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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Tweetorial - What's the deal with Ammonia in hepatic encephalopathy?

Aims
Try to answer this question while also
Ammonia in hepatic encephalopathy ... Ammonia #Hepatic #Encephalopathy ... #Sarcopenia #Cirrhosis ... Tweetorial #Hepatology #Pathophysiology
Nutrition in Cirrhosis: Dos and Don’ts
Screening:
 • Patients at risk for RFH-Nutritional Prioritizing Tool
 • Low
Nutrition in Cirrhosis ... treat hepatic encephalopathy ... patients with liver cirrhosis ... #Nutrition #Cirrhosis ... management #hepatology #pathophysiology
Cirrhosis - Pathophysiology
 - Ascites Formation
 - Dilutional Hyponatremia
 - Hepatorenal Syndrome
 - Spontaneous Infections

#Cirrhosis #Pathophysiology
Cirrhosis - Pathophysiology ... Infections #Cirrhosis ... #Pathophysiology
Cirrhosis Timeline and Mortality Rate
Compensated Cirrhosis
Stage 1 - No varices (Annual Mortality Rate 1%)
Stage 2 -
Cirrhosis Timeline ... Rate Compensated Cirrhosis ... Decompensated Cirrhosis ... bleeding or Hepatic Encephalopathy ... Rate 57%) #Cirrhosis
Driving Impairment in Cirrhosis and Hepatic Encephalopathy 
 - Advise patients not to drive ~3 months
Impairment in Cirrhosis ... and Hepatic Encephalopathy ... Driving #Impairment #Cirrhosis ... #Hepatic #Encephalopathy
Management of critically-ill cirrhotic patients

Open Access Source (Intensive Care Med (2018) 44:1932–1935): https://link.springer.com/epdf/10.1007/s00134-018-5078-z?shared_access_token=rKBIIjC6Htq14G82yghJnfe4RwlQNchNByi7wbcMAY63FIMr4IeFUPHZTUFKckgGIQeEsXu7k1NhPo-T8ItytjuWlMH7y0kI6IydY2i7VzU4Y93MfuEKQruo-qIKnVF91JyuQsQbJNPJv3UJYPzkySdSktYPmFVd6xw1xJDLPqY%3D

#cirrhotic #cirrhosis #Management #CriticalCare
critically-ill cirrhotic ... rKBIIjC6Htq14G82yghJnfe4RwlQNchNByi7wbcMAY63FIMr4IeFUPHZTUFKckgGIQeEsXu7k1NhPo-T8ItytjuWlMH7y0kI6IydY2i7VzU4Y93MfuEKQruo-qIKnVF91JyuQsQbJNPJv3UJYPzkySdSktYPmFVd6xw1xJDLPqY%3D #cirrhotic ... #cirrhosis #Management
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary Cirrhosis ... - Pathophysiology ... relative with PBC Pathophysiology ... Primary #Biliary #Cirrhosis ... #Pathophysiology
Ammonia Levels & Hepatic Encephalopathy in Patients with Chronic Liver Disease 
Choosing Wisely: Things We Do
Levels & Hepatic Encephalopathy ... ammonia-levels-and-hepatic-encephalopathy-patients-known
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... Primary biliary cirrhosis ... Differential #Hepatology #Cirrhosis
FibroScan Scale from F0 to F4

#Diagnosis #Hepatology #Fibroscan #Interpretation #Cirrhosis #Fibrosis
Interpretation #Cirrhosis