The Curbsiders Internal Medicine Podcast

REBOOT #293 The Best of Liver Tests with Dr. Elliot Tapper

43 snips
Sep 4, 2023
Guest
Elliot Tapper
Dr. Elliot Tapper, liver expert, walks us through the best of liver tests. He discusses targeted labs for differentiating hepatocellular versus cholestatic injury, addresses isolated lab abnormalities, and reviews causes of severe acute liver disease and issues in pregnancy. Listen and learn what 'liver function tests' really mean!
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INSIGHT

GGT's Role in Liver Tests

  • GGT, while helpful in some contexts, isn't always reliable for determining Alk Phos origin.
  • Oxidative stress from various liver issues can elevate GGT, reducing its specificity.
ADVICE

Categorizing Liver Injury

  • Categorize liver injury as hepatocellular or cholestatic to guide your diagnostic approach.
  • Use the R-score (ALT/Alk Phos) to distinguish between them.
ADVICE

Drug-Induced Liver Injury Prognosis

  • In acute liver injury, consider bilirubin, alkaline phosphatase, and time from ingestion for drug-induced liver injury.
  • Closely monitor patients for general symptoms, anorexia, dehydration, and kidney injury.
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