ASGE Annual GI Advanced Practice Provider Course (On-Demand) - Clinical Case-Based Learning (Day Two) | April 2023-Evaluation of Abnormal Liver Function Tests

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This document is a presentation by Dr. John A. Martin on the evaluation of abnormal liver function tests. The objectives of the presentation are to define liver tests, categorize different types of liver tests, discuss the implications of abnormalities in specific liver tests, learn about the disorders associated with liver test abnormalities, and determine how to work up patients with abnormal liver tests.<br /><br />The presentation covers various liver tests and their significance. It includes polling questions to engage the audience and test their knowledge. The liver tests discussed include ALT (alanine aminotransferase), ALP (alkaline phosphatase), bilirubin, γGT (gamma-glutamyl transferase), 5’-nucleotidase, albumin, PT (prothrombin time), and INR (international normalized ratio).<br /><br />The presentation emphasizes that liver tests are more than just numbers and can provide information about liver injury, liver function, ability to synthesize proteins, serum proteins, clotting proteins, and the ability to conjugate and transport bilirubin.<br /><br />Different categories of liver tests are discussed, including liver injury tests, liver synthetic function tests, liver enzymes, and liver function tests. The presentation also clarifies common misconceptions and confusion regarding liver tests, such as the misnomers of "transaminase" and "transaminitis" and the correct usage of terms like "aminotransferase."<br /><br />Patterns of liver test abnormality are presented, including hepatocellular pattern, cholestatic pattern, ultra-high liver enzyme elevations, very high liver injury tests, and moderate elevations of aminotransferases. The presentation emphasizes the importance of history and physical examination in guiding the workup of abnormal liver tests.<br /><br />The presentation concludes with case scenarios that illustrate the application of the concepts discussed and provide examples of management approaches for different liver test abnormalities.<br /><br />Overall, this document provides a comprehensive overview of the evaluation of abnormal liver function tests and is intended to educate healthcare professionals on the topic.

Asset Subtitle

John Martin, MD, FASGE

Keywords

abnormal liver function tests

liver tests