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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 ... Drug-Induced Liver Injury ... EmoryGastroHep #ACLF #Acute ... #Cirrhosis #Hepatology
Table of Causes of Acute Liver Injury
#Diagnosis #Hepatology #Acute #Liver #Injury #Causes #Differential #Incidence #Table #Failure
Table of Causes of Acute ... Liver Injury #Diagnosis ... #Hepatology #Acute ... #Liver #Injury ... Incidence #Table #Failure
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ascites removed • Acute ... kidney injury ( ... Indications #Management #Cirrhosis ... #treatment #hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
• NAFLD • Cirrhosis ... Hepatopathy • Acute ... Drug-induced liver injury ... Differential #Diagnosis #hepatology
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver Injury ... > 20x normal - Acute ... CMV), Alcoholic cirrhosis ... Patterns #Liver #Injury ... #hepatology #LFTs
Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine
Criteria HRS-AKI (Acute ... in 3 months • Cirrhosis ... structural kidney injury ... HRS-NAKI (Non-Acute ... HRSAKI #HRSNAKI #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
Clues to non-cirrhotic ... including R heart failure ... /acute hepatitis ... Primary biliary cirrhosis ... Diagnosis #causes #hepatology
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
- Hepatic: • Cirrhosis ... Infiltrative disease • Acute ... liver failure ... Post-Hepatic: • Heart failure ... Diagnosis #Algorithm #Hepatology
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
or fibrosis • Cirrhosis ... with severe liver injury ... > 3 mg/dL) or acute ... liver failure ... Indications #management #hepatology
Causes of Gallbladder Wall Thickening - Differential Diagnosis
 • Physiologic: Contracted gall bladder in a non-fasting
Congestive heart failure ... , Liver cirrhosis ... Inflammatory conditions: Acute ... , Cholangitis, Acute ... Diagnosis #radiology #POCUS