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Cholestatic Liver Disease: Primary Biliary Cirrhosis vs Primary Sclerosing Cholangitis

#pathophysiology #pbc #psc #hepatology #comparison
Cholestatic Liver ... Disease: Primary ... Biliary Cirrhosis ... Cholangitis #pathophysiology ... #pbc #psc #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
- Differential ... • Infiltrative diseases ... sarcoidosis) • Liver ... metastasis • Fatty liver ... Veno-occlusive disease
Causes of Portal Hypertension According to Site of Vascular Obstruction
1) Prehepatic pre-sinusoidal: Portal vein thrombosis due
or secondary to cirrhosis ... 3) Sinusoidal: Cirrhosis ... , Polycystic liver ... portalhypertension #phtn #differential ... diagnosis #causes #hepatology
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Nonalcoholic fatty liver ... disease - Wilson ... #Diagnosis #Differential ... #Hepatology #Cirrhosis
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... CMV), Alcoholic cirrhosis ... #Patterns #Liver ... #Injury #hepatology ... transaminitis #differential
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic liver ... disease (cirrhosis ... failure - 3-5% Cirrhosis ... #Diagnosis #hepatology
Mechanisms Driving Increased Thrombosis and Bleeding in Liver Disease
Increased Thrombosis 
Increased Platelet-Vesset Wall Interaction 
 •
and Bleeding in Liver ... Disease Increased ... Bleeding #Clot #Cirrhosis ... #Pathophysiology ... #Hepatology #Liver
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
65 years PBC Pathophysiology ... /Liver failure ... • ALT & AST normal ... • Bilirubin - Normal ... bile ducts Differential
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
those with CLD (± cirrhosis ... months without treatment ... disease, liver ... #Failure #Cirrhosis ... #Hepatology #gastroenterology
Causes of Anemia with elevated Mean Corpuscular Volume (MCV) - Differential Diagnosis Algorithm
Normal Blood Smear
 •
Volume (MCV) - Differential ... • Pancreatic Disease ... Disease #Macrocytic ... #elevatedMCV #Differential ... Algorithm #Causes #Hematology