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 ... hepatitis - Acute biliary ... Hemochromatosis - Primary biliary ... Severe #Acute #Causes ... Differential #Hepatology #Diagnosis
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
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary ... 14 percent) #Diagnosis ... Hepatology #Cirrhosis #Causes
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
DILI) - Stepwise Diagnosis ... for alternative causes ... Benign/malignant biliary ... obstruction, Primary biliary ... Liver #Injury #Diagnosis
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Cirrhosis - Diagnosis ... after pregnancy Diagnose ... #PBC #Primary #Biliary ... #Cirrhosis #Diagnosis
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... inflammation and biliary ... #PBC #Primary #Biliary
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
Difficult Selective Biliary ... site - OTHERS: biliary ... #Selective #Biliary ... gastroenterology #management #diagnosis
Drugs and Classes Associated with DILI and Type of Liver Injury

#Medications #Differential #DrugInduced #LiverInjury #Hepatology #Pharmacology
Drugs and Classes ... #Pharmacology #Causes
Pancreatic Cyst Diagnosis on Endoscopic Ultrasound EUS
Features of low cancer risk: No symptoms caused by the
Pancreatic Cyst Diagnosis ... risk: No symptoms caused ... risk: Symptoms caused ... such as jaundice, nausea ... Pancreatic #Cyst #Diagnosis
An Approach to Jaundice - Differential Diagnosis

- Increased Production (Prehepatic)
- Decreased Clearance (Intrahepatic + Posthepatic)

Dr. Eric
- Differential Diagnosis ... Differential #Table #Causes ... #Posthepatic #Diagnosis