Specialties
Gastroenterology
Liver tests, GI bleeding, ascites, and the abdomen on call.
Presentations
Ward cases
Black stools on the surgical floor
A consult: day 2 after hip surgery, a cirrhotic patient has melena and a hemoglobin drifting down.
The cirrhotic with a sore belly
A 55-year-old with known cirrhosis feels vaguely unwell; his ascites is 'the same as always'.
Epigastric pain, boring through to the back
A 46-year-old folds forward over the triage desk, vomiting, with pain drilling straight through him.
Interpretation drills
LabsLiver enzymes in the thousandsLabsItch, dark urine, pale stoolsLabsThree days of vomitingLabsThe phosphate that fell after breakfastBlood gasThree days of vomiting, one blood gasBlood gasA week of diarrheaBlood gasThe cold, quiet abdomenBlood gasA normal pH, and nothing else normalFluidSAAG on new ascitesFluidThe low-SAAG ascitesCompareLiver injury patterns
Tools & pathways
Medications
From the library
ALP412 U/L
GGT388 U/L
Bilirubin84 umol/L
ALT66 U/L
AST58 U/L
INR1.1
A cholestatic pattern
Enzymes out of proportion: the pattern question the liver panel module teaches.