The Curbsiders Internal Medicine Podcast #293 The Best of Liver Tests with Dr. Elliot Tapper
4 snips
Sep 6, 2021 AI Snips
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Transcript
Episode notes
Differentiate Enzymes From Function
- ALT/AST are hepatocyte enzymes and ALP reflects biliary injury, so pattern matters more than the label "liver function tests."
- True liver function is tested by albumin, INR, factor V or specialized metabolic tests, not transaminases.
Use R Score To Categorize Injury
- Calculate the R score (ALT/ULN ÷ ALP/ULN) to categorize injury as hepatocellular, cholestatic, or mixed.
- Use the category to guide etiologic thinking and downstream testing.
Bilirubin Is The Prognostic Thermometer
- Bilirubin height strongly predicts prognosis in acute liver injury and drug-induced liver injury.
- Think of bilirubin as the liver's thermometer for severity.