gathered from : https://www.aafp.org/pubs/afp/issues/2017/1201/p709.html Prevalence General Guidelines Causes of Elevated Liver Transaminase Levels Normal ALT Levels AST Ratio Categorization of Causes for Mild, Asymptomatic Elevation of Transaminase Levels Nonalcoholic Fatty Liver Disease (NAFLD): Alcoholic Liver Disease: Drug-Induced Liver Injury (DILI): Viral Hepatitis: Hereditary Hemochromatosis: Alpha1-Antitrypsin Deficiency (AATD): Autoimmune Hepatitis: Wilson…

from : https://www.ncbi.nlm.nih.gov/books/NBK482489/ Liver Anatomy and Function Liver Function Tests (LFTs) Patterns of Liver Injury Etiology and Epidemiology Differential Diagnosis Based on Elevated LFTs Components of Liver Function Test Hepatocellular Labs Cholestasis Labs Synthetic Function Tests Serological Tests Secondary Biochemical Liver Tests Results, Reporting, and Critical Findings Correlation with Patient…

Pathophysiology of Jaundice Clinical Presentation of Jaundice Differentials Differential Diagnosis of Jaundice Jaundice Causes: Malfunction in prehepatic, intrahepatic, or posthepatic phases of bilirubin production. Pseudojaundice: From excessive ingestion of beta-carotene-rich foods; no scleral icterus or elevated bilirubin. Prehepatic Causes Intrahepatic Causes Posthepatic Causes Physical Examination Red Flags in History and…

20% of patients with NASH will develop cirrhosis strongly associated with      Risk Factors Management

Epidemiology Causes Clinical Features  Screening for Hepatocellular Carcinoma

A diffuse process characterized by fibrosis of the liver with conversion of normal architecture to structurally abnormal nodules Etiology Commonest causes is alcohol and HBV, BCV Toxins & Drugs AlcoholMethyldopaMethotrexateIsoniazid Infections HBV, HCV Auto-immune Chronic active hepatitis, Primary biliary cirrhosis Metabolic Wilsons diseaseHaemachromatosisAlpha1-antitrypsin deficiencyGlycogen storage diseases Vascular Budd-chiari syndrome (hepatic…

Signs of cirrhosis Peripheral Palmar erythemaDupuytren contractureClubbingLeukonychiaPeripheral hair lossAsterixisPetechiae or ecchymosesMuscle wastingAnkle oedema Face and chest JaundiceFetor hepaticusGynaecomastiaParotid enlargementSpider naevi Abdomen SplenomegalyAscitesCaput medusaeHepatomegaly (only in alcoholic liver disease, haemochromatosis or with hepatocellular carcinoma) Screening and Diagnosis of HCV Infection Transmission Risk Factors Populations to consider for HCV screening: Screening Test…

Risk Factors Epidemiology of Hepatitis B Prevalence by Region Impact of Vaccination Epidemiology in Australia Risk Among Travelers and Overseas Workers Global Control Efforts Immunizations Clinical Investigations HBsAg anti-HBs HBeAg  anti-HBe Anti-HBc IgM Anti-HBc IgG HBV DNA Acute infection + – + –        + –        + Chronic infection…

Acutely unwell + jaundice – consider Causes: Infectious causes: Toxin or substance-related causes include:  Immunologic or inflammatory conditions  Metabolic or hereditary  Pregnancy-related  Ischemic and Vascular  Miscellaneous  Viral Hepatitis A B C D E Agent EnterovirusCapsid ssRNA HepadnaEnveloped dsDNA Unclassified enveloped ssRNA UnclassifiedEnveloped ssRNA Unclassified unenveloped ssRNA Transmission Fecal-oral→ingestion of contaminated food/waterRaw…

Clinically important hereditary Hemochromatosis is rare Only 10% of C282Y Homozygotes manifest disease (remainder are asymptomatic) Cirrhosis develops in 1-2% of C282Y Homozygotes Manifestations are twice as common and more severe in men Etiologies If one parent is affected with two mutated copies (one C282Y and one H63D) for the HFE-hemochromatosis gene, and the other parent…