ASGE Adult and Pediatric Gastroenterology and Endoscopy Board Preparatory and Review Course

Schiano_Hepatitis
Pdf Summary
In this document, multiple scenarios and questions related to hepatitis and liver diseases are discussed. Here is a summary of the key points:<br /><br />1. The document covers various cases involving different presentations and symptoms of hepatitis. It emphasizes the importance of considering different potential causes, such as acute HCV, COVID-19, infectious mononucleosis, lymphoma, or drug-induced liver injury, based on the clinical presentation and laboratory findings.<br /><br />2. The document also highlights the significance of conducting appropriate diagnostic tests and assessments in order to determine the most likely diagnosis and initiate appropriate management. These tests include liver function tests, viral serologies, imaging studies like ultrasound or CT scan, and liver biopsies.<br /><br />3. The importance of screening and managing co-infections, such as hepatitis B and HIV, in patients undergoing immunosuppressive therapies is also discussed. Patients at higher risk of HBV reactivation should receive antiviral prophylaxis.<br /><br />4. The role of immunosuppressive medications, such as tacrolimus, in causing side effects like neurotoxicity, nephrotoxicity, hypertension, electrolyte imbalances, and others is mentioned. It also emphasizes the need for monitoring and managing these side effects.<br /><br />5. The document provides recommendations for the treatment of hepatitis C, including monitoring for sustained virologic response (SVR) and the need for ongoing HCC surveillance in patients with advanced fibrosis or cirrhosis.<br /><br />6. The importance of screening for fibrosis and assessing the stage of liver disease is emphasized, as it helps in determining the appropriate management and screening for hepatocellular carcinoma (HCC).<br /><br />7. The document also discusses the changing demographics associated with HCV-positive donors and the potential risks and benefits of using these donors for liver transplantation.<br /><br />8. The significance of considering liver transplantation in patients with decompensated cirrhosis and assessing their priority on the waitlist based on laboratory data, such as the MELD score, is highlighted.<br /><br />9. It also discusses specific scenarios, such as management of hepatitis in pregnant patients and the need for antiviral prophylaxis in certain high-risk groups.<br /><br />Overall, the document covers a range of topics related to hepatitis and liver diseases, providing insights into the diagnosis, management, and considerations for specific patient populations.
Keywords
hepatitis
liver diseases
clinical presentation
diagnostic tests
antiviral prophylaxis
side effects
fibrosis
liver transplantation
MELD score
HCC surveillance