GIT CASE 3

EVALUATION OF LIVER FUNCTION

A2 GROUP 10
 LIVER FUNCTION TEST

Detect the Distinguish among To follow the

Gauge the extent
presence of Liver the different type response to the
of liver damage
Disease of liver disorders treatment
 Serum Bilirubin

Type Type of Bilirubin Increased

Prehepatic Total + Unconjugated
Intrahepatic Total + Both
Post hepatic Total + Conjugated

Bilirubin Normal values In our case

Total bilirubin 1-1.5 mg/dl 14 mg/dl ↑
Direct bilirubin <0.3 mg/dl 11 mg/dl ↑
Indirect bilirubin 0-2.0-8 mg/dl 04 mg/dl ↑
 Synthetic Function

Alpha1-
Albumin Ceruloplasmin Clotting factors
antitrypsin
Normal: 3.4-5.4 Normal: 14-40 PT time ( I, II, V, VII
Normal: 75-150
mg/dL: mg/dL & X)
mg/dL

Proteins Normal In our case

Albumin 3.4-5.4 mg/dL 1 g/dL ↓
Prothrombin time 12 seconds 28 seconds ↑
 Alpha- fetoprotein

Synthesized by: Yolk sac and embryonic

liver cells
Normal value: 10-20 ng/mL Normal value In our case
Elevation to 100-200 ng/ml can indicate the 10-20 ng/ml 200 ng/ml ↑
acute liver injury
>400 ng/ml suspects HCC
 MELD score

Purpose
Compute probability of survival
for patients with liver disease MELD SCORE 3 Month mortality (%)
0-9 1.9-3.7
For the priority of liver
10-19 6-20
transplant
20-29 19.6-45.5
Variable used for calculation 30-39 52.6-74.5
Serum bilirubin (14 mg/dL) >40 71-100
Serum creatinine (2.1 mg/dL)
PT time-INR (3.5)

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 RENAL CASE 1
CORTICOSTEROIDS & ACEIs
A2 GROUP 10
 CONTENTS OF DISCUSSION FOR THIS CASE
PHYSICAL DIAGNOSIS CLYDE
Examination of the scrotum
Peripheral Edema
GENERAL PATHOLOGY
Glomerular structure & pathologic response to injury REX
Nephrotic syndrome ANGEL
CLINICAL PATHOLOGY
Examination of urine DOC KEN
Proteinuria BAMISE
Urine cast SEBU
PHARMACOLOGY
Diuretics JAIRAH
Ace inhibitors KUNWOR
Corticosteroids
DIFFERENTIAL DIAGNOSIS & CONCEPT MAP SEBU, JAI, CLYDE
ACE INHIBITORS
CORTICOSTEROIDS