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diagnosis hepatology differential causes management albumin algorithm saag chemistry chronic coagulation dic dili disseminated druginduced failure gap gastroenterology globulin gradient
Acute-on-Chronic Liver Failure (ACLF) Clinical Guidelines ACLF = possibly reversible condition in those with CLD (± cirrhosis)
Acute-on-Chronic ... months without treatment ... disease, liver ... #Acute #Chronic ... #Cirrhosis #Hepatology
Indications for Albumin for Management of Cirrhosis • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... of ascites removed ... • Acute kidney ... Indications #Management #Cirrhosis ... #treatment #hepatology
Causes of Ascites Normal Peritoneum Portal hypertension (SAAG > 1.1 g/dL) 1. Hepatic congestionl
Liver disease ... - Cirrhosis ... fibrosis - Acute ... fatty liver of ... #differential #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 ... Veno-occlusive disease
Causes of Ascites - Differential Diagnosis Algorithm Portal Hypertension - Prehepatic: • Portal vein thrombosis • Splenic
Causes of Ascites ... - Hepatic: • Cirrhosis ... • Infiltrative disease ... • Acute liver ... Diagnosis #Algorithm #Hepatology
Serum Ascites Albumin Gradient (SAAG) - Differential Diagnosis High albumin gradient (>1.1 g/dl): - Cirrhosis - Alcoholic
>1.1 g/dl): - Cirrhosis ... - Massive liver ... - Acute fatty ... liver of pregnancy ... without cirrhosis
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 ... ALF): • Liver ... : > 1 • Acute
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
non-essential drug/HDS treatments ... disease, Hepatic ... dechallenge • Acute ... disorder (e.g. ascites ... Diagnosis #Algorithm #hepatology
Disseminated Intravascular Coagulation (DIC) Overview Increased Clotting and Consumption of Clotting Factors Findings: • Bleeding • Recent history
malignancy (Especially acute ... or venipuncture sites ... DIC • Severe Liver ... Disease: - Impaired ... #management #hematology
Elevated Globulin - Protein Gap (Total Protein - Albumin > 4) Work-up of an Elevated Globulin Gap: •
Albumin > 4) Work-up ... first step in evaluation ... Viral infections (acute ... disease: Cirrhosis ... inflammation (acute
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