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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Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Cirrhosis - Diagnosis ... 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 ... Cirrhosis - Pathophysiology ... relative with PBC ... Cholestasis #PBC ... #Cirrhosis #Pathophysiology
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... congenital - Primary biliary ... cirrhosis - α1 ... #Diagnosis #Differential ... #Causes
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Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
Biliary Cannulation ... (SBC) Factors ... SBC: - SMALL ... site - OTHERS: biliary ... #Selective #Biliary
Primary Biliary Cirrhosis (PBC) - Diagnosis Algorithm

#Primary #Biliary #Cirrhosis #PBC #Diagnosis #Algorithm #hepatology
Primary Biliary ... Cirrhosis (PBC) ... Algorithm #Primary #Biliary ... #Cirrhosis #PBC
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
Causes of Severe ... hepatitis - Acute biliary ... Hemochromatosis - Primary biliary ... Severe #Acute #Causes ... #Differential #
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% ... Gallstone #Diseases #differential ... #diagnosis #causes
Primary Biliary Cirrhosis - Management
A. Initiate therapy 
 - Initiate 1st line therapy with UDCA (13-15
Primary Biliary ... Cirrhosis - Management ... survey disease #PBC ... #Primary #Biliary ... #Cirrhosis #Management
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
include extrahepatic biliary ... body mass index; FBC ... Liver #Enzymes #Differential
Etiology and Complications of Cirrhosis

#Causes #Complications #Cirrhosis #Differential #Pathophysiology #Hepatology
Complications of Cirrhosis ... #Causes #Complications ... #Cirrhosis #Differential