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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 ... #Chronic #Liver
Ascites - Differential Diagnosis
Chronic liver disease (cirrhosis or chronic hepatitis) - 80%
Underlying malignancy - 10%
Congestive heart
Ascites - Differential ... Diagnosis Chronic ... liver disease ( ... cirrhosis or chronic ... #Diagnosis #hepatology
Differential Diagnosis and Evaluation of Hyponatremia:
1) Identification of onset (acute vs. chronic)
2) Presence of symptoms (HA,
and Evaluation ... vs. chronic) 2) ... history (cardiac, liver ... , renal disease) ... #Algorithm #Ddxof
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Nonalcoholic fatty liver ... heart failure (chronic ... #Diagnosis #Differential ... #Hepatology #Cirrhosis
Elevated Liver Function Tests (LFTs) - Differential Diagnosis Framework
Mild (<100-500): 
 • NAFLD
 • Cirrhosis
 •
Tests (LFTs) - Differential ... • NAFLD • Cirrhosis ... • Chronic Viral ... Hepatopathy • Acute ... #Diagnosis #hepatology
Causes of Thrombocytosis - Differential Diagnosis Algorithm
Spurious:
 • Artifact (redo CBC)
Autonomous:
 • Essential thrombocytosis
 • Polycythemia
Thrombocytosis - Differential ... Infectious: • Acute ... or Chronic Inflammatory ... disorders • Celiac disease ... effect following treatment
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
Approach to Thrombocytosis - Elevated Platelet Count - Differential Diagnosis Algorithm

Peripheral Smear concerning for malignancy?
Platelet Count - Differential ... for workup, including ... Rebound effect from treatment ... Vasculitides, IBD, Celiac disease ... • Infections: Chronic
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
cirrhosis, chronic ... cirrhosis, chronic ... chronic kidney disease ... cirrhosis, chronic ... Tolvaptan) • Treatment
Portal Hypertension - Differential Diagnosis
Portal Pressure = the pressure difference between the pressure in the portal
Hypertension - Differential ... /acute hepatitis ... • Infiltrative diseases ... sarcoidosis) • Liver ... Veno-occlusive disease