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Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines

ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... those with CLD (± cirrhosis ... disease, liver ... EmoryGastroHep #ACLF #Acute ... #Chronic #Liver
Differential Diagnosis and Evaluation of Hyponatremia:
1) Identification of onset (acute vs. chronic)
2) Presence of symptoms (HA,
Diagnosis and Evaluation ... Identification of onset (acute ... vs. chronic) 2) ... history (cardiac, liver ... , renal disease)
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Indications for ... Management of Cirrhosis ... ascites removed • Acute ... #Management #Cirrhosis ... #treatment #hepatology
Approach to Thrombocytosis - Elevated Platelet Count - Differential Diagnosis Algorithm

Peripheral Smear concerning for malignancy?
for workup, including ... : Acute blood loss ... , Acute hemolysis ... infections, TB, Acute ... Severe trauma, Acute
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Elevated Liver Function ... • NAFLD • Cirrhosis ... • Chronic Viral ... Hepatopathy • Acute ... Differential #Diagnosis #hepatology
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
Torsemide) • Acute ... cirrhosis, chronic ... cirrhosis, chronic ... cirrhosis, chronic ... hyperaldosteronism • Acute
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... Gl History - Cirrhosis ... current MELD - Chronic ... liver disease work ... Calling #Referral #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
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 ... hepatitis: < 1 • Cirrhosis ... : > 1 • Acute
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
/acute hepatitis ... • Infiltrative diseases ... sarcoidosis) • Liver ... metastasis • Fatty liver ... Veno-occlusive disease