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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Hepatitis B - Treatment Indications
Treatment not indicated:
 • Immune tolerant state - HBe-Ag detectable, high HBV
Family history of cirrhosis ... or fibrosis • Cirrhosis ... infection with severe liver ... mg/dL) or acute liver ... #Indications #management
Algorithm regarding the diagnosis and treatment of Hereditary Hemochromatosis HH. 

Step 1: In the patient with
diagnosis and treatment ... symptoms, elevated liver ... Patients with cirrhosis ... A liver biopsy can ... algorithm #diagnosis #management
Indications for Albumin for Management of Cirrhosis
 • Large volume paracentesis (>5 liter) - 8g per
for Albumin for Management ... of Cirrhosis ... ) - 8g per liter ... #Indications #Management ... #Cirrhosis #treatment
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
Management of critically-ill ... cirrhotic patients ... rKBIIjC6Htq14G82yghJnfe4RwlQNchNByi7wbcMAY63FIMr4IeFUPHZTUFKckgGIQeEsXu7k1NhPo-T8ItytjuWlMH7y0kI6IydY2i7VzU4Y93MfuEKQruo-qIKnVF91JyuQsQbJNPJv3UJYPzkySdSktYPmFVd6xw1xJDLPqY%3D #cirrhotic ... #cirrhosis #Management
Hepatocellular Carcinoma (HCC) in Cirrhosis - Management Algorithm

Very early (0) - Single <2 cm, Preserved liver
Carcinoma (HCC) in Cirrhosis ... - Management Algorithm ... cm, Preserved liver ... Carcinoma #HCC #Cirrhosis ... #Management #Algorithm
Cirrhosis - Pathophysiology
 - Ascites Formation
 - Dilutional Hyponatremia
 - Hepatorenal Syndrome
 - Spontaneous Infections

#Cirrhosis #Pathophysiology
Cirrhosis - Pathophysiology ... Infections #Cirrhosis ... Pathophysiology #hepatology #liver
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
The Liver Consult ... Focus on prior Liver ... Gl History - Cirrhosis ... MELD - Chronic liver ... US - Prior 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
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 ... Encephalopathy #management
Screening and surveillance of varices in patients with cirrhosis. 

- No for screening need if platelets
patients with cirrhosis ... platelets >150 Liver