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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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
Management of Cirrhosis ... paracentesis (>5 liter ... ) - 8g per liter ... Indications #Management #Cirrhosis ... #treatment #hepatology
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... Gl History - Cirrhosis ... MELD - Chronic liver ... disease work up - Liver ... US - Prior liver
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 ... HCC, End-stage liver ... Carcinoma #HCC #Cirrhosis
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... Family history of cirrhosis ... or fibrosis • Cirrhosis ... infection with severe liver ... mg/dL) or acute liver
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
Screening and surveillance of varices in patients with cirrhosis. 

- No for screening need if platelets
patients with cirrhosis ... platelets >150 Liver
The Gastroenterology Consult Primer
Guide to Calling a GI Consult
HPI:
 - Start with reason for consult
consult - I-liner ... Focus on prior GI/Liver ... last meal - Treatment ... GregoryTBrennan #Liver
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
Algorithm regarding the diagnosis and treatment of Hereditary Hemochromatosis HH. 

Step 1: In the patient with
diagnosis and treatment ... symptoms, elevated liver ... is >1,000 μg/L, liver ... Patients with cirrhosis ... A liver biopsy can