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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diagnosis hepatology gastroenterology management algorithm differential causes cirrhosis liver pbc ercp anatomy colonoscopy treatment calling cholangiogram cholangitis consultation endoscopy functional
Primary Biliary Cirrhosis - Management A. Initiate therapy - Initiate 1st line therapy with UDCA (13-15
Primary Biliary ... 1.5x ULN and/or abnormal ... disease #PBC #Primary ... #Biliary #Cirrhosis
Causes of Severe Acute Liver Injury - Ichemic hepatitis - Acute biliary obstruction - Drug-Induced liver
hepatitis - Acute biliary ... Hemochromatosis - Primary ... biliary cholangitis
Primary Biliary Cirrhosis - Pathophysiology Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish Epigentics Risk
Primary Biliary ... inflammation and biliary ... Cholestasis #PBC #Primary ... #Biliary #Cirrhosis
Primary Biliary Cirrhosis - Diagnosis Algorithm Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort Signs: Jaundice, Xanthelasmata, Hepatomegaly Associated history:
Primary Biliary ... with PBC #PBC #Primary ... #Biliary #Cirrhosis
Common Etiologies of Cirrhosis Inflammation - Hepatitis B (15 percent) - Hepatitis C (47 percent) - Schistosomiasis
congenital - Primary ... biliary cirrhosis
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 Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Benign/malignant biliary ... obstruction, Primary ... biliary cholangitis ... , Primary sclerosing
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%
Abnormal liver function tests algorithm. This figure details the initial response to abnormal liver blood tests.
Abnormal liver function ... initial response to abnormal ... *Abnormal USS may ... include extrahepatic biliary ... #LFTs #Abnormal
Primary Biliary Cirrhosis (PBC) - Diagnosis Algorithm #Primary #Biliary #Cirrhosis #PBC #Diagnosis #Algorithm #hepatology
Primary Biliary ... Algorithm #Primary ... #Biliary #Cirrhosis
Difficult Selective Biliary Cannulation (SBC) Factors associated with difficult SBC: - SMALL PAPILLA: can be difficult to
Difficult Selective Biliary ... site - OTHERS: biliary ... #Selective #Biliary
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