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Cirrhosis (etiology) (VW HAPPENS mnemonic (Viral hepatitis B/C (chronic)…

- - - - Hemachromatosis
        
        A1AT deficiency
        
        PSC
        
        PBC
        
        ETOH
        
        NAFLD/NASH
        
        2 more items...
        
        might be an alcoholic: :beer_mugs:
        
        1 more item...
        
        Intrahepatic Duct disease
        
        :female_sign: 30-50yo
        
        Pruritus
        
        Jaundice
        
        1 more item...
        
        Extrahepatic Disease: can be seen on imaging
        
        :male_sign: 30-50yo
        
        Pruritus,
        
        painless Jaundice
        
        :pencil2:associated w/ UC, IBD
        
        MRCP (MRI) : Beads on a string :checkered_flag:
        
        May do ERCP w/ biopsy: onion skin fibrosis
        
        2 more items...
        
        :pencil2:Sports center (SC) costs extra
        
        A1AT accumulates in liver causing cirrhosis
        
        Young Pt w/ COPD & cirrhosis
        
        Biopsy: PAS + Macro's
        
        Transplant, A1AT can get out of new liver. Lung damage is permanent
        
        Fe absorption/overload/deposition
        
        Bronze DM
        
        hyper pig skin
        
        DM (pancreas involved)
        
        Cirrhosis
        
        maybe diastolic CHF :<3:
        
        Ferritin :arrow_up: >1000
        
        Better test: Transferrin :arrow_up: >50%
        
        :stars:: Best test Biopsy: :arrow_up: Fe
        
        :warning:genetic tests for HFE is clinically useless
        
        Deferoxamine (chelate)
        
        :stars:best Tx: Phlebotomy
        
        Transplant if cirrhotic, not curative since GI disorder
        
        :pencil2: undo the iron from me = deferoxamine
        
        (Uworld) Pseudogout
      - Cu2+ deposition
        
        Basal ganglia: Chorea
        
        Liver: Cirrhosis
        
        Eyes: Kaiser Fleischer ring
        
        Slit lamp: KF ring
        
        :stars:Best: Biopsy
        
        Serum: Ceruloplasmin
        
        Urine: Copper
        
        :warning:don't get ~~Serum Copper~~
        
        Transplant: Cures
        
        Tx copper overload: Pennicillamine :pencil2:
    - - IVDA: Hep C
        Sex: Hep B
        
        Serologies: HC/HB Ab
        
        Curable: Direct acting antagonists. ~~Transplant~~ possible, but HCV can infect new transplant
  - - - Dx
        
        Tx