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 ... Severe #Acute #Causes
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Liver biopsy findings ... consistent with PBC ... #PBC #Primary ... #Biliary #Cirrhosis
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... relative with PBC ... inflammation and biliary ... Cholestasis #PBC ... #Primary #Biliary
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Drug Induced Liver ... for alternative causes ... Alcohol-related liver ... Benign/malignant biliary ... obstruction, Primary biliary
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary ... Nonalcoholic fatty liver ... Hepatology #Cirrhosis #Causes
Drugs and Classes Associated with DILI and Type of Liver Injury

#Medications #Differential #DrugInduced #LiverInjury #Hepatology #Pharmacology
Drugs and Classes ... DILI and Type of Liver ... #Pharmacology #Causes
Table of Causes of Acute Liver Injury
#Diagnosis #Hepatology #Acute #Liver #Injury #Causes #Differential #Incidence #Table #Failure
Table of Causes ... of Acute Liver Injury ... Hepatology #Acute #Liver ... #Injury #Causes
The Gastroenterology Consult Primer
Guide to Calling a GI Consult
HPI:
 - Start with reason for consult
consult - I-liner ... rectal exam) - CBC ... Focus on prior GI/Liver ... GregoryTBrennan #Liver
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
Abnormal liver function ... response to abnormal liver ... derangement of liver ... include extrahepatic biliary ... body mass index; FBC
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% ... differential #diagnosis #causes