38 results
Clinical Examination for Liver and Biliary Diseases
1) Hands: Clubbing, Dupuytren's contracture, Leuconychia, Bruising, Flapping tremor (hepatic
Examination for Liver ... and Biliary Diseases ... Xanthelasma and jaundiced ... #physicalexam #cirrhosis ... #liver #disease
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic liver ... disease (cirrhosis ... or chronic hepatitis ... Failure, Pancreatic, Biliary
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
HTN: ascites (SAAG ... Ascites protein ... /acute hepatitis ... sarcoidosis) • Liver ... pregnancy • Primary biliary
Diagnosis of ascites according to the serum ascites albumin gradient (SAAG)
SAAG ≥ 1.1:
 - Ascitic protein
Diagnosis of ascites ... SAAG ≥ 1.1: - Ascitic ... protein ≤ 2.5 g/dL: Cirrhosis ... syndrome, Massive liver ... syndrome SAAG < 1.1: Biliary
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Hepatic: • Cirrhosis ... disease • Acute liver ... failure • Primary biliary ... amzn.to/2LmUODZ #Ascites
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... , Toxic Hepatitis ... CMV), Alcoholic cirrhosis ... , Portal Vein Thrombosis ... #Patterns #Liver
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Inflammation - Hepatitis ... 15 percent) - Hepatitis ... congenital - Primary biliary ... Nonalcoholic fatty liver
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Liver disease ... - Cirrhosis ... - Alcoholic hepatitis ... - Acute fatty liver ... Portal vein occlusion
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis
High albumin gradient (>1.1 g/dl):
 - Cirrhosis	
 - Alcoholic
>1.1 g/dl): - Cirrhosis ... - Alcoholic hepatitis ... - Massive liver ... syndrome) - Portal ... Tuberculosis - Biliary
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
Primary Biliary ... /Liver failure ... hyperpigmentation • Jaundice ... or higher • Liver ... Diagnosis: • Viral hepatitis