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Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
of Severe Acute Liver ... Injury - Ichemic hepatitis ... - Acute biliary ... - Drug-Induced liver ... Hemochromatosis - Primary biliary
Clinical Examination for Liver and Biliary Diseases
1) Hands: Clubbing, Dupuytren's contracture, Leuconychia, Bruising, Flapping tremor (hepatic
Examination for Liver ... and Biliary Diseases ... erythema 2) Face: Jaundice ... Xanthelasma and jaundiced ... Bruising, Edema #biliary
Right Upper Quadrant Pain
Liver:
 - Infectious: Acute viral hepatitis, Liver abscess
 - Non-infectious: hepatitis (Alcohol, Medications),
Quadrant Pain Liver ... Infectious: Acute viral hepatitis ... , Liver abscess ... Non-infectious: hepatitis ... "biliary colic")
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
• Infectious: Hepatitis ... NAFLD, Autoimmune hepatitis ... , Acute biliary ... Sepsis, Viral Hepatitis ... Extrahepatic • Biliary
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... - Ischemic Hepatitis ... , Toxic Hepatitis ... Alcoholic cirrhosis, Portal ... #Patterns #Liver
Clinical diagnosis of Alcoholic Hepatitis (AH)
 • Onset of jaundice within prior 8 weeks
 • Ongoing
diagnosis of Alcoholic Hepatitis ... ) • Onset of jaundice ... IU/L • Serum total ... ) or metabolic liver ... Possible drug-induced liver
Clinical Diagnosis of Autoimmune Hepatitis
 - Onset of jaundice within prior 8 weeks
 - Ongoing consumption
of Autoimmune Hepatitis ... - Onset of jaundice ... <400 - Serum total ... ) or metabolic liver ... Possible drug-induced liver
Classification of Jaundice
Unconjugated hyperbilirubinemia (predominantly indirect bilirubin)
 • Increased bilirubin production (eg, hemolytic anemias, hemolytic reactions,
Classification of Jaundice ... Dysfunction - Biliary ... hepatocyte damage (eg, hepatitis ... postoperative jaundice ... neoplasms #Jaundice
Jaundice - Differential Diagnosis Algorithm
Pre-Hepatic - Unconjugated Hyperbilirubinemia
Increased Production
 • Hemolysis
 • Ineffective Erythropoiesis
 • Hematoma
Decreased
Jaundice - Differential ... Dilatation on Ultrasound ... Biliary Duct Compression ... Gallstones • Biliary ... Cholangitis #Jaundice
Primary Biliary Cirrhosis (PBC) - Summary

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