Morning Report: Cold case 6.27.17

Morning Report: Cold case 6.27.17

Jin Packard presented a very interesting case about acute hepatitis! Thank you Jin, for admitting overnight AND presenting an awesome case. Thank you to Dr. Wong for offering his expert opinion.

This morning we learned:

  1. Ddx for hepatitis with LFTs>1000 is narrow
    • Venous obstruction – Bud-chiari
    • Ischemia – shock liver
    • Toxins – tylenol, aminita mushroom
    • Acute hepatits – A&B
  2. Acute hepatitis C infection…
    • is usually¬†not¬†symptomatic
    • does not result in LFT’s >1000
    • does not commonly occur as far as 6 months after infection
  3. Which hepatitis labs should we order to work-up acute hepatitis?
    • HAV AB
    • HBV AB IgM and viral load
    • HCV AB and viral load
  4. When do we call it liver failure?
    • LFT abnormalities WITH abnormalities in synthetic function (coagulopathy, encephalopathy)

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