Approach to Abnormal LFTs
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Hepatocellular Versus a Mixed Liver Injury Process
There is a helpful calculation you can do called the R factor which essentially differentiates between a colostatic versus hepatocellular versus a mixed liver injury process. The actual calculation is taking the ALT over the upper limit of normal ALT and then dividing that by the alkphosph over the upperlimit normal of alkphosph. You kind of actually just figure out which one will lead to hepato cellular which one will leading to colostatic process. So once I've gone through that process which we just did here right we said mild hepatoCellular injury but more significant colostatic injury based on the alkaline phosphatase being over twofold up and limited normal
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