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diagnosis hepatology management differential algorithm lfts syndrome transaminitis dermatology gastroenterology hbv hepatitis hepatitisb hepatopulmonary indications aclf acute aih albumin autoimmune
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 ... Injury (DILI) ... #Cirrhosis #Hepatology
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework Mild (<100-500): • NAFLD • Cirrhosis •
Elevated Liver Function ... • NAFLD • Cirrhosis ... • Chronic Viral ... injury) • Ischemic ... Differential #Diagnosis #hepatology
Common Etiologies of Cirrhosis Inflammation - Hepatitis B (15 percent) - Hepatitis C (47 percent) - Schistosomiasis
Etiologies of Cirrhosis ... Nonalcoholic fatty liver ... heart failure (chronic ... #Differential #Hepatology ... #Cirrhosis #Causes
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 Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ) - 8g per liter ... • Acute kidney injury ... Indications #Management #Cirrhosis ... #treatment #hepatology
Patterns of Liver Injury Transaminase Levels: > 50x normal - Ischemic Hepatitis > 20x normal
Patterns of Liver ... Injury Transaminase ... CMV), Alcoholic cirrhosis ... 5-10x normal - Chronic ... #Injury #hepatology
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
non-essential drug/HDS treatments ... for alternative causes ... dechallenge • Acute or chronic ... e.g. ascites), Chronic ... #Algorithm #hepatology
Acute Liver Injury - Differential Diagnosis Algorithm Vascular Causes of Acute Liver Injury: • Hepatic vein:
Acute Liver Injury ... Algorithm Vascular Causes ... > 2 • NASH, Chronic ... hepatitis: < 1 • Cirrhosis ... : > 3 • Chronic
Liver Chemistries - Interpretation of LFTs R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP) • R >
injury < 26 weeks ... > 2 • NASH, Chronic ... hepatitis: < 1 • Cirrhosis ... : > 3 • Chronic ... #differential #Hepatology
Chronic Hepatitis B - Diagnosis and Management Algorithm • Who to treat: Essentially treat the pts with
viremia or have cirrhosis ... HAV immunity; Liver ... • Liver is the ... Diagnosis #Management #Treatment ... #Hepatology
Hepatitis B - Treatment Indications Treatment not indicated: • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... infection with severe liver ... injury (INR > 2 ... mg/dL) or acute liver
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