The Curbsiders Internal Medicine Podcast

REBOOT #293 The Best of Liver Tests with Dr. Elliot Tapper

33 snips
Sep 4, 2023
Guest
Elliot Tapper
Dr. Elliot Tapper, liver expert, walks us through the best of liver tests. He discusses targeted labs for differentiating hepatocellular versus cholestatic injury, addresses isolated lab abnormalities, and reviews causes of severe acute liver disease and issues in pregnancy. Listen and learn what 'liver function tests' really mean!
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ADVICE

Liver Function Tests Terminology

  • Avoid using the term "liver function tests (LFTs)" for ALT and AST.
  • These enzymes indicate hepatocyte injury, while other tests reflect liver function.
INSIGHT

GGT's Role in Liver Tests

  • GGT, while helpful in some contexts, isn't always reliable for determining Alk Phos origin.
  • Oxidative stress from various liver issues can elevate GGT, reducing its specificity.
ADVICE

Categorizing Liver Injury

  • Categorize liver injury as hepatocellular or cholestatic to guide your diagnostic approach.
  • Use the R-score (ALT/Alk Phos) to distinguish between them.
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