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Chronic liver disease Cirrhosis hepatic Encephalopathy

Chronic liver disease Cirrhosis hepatic Encephalopathy. Dr . Yasir M Khayyat MBcHB,FRCPC,FACP,ABIM Assistant professor of Medicine Faculty of Medicine Umm AlQura University. Chronic Liver disease …? Does this means there is acute liver disease ? Yes ,but its ” acute liver insult “

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Chronic liver disease Cirrhosis hepatic Encephalopathy

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  1. Chronic liver disease Cirrhosishepatic Encephalopathy Dr . Yasir M Khayyat MBcHB,FRCPC,FACP,ABIM Assistant professor of Medicine Faculty of Medicine Umm AlQura University

  2. Chronic Liver disease …? • Does this means there is acute liver disease ? Yes ,but its ” acute liver insult “ • Viral • Metabolic • Alcohol • Autoimmune • Vascular • Toxins • Drugs • Inherited disorders سمعوني ايش هي ؟

  3. Chronic liver disease Cirrhosishepatic Encephalopathy Dr . Yasir M Khayyat MBcHB,FRCPC,FACP,ABIM Assistant professor of Medicine Faculty of Medicine Umm AlQura University

  4. Chronic Inflammation Or Chronic Hepatitis Healing with Fibrosis Or Liver Cirrhosis Acute Liver insult Resolution without Clinical or histological consequences Development of Portal hypertension And Development of stigmata of Chronic Liver disease Compensated State Compensated Cirrhosis Decompensated State Or Decompensated Cirrhosis End Stage liver disease HCC death

  5. Natural history of Cirrhosis • 50 % over 10 years Compensated Cirrhosis Decompensated Cirrhosis Which is …… Variceal hemorrhage Ascites 50 % die in 2 years Hepatic Encephalopathy

  6. Varices develop in 50-60 % of cirrhotics • Annual rate of development 2-5 % • 30% of them develop UGIB • Risk of rebleeding (2nd bleeding ) 60-70% over 24 months • Death in cirrhotics 1/5 – 1/3 ,due to variceal bleeding

  7. Stigmata of Chronic Liver disease • Clubbing • Leukonychia • Palmar erythema • Dupuytren's contracture • Asterixis • Spider angiomata • Purpura • Gynaecomastiaor Feminizing Hair Re-distribution • Testicular atrophy • Hepatomegaly • Splenomegaly • Ascites • Distended abdominal veins in which flow is away from the umbilicus (caput medusae)

  8. Clinical features Symptoms Complications: Portal hypertension • Hepatic encephalopathy • GI bleeding • Ascites • Lower limbs edema Incidental abnormality of LFT

  9. Clinical features Symptoms Complications: Portal hypertension • Hepatic encephalopathy • GI bleeding • Ascites • Lower limbs edema Incidental abnormality of LFT

  10. Gynecomastia due to hypersestogenemia state • Also noted in spironolactone use Flapping tremor due to False neurotransmitters Causing imbalance at the cerebellar function

  11. Caput medusa • due to portal • hypertension with collateral • formation between paraumbilical veins that arise from the umbilical portion of the left portal vein that connect to the epigastric and and internalmammry veins through the round ligament

  12. Causes of Chronic Liver diseases

  13. Causes of chronic liver disease

  14. Laboratory markers for HBV infection and its interpretation

  15. Diagnosis of HCV infection

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