cases can be diagnosed noninvasively, and the most common findings are non-alcoholic fatty liver disease and steatohepatitis. A thorough history and physical exam is important to identify potential causes like medications, viruses, autoimmune conditions, or metabolic disorders. Common patterns on lab testing can help indicate hepatocellular injury, cholestasis or other chronic processes. A methodical evaluation and testing approach is outlined.

EducationHealth & Medicine
1 of 38
Approach to The Patient with Abnormal Liver Function Tests Bushra MI Sulieman, MD MS Consultant, Gastroenterology & Hepatology Department of Medicine King Faisal Specialist Hospital & Research Center - Jeddah
Definition  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Kundrotas Dig Dis Sci. 1993;38(12):2145-50. Daniel Am J Gastroenterol. 1999;94(10):3010-4. Skelley J Hepatol. 2001;35(2):195-9. Ruhl Gastroenterology. 2009;136(2):477-85.e11.
Epidemiology Conclusions ,[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical Examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patterns ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory Testing Patterns Pattern Cause  AST/ALT >  ALP  Bilirubin Hepatocellular Injury  ALP > AST/ALT  Bilirubin Cholestasis  Albumin Chronic process (cirrhosis / cancer)  Albumin Acute process (viral hepatitis / choledocholithiasis.  PT/INR Prolonged jaundice / Vit K malabsorption Hepatocellular dysfunction.
Mild Chronic AST/ALT Elevation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation Medications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Watkins JAMA. 2006;296(1):87-93.
Mild Chronic AST/ALT Elevation Alcohol Abuse ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Cohen Dig Dis Sci. 1979;24(11):835-8.
Mild Chronic AST/ALT Elevation Viral Hepatitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation Hereditary Hemochromatosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation Fatty Liver/NASH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation Autoimmune Hepatitis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation Metabolic/other conditions ,[object Object],[object Object]
Mild Chronic AST/ALT Elevation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mild Chronic AST/ALT Elevation ,[object Object],[object Object],[object Object],[object Object],Das, A, Post, AB. Should liver biopsy be done in asymptomatic patients with chronically elevated transaminases: A cost-utility analysis (abstract). Gastroenterology 1998; 114:A9. ,[object Object],[object Object],[object Object]
Isolated Hyperbilirubinemia Unconjugated ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Isolated Hyperbilirubinemia Conjugated ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Isolated Elevation in GGT ± ALP
Laboratory Testing Patterns Pattern Cause  AST/ALT >  ALP  Bilirubin Hepatocellular Injury  ALP > AST/ALT  Bilirubin Cholestasis  Albumin Chronic process (cirrhosis / cancer)  Albumin Acute process (viral hepatitis / choledocholithiasis.  PT/INR Prolonged jaundice / Vit K malabsorption Hepatocellular dysfunction.
Imaging ,[object Object],[object Object],[object Object],[object Object]
 
 
 
Case One ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case One ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Two ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Two ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Three ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Three ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Four ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case Four ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SAMA www.sama-sd.org

Recommended

Abnormal liver function tests
Abnormal liver function testsAbnormal liver function tests
Abnormal liver function testsAhmed Adel
 
Evaluation of liver function tests ppt
Evaluation of liver function tests pptEvaluation of liver function tests ppt
Evaluation of liver function tests pptDhiraj Kumar
 
APPROACH TO ABNORMAL LFT
APPROACH TO ABNORMAL LFTAPPROACH TO ABNORMAL LFT
APPROACH TO ABNORMAL LFTNavas Shareef
 
Liver Function Tests - An Approach for Primary Care
Liver Function Tests - An Approach for Primary CareLiver Function Tests - An Approach for Primary Care
Liver Function Tests - An Approach for Primary CareJarrod Lee
 
Approach to lft
Approach to lftApproach to lft
Approach to lftAbhinav Srivastava
 
Approach To A Patient With Jaundice
Approach To A Patient With JaundiceApproach To A Patient With Jaundice
Approach To A Patient With JaundiceTanuj Bhatia
 
An approach to jaundice
An approach to jaundiceAn approach to jaundice
An approach to jaundiceKathiravan Ar
 
Autoimmune hepatitis rajesh
Autoimmune hepatitis rajeshAutoimmune hepatitis rajesh
Autoimmune hepatitis rajeshMohit Aggarwal
 

Recommended

Abnormal liver function tests
Abnormal liver function testsAbnormal liver function tests
Abnormal liver function testsAhmed Adel
 
Evaluation of liver function tests ppt
Evaluation of liver function tests pptEvaluation of liver function tests ppt
Evaluation of liver function tests pptDhiraj Kumar
 
APPROACH TO ABNORMAL LFT
APPROACH TO ABNORMAL LFTAPPROACH TO ABNORMAL LFT
APPROACH TO ABNORMAL LFTNavas Shareef
 
Liver Function Tests - An Approach for Primary Care
Liver Function Tests - An Approach for Primary CareLiver Function Tests - An Approach for Primary Care
Liver Function Tests - An Approach for Primary CareJarrod Lee
 
Approach to lft
Approach to lftApproach to lft
Approach to lftAbhinav Srivastava
 
Approach To A Patient With Jaundice
Approach To A Patient With JaundiceApproach To A Patient With Jaundice
Approach To A Patient With JaundiceTanuj Bhatia
 
An approach to jaundice
An approach to jaundiceAn approach to jaundice
An approach to jaundiceKathiravan Ar
 
Autoimmune hepatitis rajesh
Autoimmune hepatitis rajeshAutoimmune hepatitis rajesh
Autoimmune hepatitis rajeshMohit Aggarwal
 
Approach to a patient with JAUNDICE
Approach to a patient with JAUNDICEApproach to a patient with JAUNDICE
Approach to a patient with JAUNDICEDJ CrissCross
 
Bilirubin metabolism
Bilirubin metabolismBilirubin metabolism
Bilirubin metabolismMista Farace
 
Interpretation of Liver Function Tests
Interpretation of Liver Function TestsInterpretation of Liver Function Tests
Interpretation of Liver Function TestsStanley Medical College, Department of Medicine
 
jaundice approach
jaundice approachjaundice approach
jaundice approachNavas Shareef
 
Liver function tests final
Liver function tests finalLiver function tests final
Liver function tests finalPrabhakaranpd Payam
 
Clinical approach to jaundice
Clinical approach to jaundiceClinical approach to jaundice
Clinical approach to jaundiceKarthika Ramadoss
 
L2. approach to jaundice
L2. approach to jaundiceL2. approach to jaundice
L2. approach to jaundicebilal natiq
 
Diagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesDiagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesWaleed El-Refaey
 
Interpretation of Liver function test
Interpretation of Liver function testInterpretation of Liver function test
Interpretation of Liver function testKinisha Patel
 
Laboratory Diagnosis of Jaundice
Laboratory Diagnosis of JaundiceLaboratory Diagnosis of Jaundice
Laboratory Diagnosis of JaundiceDr. Varughese George
 
Abnormal LFT's
Abnormal LFT'sAbnormal LFT's
Abnormal LFT'sElmuhtady Said FRCP FEBGH
 
Hepatitis C.Diagnosis and Management. AASLD Guidelines
Hepatitis C.Diagnosis and Management. AASLD GuidelinesHepatitis C.Diagnosis and Management. AASLD Guidelines
Hepatitis C.Diagnosis and Management. AASLD GuidelinesDr. Afzal Haq Asif
 
Approach to jaundice
Approach to jaundiceApproach to jaundice
Approach to jaundiceDr. RAJKOTI REDDY GONDI
 
Approach to jaundice
Approach to jaundice Approach to jaundice
Approach to jaundice AZu SA
 
Autoimmune Hepatitis
Autoimmune HepatitisAutoimmune Hepatitis
Autoimmune HepatitisPratap Tiwari
 
Jaundice
JaundiceJaundice
Jaundiceautumnpianist
 
Approach To a Patient with Ascitis
Approach To a Patient with AscitisApproach To a Patient with Ascitis
Approach To a Patient with AscitisDr. Ahammad Shamir Shawrov
 
Approach to jaundice
Approach to jaundiceApproach to jaundice
Approach to jaundiceSaurabh Singhal
 
Case scenarios in wilson disease by Dr Aabha Nagral
Case scenarios in wilson disease by Dr Aabha NagralCase scenarios in wilson disease by Dr Aabha Nagral
Case scenarios in wilson disease by Dr Aabha NagralSanjeev Kumar
 
Approach to cholestatic jaundice
Approach to cholestatic jaundiceApproach to cholestatic jaundice
Approach to cholestatic jaundiceRam Raut
 
Liver function tests
Liver function testsLiver function tests
Liver function testsEkta Jajodia
 
Liver Function Test
Liver Function TestLiver Function Test
Liver Function TestDr.M.Prasad Naidu
 

More Related Content

What's hot

Approach to a patient with JAUNDICE
Approach to a patient with JAUNDICEApproach to a patient with JAUNDICE
Approach to a patient with JAUNDICEDJ CrissCross
 
Bilirubin metabolism
Bilirubin metabolismBilirubin metabolism
Bilirubin metabolismMista Farace
 
Clinical approach to jaundice
Clinical approach to jaundiceClinical approach to jaundice
Clinical approach to jaundiceKarthika Ramadoss
 
L2. approach to jaundice
L2. approach to jaundiceL2. approach to jaundice
L2. approach to jaundicebilal natiq
 
Diagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesDiagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesWaleed El-Refaey
 
Interpretation of Liver function test
Interpretation of Liver function testInterpretation of Liver function test
Interpretation of Liver function testKinisha Patel
 
Hepatitis C.Diagnosis and Management. AASLD Guidelines
Hepatitis C.Diagnosis and Management. AASLD GuidelinesHepatitis C.Diagnosis and Management. AASLD Guidelines
Hepatitis C.Diagnosis and Management. AASLD GuidelinesDr. Afzal Haq Asif
 
Approach to jaundice
Approach to jaundice Approach to jaundice
Approach to jaundice AZu SA
 
Autoimmune Hepatitis
Autoimmune HepatitisAutoimmune Hepatitis
Autoimmune HepatitisPratap Tiwari
 
Case scenarios in wilson disease by Dr Aabha Nagral
Case scenarios in wilson disease by Dr Aabha NagralCase scenarios in wilson disease by Dr Aabha Nagral
Case scenarios in wilson disease by Dr Aabha NagralSanjeev Kumar
 
Approach to cholestatic jaundice
Approach to cholestatic jaundiceApproach to cholestatic jaundice
Approach to cholestatic jaundiceRam Raut
 

What's hot (20)

Approach to a patient with JAUNDICE
Approach to a patient with JAUNDICEApproach to a patient with JAUNDICE
Approach to a patient with JAUNDICE
 
Bilirubin metabolism
Bilirubin metabolismBilirubin metabolism
Bilirubin metabolism
 
Interpretation of Liver Function Tests
Interpretation of Liver Function TestsInterpretation of Liver Function Tests
Interpretation of Liver Function Tests
 
jaundice approach
jaundice approachjaundice approach
jaundice approach
 
Liver function tests final
Liver function tests finalLiver function tests final
Liver function tests final
 
Clinical approach to jaundice
Clinical approach to jaundiceClinical approach to jaundice
Clinical approach to jaundice
 
L2. approach to jaundice
L2. approach to jaundiceL2. approach to jaundice
L2. approach to jaundice
 
Diagnosis and Treatment of Ascites
Diagnosis and Treatment of AscitesDiagnosis and Treatment of Ascites
Diagnosis and Treatment of Ascites
 
Interpretation of Liver function test
Interpretation of Liver function testInterpretation of Liver function test
Interpretation of Liver function test
 
Laboratory Diagnosis of Jaundice
Laboratory Diagnosis of JaundiceLaboratory Diagnosis of Jaundice
Laboratory Diagnosis of Jaundice
 
Abnormal LFT's
Abnormal LFT'sAbnormal LFT's
Abnormal LFT's
 
Hepatitis C.Diagnosis and Management. AASLD Guidelines
Hepatitis C.Diagnosis and Management. AASLD GuidelinesHepatitis C.Diagnosis and Management. AASLD Guidelines
Hepatitis C.Diagnosis and Management. AASLD Guidelines
 
Approach to jaundice
Approach to jaundiceApproach to jaundice
Approach to jaundice
 
Approach to jaundice
Approach to jaundice Approach to jaundice
Approach to jaundice
 
Autoimmune Hepatitis
Autoimmune HepatitisAutoimmune Hepatitis
Autoimmune Hepatitis
 
Jaundice
JaundiceJaundice
Jaundice
 
Approach To a Patient with Ascitis
Approach To a Patient with AscitisApproach To a Patient with Ascitis
Approach To a Patient with Ascitis
 
Approach to jaundice
Approach to jaundiceApproach to jaundice
Approach to jaundice
 
Case scenarios in wilson disease by Dr Aabha Nagral
Case scenarios in wilson disease by Dr Aabha NagralCase scenarios in wilson disease by Dr Aabha Nagral
Case scenarios in wilson disease by Dr Aabha Nagral
 
Approach to cholestatic jaundice
Approach to cholestatic jaundiceApproach to cholestatic jaundice
Approach to cholestatic jaundice
 

Viewers also liked

Liver function tests
Liver function testsLiver function tests
Liver function testsEkta Jajodia
 
LIVER FUNCTION TESTS (LFT)
LIVER FUNCTION TESTS (LFT)LIVER FUNCTION TESTS (LFT)
LIVER FUNCTION TESTS (LFT)YESANNA
 
Liver anatomy, physiology and imporatance to anesthesia
Liver anatomy, physiology and imporatance to anesthesia Liver anatomy, physiology and imporatance to anesthesia
Liver anatomy, physiology and imporatance to anesthesia Dr. Priyanka Shah
 
complex medical disorders in pregnancy
complex medical disorders in pregnancy complex medical disorders in pregnancy
complex medical disorders in pregnancy partha sarathi roy
 
Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...
Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...
Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...Apollo Hospitals
 
Top 20 disaster remedies
Top 20 disaster remediesTop 20 disaster remedies
Top 20 disaster remediesKohinour Osman
 
Liver Failure Case
Liver Failure CaseLiver Failure Case
Liver Failure Casejcm MD
 
Serology for viral hepatitis
Serology for viral hepatitisSerology for viral hepatitis
Serology for viral hepatitisMohammed Sabry
 

Viewers also liked (20)

Liver function tests
Liver function testsLiver function tests
Liver function tests
 
Liver Function Test
Liver Function TestLiver Function Test
Liver Function Test
 
LIVER FUNCTION TESTS (LFT)
LIVER FUNCTION TESTS (LFT)LIVER FUNCTION TESTS (LFT)
LIVER FUNCTION TESTS (LFT)
 
Liver function test
Liver function testLiver function test
Liver function test
 
Liver function tests
Liver function testsLiver function tests
Liver function tests
 
Liver anatomy, physiology and imporatance to anesthesia
Liver anatomy, physiology and imporatance to anesthesia Liver anatomy, physiology and imporatance to anesthesia
Liver anatomy, physiology and imporatance to anesthesia
 
Shock
ShockShock
Shock
 
Chapter 4 enzymes and vitamins
Chapter 4 enzymes and vitaminsChapter 4 enzymes and vitamins
Chapter 4 enzymes and vitamins
 
Managing Abnormal LFTs
Managing Abnormal LFTsManaging Abnormal LFTs
Managing Abnormal LFTs
 
complex medical disorders in pregnancy
complex medical disorders in pregnancy complex medical disorders in pregnancy
complex medical disorders in pregnancy
 
Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...
Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...
Extra Hepatic Portal Vein Obstruction (EHPVO) with Extensive Mesenteric Venou...
 
Top 20 disaster remedies
Top 20 disaster remediesTop 20 disaster remedies
Top 20 disaster remedies
 
CNS and Liver in Pregnancy
CNS and Liver in PregnancyCNS and Liver in Pregnancy
CNS and Liver in Pregnancy
 
Non Alcoholic Steatohepatitis
Non Alcoholic SteatohepatitisNon Alcoholic Steatohepatitis
Non Alcoholic Steatohepatitis
 
Liver 1
Liver 1Liver 1
Liver 1
 
Physiology of liver
Physiology of liverPhysiology of liver
Physiology of liver
 
NAFLD
NAFLDNAFLD
NAFLD
 
functions-of-the-liver-lft
functions-of-the-liver-lftfunctions-of-the-liver-lft
functions-of-the-liver-lft
 
Liver Failure Case
Liver Failure CaseLiver Failure Case
Liver Failure Case
 
Serology for viral hepatitis
Serology for viral hepatitisSerology for viral hepatitis
Serology for viral hepatitis
 

Similar to Approach to the patient with abnormal LFTs

2-Approach-to-Elevated-LFT.ppt
2-Approach-to-Elevated-LFT.ppt2-Approach-to-Elevated-LFT.ppt
2-Approach-to-Elevated-LFT.pptssuserfc13e9
 
Nonalcoholic fatty liver disease
Nonalcoholic fatty liver diseaseNonalcoholic fatty liver disease
Nonalcoholic fatty liver diseaseAshish Kumar
 
Liver functions, disorders and diagnostic tests - ppt
Liver functions, disorders and diagnostic tests - pptLiver functions, disorders and diagnostic tests - ppt
Liver functions, disorders and diagnostic tests - pptTeja Naveen
 
Interpretation of Routine Laboratory investigations in General practice
Interpretation of Routine Laboratory investigations in General practiceInterpretation of Routine Laboratory investigations in General practice
Interpretation of Routine Laboratory investigations in General practiceDr.Jithesh.K,MD(Med) MBA(Hosp.Admin)
 
Acute Liver Failure
Acute Liver Failure Acute Liver Failure
Acute Liver Failure AnandNaik65
 
LFT.pptx
LFT.pptxLFT.pptx
LFT.pptxRAJNKIT
 
Investigations in jaundice
Investigations in jaundiceInvestigations in jaundice
Investigations in jaundiceNikhil Bansal
 
DOC-20230920-WA0002..pdf
DOC-20230920-WA0002..pdfDOC-20230920-WA0002..pdf
DOC-20230920-WA0002..pdfSouravPatra73
 
Postoperative jaundice - Dr PSN Raju
Postoperative jaundice - Dr PSN RajuPostoperative jaundice - Dr PSN Raju
Postoperative jaundice - Dr PSN Rajuisakakinada
 
Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-Alcoholic Fatty Liver Disease (NAFLD)Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-Alcoholic Fatty Liver Disease (NAFLD)Sariu Ali
 
Non alcoholic fatty liver disease(NAFLD)
Non alcoholic fatty liver disease(NAFLD)Non alcoholic fatty liver disease(NAFLD)
Non alcoholic fatty liver disease(NAFLD)Bhavin Mandowara
 
11 Turman Management Of Acute Renal Failure In Picu
11 Turman Management Of Acute Renal Failure In Picu11 Turman Management Of Acute Renal Failure In Picu
11 Turman Management Of Acute Renal Failure In PicuDang Thanh Tuan
 

Similar to Approach to the patient with abnormal LFTs (20)

ABNORMAL LFT.ppt
ABNORMAL LFT.pptABNORMAL LFT.ppt
ABNORMAL LFT.ppt
 
2-Approach-to-Elevated-LFT.ppt
2-Approach-to-Elevated-LFT.ppt2-Approach-to-Elevated-LFT.ppt
2-Approach-to-Elevated-LFT.ppt
 
Common liver problems for extern
Common liver problems for externCommon liver problems for extern
Common liver problems for extern
 
Pruebas hepáticas
Pruebas hepáticasPruebas hepáticas
Pruebas hepáticas
 
Nonalcoholic fatty liver disease
Nonalcoholic fatty liver diseaseNonalcoholic fatty liver disease
Nonalcoholic fatty liver disease
 
Liver disease
Liver diseaseLiver disease
Liver disease
 
Liver disease
Liver diseaseLiver disease
Liver disease
 
Liver functions, disorders and diagnostic tests - ppt
Liver functions, disorders and diagnostic tests - pptLiver functions, disorders and diagnostic tests - ppt
Liver functions, disorders and diagnostic tests - ppt
 
Interpretation of Routine Laboratory investigations in General practice
Interpretation of Routine Laboratory investigations in General practiceInterpretation of Routine Laboratory investigations in General practice
Interpretation of Routine Laboratory investigations in General practice
 
Acute Liver Failure
Acute Liver Failure Acute Liver Failure
Acute Liver Failure
 
LFT.pptx
LFT.pptxLFT.pptx
LFT.pptx
 
Investigations in jaundice
Investigations in jaundiceInvestigations in jaundice
Investigations in jaundice
 
Liver functions, disorders
Liver functions, disordersLiver functions, disorders
Liver functions, disorders
 
DOC-20230920-WA0002..pdf
DOC-20230920-WA0002..pdfDOC-20230920-WA0002..pdf
DOC-20230920-WA0002..pdf
 
Postoperative jaundice - Dr PSN Raju
Postoperative jaundice - Dr PSN RajuPostoperative jaundice - Dr PSN Raju
Postoperative jaundice - Dr PSN Raju
 
Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-Alcoholic Fatty Liver Disease (NAFLD)Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-Alcoholic Fatty Liver Disease (NAFLD)
 
Acute hepatitis 2
Acute hepatitis 2Acute hepatitis 2
Acute hepatitis 2
 
Non alcoholic fatty liver disease(NAFLD)
Non alcoholic fatty liver disease(NAFLD)Non alcoholic fatty liver disease(NAFLD)
Non alcoholic fatty liver disease(NAFLD)
 
Acute Liver Failure
Acute Liver Failure Acute Liver Failure
Acute Liver Failure
 
11 Turman Management Of Acute Renal Failure In Picu
11 Turman Management Of Acute Renal Failure In Picu11 Turman Management Of Acute Renal Failure In Picu
11 Turman Management Of Acute Renal Failure In Picu
 

More from salaheldin abusin

CAD 2014 - Introduction to Stress testing
CAD 2014 - Introduction to Stress testingCAD 2014 - Introduction to Stress testing
CAD 2014 - Introduction to Stress testingsalaheldin abusin
 
ARLC 2014 - Narrow complex tachycardias
ARLC 2014 - Narrow complex tachycardiasARLC 2014 - Narrow complex tachycardias
ARLC 2014 - Narrow complex tachycardiassalaheldin abusin
 
Management of chemotherapy complications
Management of chemotherapy complicationsManagement of chemotherapy complications
Management of chemotherapy complicationssalaheldin abusin
 
St elevation myocardial infarction
St elevation myocardial infarctionSt elevation myocardial infarction
St elevation myocardial infarctionsalaheldin abusin
 
Chest pain structured approach
Chest pain structured approachChest pain structured approach
Chest pain structured approachsalaheldin abusin
 

More from salaheldin abusin (20)

CAD 2014 - Introduction to Stress testing
CAD 2014 - Introduction to Stress testingCAD 2014 - Introduction to Stress testing
CAD 2014 - Introduction to Stress testing
 
CAD 2014 - NSTE ACS
CAD 2014 - NSTE ACS CAD 2014 - NSTE ACS
CAD 2014 - NSTE ACS
 
ARLC 2014 - Narrow complex tachycardias
ARLC 2014 - Narrow complex tachycardiasARLC 2014 - Narrow complex tachycardias
ARLC 2014 - Narrow complex tachycardias
 
ARLC 2014 - Bradycardias
ARLC 2014 - Bradycardias ARLC 2014 - Bradycardias
ARLC 2014 - Bradycardias
 
Management of chemotherapy complications
Management of chemotherapy complicationsManagement of chemotherapy complications
Management of chemotherapy complications
 
Electrolytes disorders
Electrolytes disordersElectrolytes disorders
Electrolytes disorders
 
St elevation myocardial infarction
St elevation myocardial infarctionSt elevation myocardial infarction
St elevation myocardial infarction
 
Acute respiratory failure
Acute respiratory failureAcute respiratory failure
Acute respiratory failure
 
Heart failure
Heart failure Heart failure
Heart failure
 
Sepsis
SepsisSepsis
Sepsis
 
Pulmonary embolism
Pulmonary embolismPulmonary embolism
Pulmonary embolism
 
Heart Failure
Heart FailureHeart Failure
Heart Failure
 
Wide complex tachycardia
Wide complex tachycardiaWide complex tachycardia
Wide complex tachycardia
 
Approaching an acutely ill
Approaching an acutely illApproaching an acutely ill
Approaching an acutely ill
 
Shock
ShockShock
Shock
 
Ethics and Professionalism
Ethics and ProfessionalismEthics and Professionalism
Ethics and Professionalism
 
Narrow complex tachycardias
Narrow complex tachycardiasNarrow complex tachycardias
Narrow complex tachycardias
 
Bradycardias
BradycardiasBradycardias
Bradycardias
 
Chest pain structured approach
Chest pain structured approachChest pain structured approach
Chest pain structured approach
 
Course overview
Course overviewCourse overview
Course overview
 

Recently uploaded

SKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptx
SKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptxSKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptx
SKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptxAmanpreet Kaur
 
Python Notes for mca i year students osmania university.docx
Python Notes for mca i year students osmania university.docxPython Notes for mca i year students osmania university.docx
Python Notes for mca i year students osmania university.docxRamakrishna Reddy Bijjam
 
UGC NET Paper 1 Mathematical Reasoning & Aptitude.pdf
UGC NET Paper 1 Mathematical Reasoning & Aptitude.pdfUGC NET Paper 1 Mathematical Reasoning & Aptitude.pdf
UGC NET Paper 1 Mathematical Reasoning & Aptitude.pdfNirmal Dwivedi
 
PROCESS RECORDING FORMAT.docx
PROCESS RECORDING FORMAT.docxPROCESS RECORDING FORMAT.docx
PROCESS RECORDING FORMAT.docxPoojaSen20
 
Application orientated numerical on hev.ppt
Application orientated numerical on hev.pptApplication orientated numerical on hev.ppt
Application orientated numerical on hev.pptRamjanShidvankar
 
Micro-Scholarship, What it is, How can it help me.pdf
Micro-Scholarship, What it is, How can it help me.pdfMicro-Scholarship, What it is, How can it help me.pdf
Micro-Scholarship, What it is, How can it help me.pdfPoh-Sun Goh
 
General Principles of Intellectual Property: Concepts of Intellectual Proper...
General Principles of Intellectual Property: Concepts of Intellectual Proper...General Principles of Intellectual Property: Concepts of Intellectual Proper...
General Principles of Intellectual Property: Concepts of Intellectual Proper...Poonam Aher Patil
 
Third Battle of Panipat detailed notes.pptx
Third Battle of Panipat detailed notes.pptxThird Battle of Panipat detailed notes.pptx
Third Battle of Panipat detailed notes.pptxAmita Gupta
 
1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdf1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdfQucHHunhnh
 
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in DelhiRussian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhikauryashika82
 
ICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptxICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptxAreebaZafar22
 
Dyslexia AI Workshop for Slideshare.pptx
Dyslexia AI Workshop for Slideshare.pptxDyslexia AI Workshop for Slideshare.pptx
Dyslexia AI Workshop for Slideshare.pptxcallscotland1987
 
How to Create and Manage Wizard in Odoo 17
How to Create and Manage Wizard in Odoo 17How to Create and Manage Wizard in Odoo 17
How to Create and Manage Wizard in Odoo 17Celine George
 
psychiatric nursing HISTORY COLLECTION .docx
psychiatric nursing HISTORY COLLECTION .docxpsychiatric nursing HISTORY COLLECTION .docx
psychiatric nursing HISTORY COLLECTION .docxPoojaSen20
 
SOC 101 Demonstration of Learning Presentation
SOC 101 Demonstration of Learning PresentationSOC 101 Demonstration of Learning Presentation
SOC 101 Demonstration of Learning Presentationcamerronhm
 
Sociology 101 Demonstration of Learning Exhibit
Sociology 101 Demonstration of Learning ExhibitSociology 101 Demonstration of Learning Exhibit
Sociology 101 Demonstration of Learning Exhibitjbellavia9
 
On National Teacher Day, meet the 2024-25 Kenan Fellows
On National Teacher Day, meet the 2024-25 Kenan FellowsOn National Teacher Day, meet the 2024-25 Kenan Fellows
On National Teacher Day, meet the 2024-25 Kenan FellowsMebane Rash
 
Basic Civil Engineering first year Notes- Chapter 4 Building.pptx
Basic Civil Engineering first year Notes- Chapter 4 Building.pptxBasic Civil Engineering first year Notes- Chapter 4 Building.pptx
Basic Civil Engineering first year Notes- Chapter 4 Building.pptxDenish Jangid
 
ComPTIA Overview | Comptia Security+ Book SY0-701
ComPTIA Overview | Comptia Security+ Book SY0-701ComPTIA Overview | Comptia Security+ Book SY0-701
ComPTIA Overview | Comptia Security+ Book SY0-701bronxfugly43
 

Recently uploaded (20)

SKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptx
SKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptxSKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptx
SKILL OF INTRODUCING THE LESSON MICRO SKILLS.pptx
 
Python Notes for mca i year students osmania university.docx
Python Notes for mca i year students osmania university.docxPython Notes for mca i year students osmania university.docx
Python Notes for mca i year students osmania university.docx
 
UGC NET Paper 1 Mathematical Reasoning & Aptitude.pdf
UGC NET Paper 1 Mathematical Reasoning & Aptitude.pdfUGC NET Paper 1 Mathematical Reasoning & Aptitude.pdf
UGC NET Paper 1 Mathematical Reasoning & Aptitude.pdf
 
PROCESS RECORDING FORMAT.docx
PROCESS RECORDING FORMAT.docxPROCESS RECORDING FORMAT.docx
PROCESS RECORDING FORMAT.docx
 
Application orientated numerical on hev.ppt
Application orientated numerical on hev.pptApplication orientated numerical on hev.ppt
Application orientated numerical on hev.ppt
 
Micro-Scholarship, What it is, How can it help me.pdf
Micro-Scholarship, What it is, How can it help me.pdfMicro-Scholarship, What it is, How can it help me.pdf
Micro-Scholarship, What it is, How can it help me.pdf
 
General Principles of Intellectual Property: Concepts of Intellectual Proper...
General Principles of Intellectual Property: Concepts of Intellectual Proper...General Principles of Intellectual Property: Concepts of Intellectual Proper...
General Principles of Intellectual Property: Concepts of Intellectual Proper...
 
Third Battle of Panipat detailed notes.pptx
Third Battle of Panipat detailed notes.pptxThird Battle of Panipat detailed notes.pptx
Third Battle of Panipat detailed notes.pptx
 
1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdf1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdf
 
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in DelhiRussian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
 
ICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptxICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptx
 
Dyslexia AI Workshop for Slideshare.pptx
Dyslexia AI Workshop for Slideshare.pptxDyslexia AI Workshop for Slideshare.pptx
Dyslexia AI Workshop for Slideshare.pptx
 
How to Create and Manage Wizard in Odoo 17
How to Create and Manage Wizard in Odoo 17How to Create and Manage Wizard in Odoo 17
How to Create and Manage Wizard in Odoo 17
 
psychiatric nursing HISTORY COLLECTION .docx
psychiatric nursing HISTORY COLLECTION .docxpsychiatric nursing HISTORY COLLECTION .docx
psychiatric nursing HISTORY COLLECTION .docx
 
SOC 101 Demonstration of Learning Presentation
SOC 101 Demonstration of Learning PresentationSOC 101 Demonstration of Learning Presentation
SOC 101 Demonstration of Learning Presentation
 
Sociology 101 Demonstration of Learning Exhibit
Sociology 101 Demonstration of Learning ExhibitSociology 101 Demonstration of Learning Exhibit
Sociology 101 Demonstration of Learning Exhibit
 
Asian American Pacific Islander Month DDSD 2024.pptx
Asian American Pacific Islander Month DDSD 2024.pptxAsian American Pacific Islander Month DDSD 2024.pptx
Asian American Pacific Islander Month DDSD 2024.pptx
 
On National Teacher Day, meet the 2024-25 Kenan Fellows
On National Teacher Day, meet the 2024-25 Kenan FellowsOn National Teacher Day, meet the 2024-25 Kenan Fellows
On National Teacher Day, meet the 2024-25 Kenan Fellows
 
Basic Civil Engineering first year Notes- Chapter 4 Building.pptx
Basic Civil Engineering first year Notes- Chapter 4 Building.pptxBasic Civil Engineering first year Notes- Chapter 4 Building.pptx
Basic Civil Engineering first year Notes- Chapter 4 Building.pptx
 
ComPTIA Overview | Comptia Security+ Book SY0-701
ComPTIA Overview | Comptia Security+ Book SY0-701ComPTIA Overview | Comptia Security+ Book SY0-701
ComPTIA Overview | Comptia Security+ Book SY0-701
 

Approach to the patient with abnormal LFTs

  • 1. Approach to The Patient with Abnormal Liver Function Tests Bushra MI Sulieman, MD MS Consultant, Gastroenterology & Hepatology Department of Medicine King Faisal Specialist Hospital & Research Center - Jeddah
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8. Laboratory Testing Patterns Pattern Cause  AST/ALT >  ALP  Bilirubin Hepatocellular Injury  ALP > AST/ALT  Bilirubin Cholestasis  Albumin Chronic process (cirrhosis / cancer)  Albumin Acute process (viral hepatitis / choledocholithiasis.  PT/INR Prolonged jaundice / Vit K malabsorption Hepatocellular dysfunction.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24. Isolated Elevation in GGT ± ALP
  • 25. Laboratory Testing Patterns Pattern Cause  AST/ALT >  ALP  Bilirubin Hepatocellular Injury  ALP > AST/ALT  Bilirubin Cholestasis  Albumin Chronic process (cirrhosis / cancer)  Albumin Acute process (viral hepatitis / choledocholithiasis.  PT/INR Prolonged jaundice / Vit K malabsorption Hepatocellular dysfunction.
  • 26.
  • 27.  
  • 28.  
  • 29.  
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.