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Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... months without treatment ... #Failure #Cirrhosis ... #Hepatology #gastroenterology
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
Causes of Severe ... Acute Liver Injury ... - Drug-Induced liver ... #Causes #Differential ... #Hepatology #Diagnosis
Hepatitis B Virus Serology and Interpretation
HBsAg - Anti-HBs - Anti-HBc - HBeAg - Anti-HBe
 - Acute
- Anti-HBe - Acute ... state (low HBV DNA level ... (high HBV DNA level ... (about 10% of cases ... ) - Acute hepatitis
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Inflammation - Hepatitis ... 15 percent) - Hepatitis ... Nonalcoholic fatty liver ... #Differential #Hepatology ... #Cirrhosis #Causes
Hepatobiliary Manifestations of Sickle Cell Disease
Acute sickle cell hepatic crisis:
 • Fever, acute onset RUQ pain,
Supportive with treatment ... liver failure ... Liver transplant ... Hepatobiliary #hepatology ... #hepatitis #differential
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
• NAFLD • Cirrhosis ... Chronic Viral Hepatitis ... Hepatopathy • Acute ... Viral Hepatitis ... Differential #Diagnosis #hepatology
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... > 20x normal - Acute ... CMV), Alcoholic cirrhosis ... #Patterns #Liver ... #Injury #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
to non-cirrhotic ... Intrahepatic: • Cirrhosis ... /acute hepatitis ... Primary biliary cirrhosis ... #hepatology
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Causes of Acute ... , Acute biliary ... Differential #Diagnosis #Causes ... #Acute #algorithm ... #hepatology
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Non-Malignant • Fatty Liver ... Infectious • Hepatitis ... Primary Biliary Cirrhosis ... Diagnosis #Algorithm #Causes ... #Hepatology