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hepatology diagnosis differential liver management causes albumin ascites indications lfts saag transaminitis aclf chemistry chronic dili druginduced failure gastroenterology gradient
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... months without treatment ... Failure Infections Alcohol-Associated ... Hepatitis (AAH) ... Drug-Induced Liver Injury
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver Injury ... > 20x normal - Acute ... cirrhosis, Portal ... Patterns #Liver #Injury ... #hepatology #LFTs
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
Liver Injury - Differential ... HSV • Toxic: Alcohol ... obstruction, HELLP Syndrome ... Medication, Pregnancy, Alcoholic ... #algorithm #hepatology
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Differential Diagnosis Algorithm ... • Budd-Chiari Syndrome ... Inflammatory • Alcoholic ... Primary Biliary Cirrhosis ... #Causes #Hepatology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... vein: Budd-chiari syndrome ... ALT Ratios: • Alcoholic ... : < 1 • Cirrhosis ... #hepatology
Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ascites removed • Acute ... kidney injury ( ... • Hepatorenal syndrome ... #treatment #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... non-essential drug/HDS treatments ... HEV, EBV, CMV), Alcohol-related ... dechallenge • Acute ... #hepatology
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... Family history of cirrhosis ... or fibrosis • Cirrhosis ... with severe liver injury ... > 3 mg/dL) or acute
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
viral hepatitis ... ALT Ratios: • Alcoholic ... : < 1 • Cirrhosis ... • Gilbert's syndrome ... #differential #Hepatology
Alcoholic Hepatitis - Management Algorithm Assess Eligibility for Treatment: - Maddrey Discriminant Function ≥ (or possibly MELD
Alcoholic Hepatitis ... - Management Algorithm ... : - Acute kidney ... injury with serum ... #Algorithm #hepatology
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