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
of Severe Acute Liver ... hepatitis - Acute biliary ... - Drug-Induced liver ... Hemochromatosis - Primary biliary
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Drug Induced Liver ... non-essential drug/HDS treatments ... Alcohol-related liver ... Benign/malignant biliary ... obstruction, Primary biliary
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
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... Liver biopsy findings ... #PBC #Primary #Biliary
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary ... Nonalcoholic fatty liver
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
for Albumin for Management ... paracentesis (>5 liter ... ) - 8g per liter ... #Indications #Management ... #Cirrhosis #treatment
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
Abnormal liver function ... response to abnormal liver ... derangement of liver ... the pattern of liver ... include extrahepatic biliary
Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Hepatitis B - Treatment ... Indications Treatment ... infection with severe liver ... mg/dL) or acute liver ... #Indications #management
Hepatocellular Carcinoma (HCC) in Cirrhosis - Management Algorithm

Very early (0) - Single <2 cm, Preserved liver
in Cirrhosis - Management ... cm, Preserved liver ... cm, Preserved liver ... HCC, End-stage liver ... HCC #Cirrhosis #Management
Alcoholic Hepatitis - Management Algorithm
1. Severity assessed not only by MDF (>32) but also by MELD
Alcoholic Hepatitis - Management ... can be bridge to Liver ... Alcoholic #Hepatitis #Management ... #Algorithm #treatment