Laboratory studies-cirrhosis
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LFTs: ↑ bili, ↑ PT/INR (poor correlation w/ bleeding; factor VIII nl b/c not synthesized by liver), ↓ alb, ± ↑ aminotransferases (AST >ALT if late) and ↑ Aϕ (variable)
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Hematologic tests: anemia (marrow suppress., hypersplenism, Fe ± folate defic.), neutro-penia (hypersplenism), thrombocytopenia (hypersplenism, ↓ Tpo production, EtOH tox)
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Chem: ↓ Na (↑ ADH due to ↓ EAV); ↑ Fe/TIBC, ↑ ferritin (released from hepatocytes)
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Lab indices predictive of cirrhosis: AST/plt >2; Lok index; Bonacini score (JAMA 2012;307:832)
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Indirect markers of fibrosis: FibroTest/FibroSURE, Hepascore (good at differentiating significant fibrosis F2 to F4), FIB-4 index (NAFLD, HCV), NAFLD fibrosis score, APRI (HCV), non-invasive imaging (eg, U/S or MR elastography)
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