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 - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... Cirrhosis - Pathophysiology ... Cholestasis #PBC #Primary ... #Biliary #Cirrhosis ... #Pathophysiology
Cirrhosis - Pathophysiology
 - Ascites Formation
 - Dilutional Hyponatremia
 - Hepatorenal Syndrome
 - Spontaneous Infections

#Cirrhosis #Pathophysiology
Cirrhosis - Pathophysiology ... Infections #Cirrhosis ... #Pathophysiology
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
Etiologies of Cirrhosis ... congenital - Primary ... biliary cirrhosis ... Differential #Hepatology #Cirrhosis
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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 ... with PBC #PBC #Primary ... #Biliary #Cirrhosis
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
Management of Cirrhosis ... Indications #Management #Cirrhosis ... #treatment #hepatology
Driving Impairment in Cirrhosis and Hepatic Encephalopathy 
 - Advise patients not to drive ~3 months
Impairment in Cirrhosis ... or optimize HE treatment ... medications - Optimize treatment ... Driving #Impairment #Cirrhosis
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... Indications Treatment ... ), normal ALT Treatment ... Family history of cirrhosis ... or fibrosis • Cirrhosis
A cirrhosis tweetorial all about the platelet

Aims:
- Identify cirrhosis based on blood tests- 
- Understand why
A cirrhosis tweetorial ... Aims: - Identify cirrhosis ... platelets are low in #cirrhosis ... s role in the #cirrhotic ... Tweetorial #Hepatology #Pathophysiology
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
Liver Consult Primer ... Gl History - Cirrhosis ... Consultation #GIConsult #Primer
The Gastroenterology Consult Primer
Guide to Calling a GI Consult
HPI:
 - Start with reason for consult
Gastroenterology Consult Primer ... last meal - Treatment ... Consultation #GIConsult #Primer