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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 ... months without treatment ... disease, liver ... EmoryGastroHep #ACLF #Acute
Hepatobiliary Manifestations of Sickle Cell Disease
Acute sickle cell hepatic crisis:
 • Fever, acute onset RUQ pain,
Acute sickle cell ... crisis: • Fever, acute ... Supportive with treatment ... of SCD crisis Acute ... progressing to acute
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 ... history (cardiac, liver ... , renal disease) ... Differential #Algorithm #Ddxof
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... ) - 8g per liter ... ascites removed • Acute ... Indications #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
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
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
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... immunosuppression • Acute ... > 3 mg/dL) or acute ... liver failure
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
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
Torsemide) • Acute ... cirrhosis, and ... hyperaldosteronism • Acute ... patients with acutely ... Tolvaptan) • Treatment