ALT, AST yüksekliği  akut hepatocellular hasar

ALT, AST normali:

Akut viral hepatit – hepatit A, hepatit E: kronikleşmez
B, C, D kronikleşir
Fulminant hepatit  Yüksek mortalite ile seyreder
Acute hepatitis + hepatic encephalopathy  fulminant hepatitis
PE:
0.WASH HANDS – be on the right side of the patient
1.BP
2.Temperature
3.HR: Radial pulse: Check heart rate
4.RR: Tell respiration rhythm and rate is normal
5.Check eyes for anemia
6.LN: suboccipital, postauricular, preauricular, post neck, anterior neck, submandibular
from both sides, mental, supraclavicular lymph nodes
7. Open mouth – feel dryness in your mouth?
8. Carotid auscultation
9. Carotid pulse check
10. Thyroid?
11. Checking hands
12. Digital clubbing
13. Axillary lymph nodes
14. Costovertebral angle tenderness
15. Abdomen
1. Inspecting abdomen if is there any abnormality seen
2. Inspecting abdomen if is there any scar and any bruising
3. Auscultation of 4 quadrants
4. Auscultation of renal arteries & abdomen
5. Percussion of liver
6. Percussion of Traube space
7. Palpation light
8. Palpation (deep)—Hepatomegaly// Splenomegaly
9. Rebound tenderness in McBurney
10. Rebound tenderness in left
11. SUPRAPUBIC TENDERNESS CHECK
12. Palpation of kidney
16.Inguinal lymphadenopathy-femoral artery pulse
17. Posterior tibial pulse
18.Pretibial edema
19.HEADACHE & PHOTOPHOBIA CHECK NECK STIFFNESS
20. WASH HANDS
0. Wash hands
1. BP
2. Temp
3. HR
4. RR
5. Check eyes for anemia
6. Check LNN
7. Open mouth?? Dry mouth
8. Carotid auscultation
9. Carotid pulse check
10. Thyroid check
11. Check hands
12. Check for clubbing
13. Axillary lymph node
14. Costovertebral angle tenderness
15. Abdomen
1. Inspect
2. Inspect
3. Auscultate 4
4. Auscultate renal arteries & abdomen
5. Percussion of liver
6. Percussion of Traube
7. Palpation (light)
8. Palpation (Deep): organomegaly
9. Rebound tenderness right  McBurney
10. Rebound tenderness left
11. Suprapubic tenderness
12. Palpate kidneys
16. Inguinal lymph nodes & Inguinal vessels
17. Posterior medial artery pulse
18. Pretibial edema
19. Headache & photophobia  NECK STIFFNESS
20. WASH HANDS