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Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Inflammation - Hepatitis ... 15 percent) - Hepatitis ... congenital - Primary biliary ... Nonalcoholic fatty liver ... #Differential #Hepatology
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Non-Malignant • Fatty Liver ... Hemochromatosis • Wilson's Disease ... Cholangitis • Primary Biliary ... Cirrhosis #Hepatomegaly ... #Causes #Hepatology
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Diagnosis Chronic liver ... disease (cirrhosis ... or chronic hepatitis ... failure - 3-5% Cirrhosis ... Failure, Pancreatic, Biliary
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
, Acute biliary ... Syndrome, Celiac Disease ... Extrahepatic • Biliary ... Causes #Acute #algorithm ... #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
those with CLD (± cirrhosis ... disease, liver ... (DILI) Viral Hepatitis ... #Failure #Cirrhosis ... #Hepatology #gastroenterology
Approach to Hypoproliferative Macrocytic Anemia

 • 812, Folate Deficiency
 • MDS+
 • Hypothyroid
 • Liver Disease
Macrocytic Anemia • 812 ... Hypothyroid • Liver ... Disease • Alcohol ... differential #diagnosis #algorithm ... #hematology #workup
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
/Liver failure ... or higher • Liver ... Diagnosis: • Viral hepatitis ... cholangitis #diagnosis #workup ... #hepatology
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Elevated Liver Enzymes ... • Cholestatic disease ... • Alcoholic hepatitis ... Infiltrative • Cirrhosis ... Duct Stone • Biliary
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Cirrhosis - Diagnosis ... Algorithm Symptoms ... Liver biopsy findings ... #Algorithm #hepatology
Autoantibodies and their Disease Associations
ANA - Non-specific; common in SLE, autoimmune hepatitis
Anti-CCP, Rheumatoid factor - RA
Anti-dsDNA
SLE, autoimmune hepatitis ... Dermatomyositis Anti-LKM (liver ... ) - Autoimmune hepatitis ... Anti-gp210 - Primary biliary ... cirrhosis (PBC)