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 ... Liver biopsy findings ... #PBC #Primary ... #Biliary #Cirrhosis ... Diagnosis #Algorithm #hepatology
Cirrhosis - Pathophysiology
 - Ascites Formation
 - Dilutional Hyponatremia
 - Hepatorenal Syndrome
 - Spontaneous Infections

#Cirrhosis #Pathophysiology
Cirrhosis - Pathophysiology ... Infections #Cirrhosis ... Pathophysiology #hepatology ... #liver
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Indications for ... Management of Cirrhosis ... terlipressin #Albumin #Indications ... #Management #Cirrhosis ... #treatment #hepatology
Hepatocellular Carcinoma (HCC) in Cirrhosis - Management Algorithm

Very early (0) - Single <2 cm, Preserved liver
Carcinoma (HCC) in Cirrhosis ... cm, Preserved liver ... cm, Preserved liver ... Carcinoma #HCC #Cirrhosis ... Management #Algorithm #hepatology
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Primary biliary cirrhosis ... Nonalcoholic fatty liver ... #Differential #Hepatology ... #Cirrhosis #Causes
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... Focus on prior Liver ... Gl History - Cirrhosis ... US - Prior liver ... Calling #Referral #Hepatology
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary Cirrhosis ... relative with PBC ... Cholestasis #PBC ... Primary #Biliary #Cirrhosis ... Pathophysiology #hepatology
Drugs and Classes Associated with DILI and Type of Liver Injury

#Medications #Differential #DrugInduced #LiverInjury #Hepatology #Pharmacology
DILI and Type of Liver ... Injury #Medications ... #LiverInjury #Hepatology
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
B - Treatment Indications ... Presence of CP or PC ... or fibrosis • Cirrhosis ... mg/dL) or acute liver ... #management #hepatology
Screening and surveillance of varices in patients with cirrhosis. 

- No for screening need if platelets
patients with cirrhosis ... platelets >150 Liver ... #Surveillance #Hepatology