PHAR3819 Lecture Notes - Lecture 12: Viral Hepatitis, Alkaline Phosphatase, Liver Biopsy
23 Jul 2018
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Infections: poisons, diet and lifestyle, malignancy, genetics, medical and social history. Alanine aminotransferase (alt) level of more than three the upper limit of normal. Alkaline phosphatase (alp) level of more than twice the upper limit of normal. A total bilirubin concentration of more than twice. Uln if associated with any elevation of the alanine aminotransferase or alkaline phosphatase level. Drug induced liver disease: often hard to diagnose. Accounts for less than 5% of jaundices patients: higher in older people, at risk drugs, drugs account for 20-50% of fulminant hepatic failure the severe impairment of hepatic functions in the absence of pre-existing liver disease . Predominant initial elevation of the alanine aminotransferase level (alt) Predominant initial elevation of the alkaline phosphatase level (alp) Elevations of both the alanine aminotransferase and alkaline phosphatase levels (alt + alp) Mechanism: hepatocellular impaired formation, obstructive impaired flow, drug toxicity, hepatitis, alcohol etc. Rash or fever in some cases of drug-induced cholestasis.
