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→Approach to LFTs
==PBC==
==PBC==
*H&P: Age 30-65; F>M; Fatigue and jaundice; pruritis and osteoporosis; associated with hypothyroid and arthritis
*H&P: '''Intrahepatic''' bile duct '''destruction'''; Age 30-65; F>M; Fatigue and jaundice; pruritis and osteoporosis; associated with hypothyroid and arthritis
*Dx: Elevated ALK + bili; '''positive AMA'''
*Dx: Elevated ALK + bili; '''positive AMA'''
*Tx: Ursodeoxycholic acid, cholestyramine, fat-soluble vitamins; transplant in rare cases
*Tx: Ursodeoxycholic acid, cholestyramine, fat-soluble vitamins; transplant in rare cases
==PSC==
==PSC==
*H&P: Age 30-40; M>F; associated with IBD (UC>Crohn's); asymptomatic or presenting with fatigue, pruritic, RUQ pain
*H&P: '''Intra and extra hepatic''' bile duct '''fibrosis'''; Age 30-40; M>F; associated with IBD (UC>Crohn's); asymptomatic or presenting with fatigue, pruritic, RUQ pain
*Dx: Elevated ALK + bili; '''ANA, anti smooth muscle, and anti pANCA''' antibodies.
*Dx: Elevated ALK + bili; '''ANA, anti smooth muscle, and anti pANCA''' antibodies.
*Tx: Ursodeoxycholic acid, cholestyramine, fat-soluble vitamins; transplant '''frequently''' required
*Tx: Ursodeoxycholic acid, cholestyramine, fat-soluble vitamins; transplant '''frequently''' required