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
Causes of Severe ... Acute Liver Injury ... hepatitis - Acute biliary ... - Drug-Induced liver ... cholangitis
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... for alternative causes ... Benign/malignant biliary ... cholangitis, Primary ... sclerosing cholangitis
Focused evaluation algorithm for acute liver injury

#Liver #Injury #Acute #Evaluation #Algorithm #Diagnosis #Hepatology
Focused evaluation ... algorithm for acute ... liver injury ... #Liver #Injury # ... Acute #Evaluation
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 ... differential #diagnosis #causes
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
tests algorithm ... indicate the initial evaluation ... history alongside evaluation ... include extrahepatic biliary ... LFTs #Abnormal #Algorithm
Algorithm regarding the diagnosis and treatment of Hereditary Hemochromatosis HH. 

Step 1: In the patient with
Algorithm regarding ... normal, further evaluation ... C282Y homozygote, evaluation ... If other causes ... hemochromatosis #algorithm
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Cirrhosis - Diagnosis Algorithm ... Liver biopsy findings ... #PBC #Primary #Biliary ... Cirrhosis #Diagnosis #Algorithm
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary ... Nonalcoholic fatty liver ... Hepatology #Cirrhosis #Causes
Algorithm for the Diagnosis of Primary Biliary Cholangitis (PBC). 

US, ultrasound; MRCP, magnetic resonance cholangiopancreatography; ALP,
Algorithm for the ... Diagnosis of Primary Biliary ... Cholangitis (PBC ... #Cholangitis #PBC ... #Algorithm #Diagnosis
Antibiotic Prophylaxis for Endoscopy (ASGE 2015) 

Give Antibiotics: 
 - PEG tube placement (or PEG-J)
mediastinal cysts - Biliary ... obstruction without cholangitis ... - Patient s/p liver ... GI tract) - Biliary ... obstruction without cholangitis