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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
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Nonalcoholic fatty liver ... disease - Wilson ... #Differential #Hepatology ... #Cirrhosis #Causes
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
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 Portal Hypertension According to Site of Vascular Obstruction
1) Prehepatic pre-sinusoidal: Portal vein thrombosis due
Causes of Portal ... or secondary to cirrhosis ... 3) Sinusoidal: Cirrhosis ... , Polycystic liver ... #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
• Infiltrative diseases ... sarcoidosis) • Liver ... metastasis • Fatty liver ... Veno-occlusive disease ... #hepatology
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Non-Malignant • Fatty Liver ... Hemochromatosis • Wilson's Disease ... Primary Biliary Cirrhosis ... Diagnosis #Algorithm #Causes ... #Hepatology
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
65 years PBC Pathophysiology ... intralobular bile ducts causes ... /Liver failure ... or higher • Liver ... diagnosis #workup #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Elevated Liver Enzymes ... • Cholestatic disease ... Infiltrative • Cirrhosis ... Others #LFTs #Hepatology ... Diagnosis #Algorithm #Causes
Causes of Ascites
Normal Peritoneum
Portal hypertension (SAAG > 1.1 g/dL)
  1. Hepatic congestionl
Causes of Ascites ... Liver disease ... - Cirrhosis ... - Acute fatty liver ... #differential #hepatology