ASGE Annual GI Advanced Practice Provider Course (Virtual) - Day Two

Video Transcription

Video Summary

In this video, Dr. Martin discusses various topics related to liver function tests and their interpretation. He explains that when bilirubin levels are elevated, it is important to differentiate between direct and indirect bilirubin fractions. If the liver enzymes AST, ALT, and alkaline phosphatase are normal, and the total bilirubin is elevated, it is likely due to indirect hyperbilirubinemia, which could be caused by factors such as excess hemolysis or certain syndromes. <br /><br />The discussion also covers the topic of vaccines in patients with inflammatory bowel disease (IBD). While non-live vaccines are safe for patients on biologics, live vaccines should be avoided. Additionally, the COVID-19 vaccine is recommended for IBD patients, with the exception of those on high-dose steroids.<br /><br />The video touches on the management of acute pancreatitis, including the duration of aggressive IV fluid resuscitation, which is typically 24-48 hours. The use of MRCP (magnetic resonance cholangiopancreatography) in cases of idiopathic pancreatitis is discussed, highlighting its value in detecting abnormalities such as pancreas divisum and common bile duct stones. The importance of high-quality imaging and experienced interpretation is emphasized.<br /><br />The conversation also briefly touches on liver testing priorities, with viral hepatitis and autoimmune markers being the initial focus, followed by metabolic markers like iron profiles and celluloplasmin for Wilson's disease. The use of liver biopsy in autoimmune diagnoses is mentioned, highlighting its role in confirming the diagnosis and monitoring treatment effectiveness and prognosis.<br /><br />No credits are mentioned in the video transcript.

Keywords

liver function tests

bilirubin levels

indirect hyperbilirubinemia

IBD vaccines

acute pancreatitis