83 years old male has been brought to ED by his wife with fever, confusion and epigastric pain. He was seen by GP 2 days ago with fever and was diagnosed as having LRTI ( no antibiotics given ). He has history of T2DM, HTN, and cholecystectomy 10 years ago.
His vitals are : HR 115, BP 105/70, temp 39. RR 22, sats 95 RA, GCS 14 ( confused). abdomen soft, mildly tender RUQ, and epigastrium.
Patient had VBG which was consistent with HAGMA . Electrolytes were normal, lactate 2.5, and Creatinine 125. Patient had other blood tests done as part of workup and LFTs came back as following.
Bilirubin 67 (< 21)
ALP 320 ( 30 -110)
GGT 368 ( < 41)
ALT 248 ( < 36)
Q1: Interpret above Liver function tests ?
2. What is the most likely diagnosis with this clinical picture and LFTs?
3. What are the important considerations in management of this patient ?