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Clinical Examination for Liver and Biliary Diseases
1) Hands: Clubbing, Dupuytren's contracture, Leuconychia, Bruising, Flapping tremor (hepatic
Examination for Liver ... abdominal wall veins (caput ... physicalexam #cirrhosis #liver
Portosystemic collaterals in Cirrhosis

Milking abdominal veins demonstrates centrifugal blood flow in caput medusae.

Dr. Boby Varkey Maramattom
blood flow in caput ... abdominal #veins #caput
Demonstrating Rostral Venous Flow of Caput Medusae in Portal Hypertension

We do the milking method as depicted
Venous Flow of Caput ... DrArunKValsan #Caput
Dilated Abdominal Veins and Caput Medusae - Direction of Blood Flow

Vein Milking technique can be used
Abdominal Veins and Caput ... DrArunKValsan #Caput
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... Focus on prior Liver ... MELD - Chronic liver ... disease work up - Liver ... US - Prior liver
Caput Medusae on Physical Exam - Secondary to Portal Hypertension

You can tell the direction of flow
Caput Medusae on ... PeteSullivanPDx #Caput
The Gastroenterology Consult Primer
Guide to Calling a GI Consult
HPI:
 - Start with reason for consult
consult - I-liner ... Focus on prior GI/Liver ... GregoryTBrennan #Liver
Liver Enzymes (LFTs) - Causes of Hepatocellular and Cholestatic Liver Injury
Hepatocellular Liver Injury
 • AST/ALT elevation
Liver Enzymes (LFTs ... and Cholestatic Liver ... Hepatocellular Liver ... or Cholestatic Liver ... @AnnKumfer #Liver
Liver Function Tests (LFTs)
 - Aspartate aminotransferase (AST) 
 - Alanine aminotransferase (ALT) 
 - Alkaline
Liver Function Tests ... Prothrombin #Liver
Liver Chemistries - Interpretation of LFTs

R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP)
 • R >
Liver Chemistries ... Identify Acute Liver ... Less specific to liver ... - Specific to liver ... - Assists in liver