Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
hepatitis - Acute biliary ... Hemochromatosis - Primary biliary ... cholangitis ... Acute #Causes #Differential ... #Hepatology #Diagnosis
Algorithm for the Diagnosis of Primary Biliary Cholangitis (PBC). 

US, ultrasound; MRCP, magnetic resonance cholangiopancreatography; ALP,
Algorithm for the ... Diagnosis of Primary ... Biliary Cholangitis ... US, ultrasound; MRCP ... #Algorithm #Diagnosis
Gallstone Diseases
1. Asymptomatic Stones 75%
2. Biliary Pain 20%
3. Acute Cholecystitis 10%
4. Mirizzi's Syndrome < 0.1%
5. Cholangitis/
Biliary Pain 20% ... Cholangitis/ Pancreatitis ... Gallstone #Diseases #differential ... #diagnosis #causes
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
DILI) - Stepwise Diagnosis ... Algorithm DILI ... Benign/malignant biliary ... cholangitis, Primary ... sclerosing cholangitis
Antibiotic Prophylaxis for Endoscopy (ASGE 2015) 

Give Antibiotics: 
 - PEG tube placement (or PEG-J)
mediastinal cysts - Biliary ... obstruction without cholangitis ... GI tract) - Biliary ... obstruction without cholangitis ... Gastroenterology #Management
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
Difficult Selective Biliary ... #Selective #Biliary ... SBC #Difficult #ercp ... gastroenterology #management ... #diagnosis
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
tests algorithm ... include extrahepatic biliary ... #Algorithm #Hepatology ... Liver #Enzymes #Differential ... #Diagnosis
Functional Dyspepsia - Pathophysiology, Diagnosis and Management
Risk factors: Non-steroidal anti-inflammatory drugs, Psychological comorbidity, Helicobacter pylori infection,
Pathophysiology, Diagnosis ... and Management ... months before diagnosis ... a structurally normal ... #Management #algorithm
Gastric Intestinal Metaplasia (GIM)
 • GIM is a precancerous, histopathologic change characterized by replacement of normal
replacement of normal ... Clinical decision algorithm ... for GIM management ... Metaplasia #GIM #diagnosis ... #management #gastroenterology
Algorithm regarding the diagnosis and treatment of Hereditary Hemochromatosis HH. 

Step 1: In the patient with
Algorithm regarding ... the diagnosis and ... <45% and SF is normal ... hemochromatosis #algorithm ... #diagnosis #management