Approach to Abnormal LFTs
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Hepatobiliary Lung Injury
The R factor can be a more objective measure of the injury type I think we all do a kind of gestalt about is the AST ALT most elevator is at the alcfos but to really kind of clinch it objectively you can use the R factor which is again the ALT over the upper limit normal ALT and then divide that by the alCFos. For patients who like like ours who had a very high level of liver enzyme abnormality such as our patient this having right upper quadrant pain definitely point us to towards the billy area tree although heptidities can cause right upper car pain as well.
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