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Focused evaluation algorithm for acute liver injury

#Liver #Injury #Acute #Evaluation #Algorithm #Diagnosis #Hepatology
algorithm for acute ... liver injury ... #Liver #Injury # ... Acute #Evaluation ... Algorithm #Diagnosis #Hepatology
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... of ascites removed ... • Acute kidney ... injury (≥ 1B) - ... #treatment #hepatology
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... Injury (DILI) ... EmoryGastroHep #ACLF #Acute ... #Failure #Cirrhosis
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... • NAFLD • Cirrhosis ... Hepatopathy • Acute ... injury) • Ischemic ... Differential #Diagnosis #hepatology
Liver Chemistries - Interpretation of LFTs

R-value: Serum (ALT/ULN ALT) / (Alk phos/ULN ALP)
 • R >
Hepatocellular - Check Acute ... Mixed - Check Acute ... Imperative to Identify Acute ... : > 1 • Acute ... #chemistry #diagnosis
Hepatorenal Syndrome (HRS) - Diagnostic Criteria
HRS-AKI (Acute: previously known as HRS Type 1)
 • ↑ Creatinine
Criteria HRS-AKI (Acute ... + ascites • No ... structural kidney injury ... HRS-NAKI (Non-Acute ... HRSAKI #HRSNAKI #hepatology
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
of portal HTN: ascites ... portal HTN: • Ascites ... /acute hepatitis ... sarcoidosis) • Liver ... metastasis • Fatty liver
Causes of Ascites - Differential Diagnosis Algorithm
Portal Hypertension - Prehepatic:
 • Portal vein thrombosis
 • Splenic
Causes of Ascites ... - Hepatic: • Cirrhosis ... Infiltrative disease • Acute ... liver failure ... Diagnosis #Algorithm #Hepatology
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Acute Liver Injury ... Vascular Causes of Acute ... Hepatocellular Acute ... Cholestatic Acute ... : > 1 • Acute
Patterns of Liver Injury
Transaminase Levels:
  > 50x normal - Ischemic Hepatitis
  > 20x normal
Patterns of Liver ... Injury Transaminase ... > 20x normal - Acute ... CMV), Alcoholic cirrhosis ... #Injury #hepatology