AFP: American Family Physician Podcast Episode 220 -- December 2024 -- Part 2 AFP: American Family Physician
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Jan 1, 2025 Explore the significance of mildly elevated liver transaminase levels and the overdiagnosis of myocardial infarction. Discover a new DOAC score tool for predicting bleeding risk in atrial fibrillation patients. Delve into the differences between keloids and hypertrophic scars while learning about their management. Gain insights on how weight loss can alleviate knee osteoarthritis symptoms, and uncover the debate around vitamin D testing and supplementation needs. The blend of clinical insights with a light-hearted banter makes for an engaging listen!
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Liver Transaminase Levels
- Elevated liver transaminase levels are surprisingly common, affecting about 10-20% of people.
- These tests, including ALT and AST, are important for liver health assessment, but don't show the whole picture.
Evaluating Elevated Liver Enzymes
- Repeat liver tests after four weeks to confirm persistent elevation.
- Get a detailed history, including alcohol and drug use, and family history of liver or autoimmune diseases.
Troponin and MI Overdiagnosis
- Troponin is a highly sensitive test for myocardial injury, but has low specificity.
- This leads to overdiagnosis of myocardial infarction (MI), as many patients with positive troponin have no coronary obstruction.