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diagnosis differential management causes injury lfts ascites chronic hbv hepatitisb indications saag transaminitis aclf chemistry dili druginduced failure gap gastroenterology
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) ... #Hepatology #gastroenterology
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... > 20x normal - Acute ... cirrhosis, Portal ... #Patterns #Liver ... #Injury #hepatology
Causes of Acute Liver Injury - Differential Diagnosis Hepatocellular - Liver Parenchyma • Infectious: Hepatitis C, A,
Causes of Acute ... HSV • Toxic: Alcohol ... , Acute biliary ... Medication, Pregnancy, Alcoholic ... #algorithm #hepatology
Hepatomegaly - Differential Diagnosis Algorithm Malignant • Primary Carcinoma • Metastases • Lymphoma • Leukemia • Polycythemia
Differential Diagnosis Algorithm ... Non-Malignant • Fatty Liver ... Inflammatory • Alcoholic ... Primary Biliary Cirrhosis ... #Causes #Hepatology
Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Indications for Albumin ... Management of Cirrhosis ... ascites removed • Acute ... terlipressin #Albumin ... #treatment #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm Severe ALT > 15x ULN • Viral • Drugs/Toxins •
Elevated Liver Enzymes ... • NAFLD • Alcohol ... hepatitis • Drugs ... Infiltrative • Cirrhosis ... Others #LFTs #Hepatology
Alcoholic Hepatitis - Management Algorithm 1. Severity assessed not only by MDF (>32) but also by MELD
Alcoholic Hepatitis ... - Management Algorithm ... can be bridge to Liver ... #Algorithm #treatment ... #hepatology
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
>1.1 g/dl): - Cirrhosis ... - Alcoholic hepatitis ... Veno-occlusive disease - Acute ... fatty liver of ... Differential #Diagnosis #hepatology
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
viral hepatitis ... Production: • Albumin ... ALT Ratios: • Alcoholic ... : < 1 • Cirrhosis ... #differential #Hepatology
Chronic Hepatitis B - Diagnosis and Management Algorithm • Who to treat: Essentially treat the pts with
and Management Algorithm ... viremia or have cirrhosis ... #HBV #Algorithm ... Diagnosis #Management #Treatment ... #Hepatology
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