LIVER AND BILIARY SYSTEM MNEMONICS | MEDICINE

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Ascites treatment options : "DAFT"
D - Diuretics
A - Ascitic tap or drain
F - Fluid and salt restriction
T - TIPS (transjugular intrahepatic portosystemic shunt)

Common causes of increased Bilirubin level: "HOT Liver"
H - Hemolysis
O - Obstruction
T - Tumor
Liver - Liver disease (eg. hepatitis)

Charcot's triad (gallstones) : "FEE"
Charcot's triad is:
F - Fever
E - Epigastric & RUQ pain
E - Emesis & nausea
Alternatively
"Charcots Triad is 3 C's"
Color change (jaundice)
Colic (biliary) pain, aka RUQ pain
Chills and fever

Cholangitis features : "CHOLANGITITS"
C - Charcot's triad/Conjugated bilirubin increase
H - Hepatic abscesses/Hepatic (intra/extra) bile ducts/ HLA B8, DR3
O - Obstruction
L - Leukocytosis
A - Alkaline phosphatase increase
N - Neoplasms
G - Gallstones
I - Inflammatory bowel disease (ulcerative colitis)
T - Transaminase increase
I - Infection
S - Sclerosing

Cirrhosis, Causes of Hepatic Cirrhosis : "HEPATIC"
H - Hemochromatosis (primary)
E - Enzyme deficiency (alpha-1-anti-trypsin)
P - Post hepatic (infection + drug induced)
A - Alcoholic
T - Tyrosinosis
I - Indian childhood (galactosemia)
C - Cardiac/Cholestatic (biliary)/ Cancer/Copper (Wilson's)

Cirrhosis Differential Common and Rarer : Common causes
"ABC"
Alcohol
B (Hepatitis)
C (Hepatitis)
Rarer Causes are
"ABC"
Autoimmune
Biliary cirrhosis
Copper (Wilsons)

Drug-induced chronic liver disease: "MAD CV"
M - Methotrexate
A - Amiodarone
D - Diclofenac
C - Chlorambucil
V - Valproate

Haemachromatosis complications : "HaemoChromatosis Can Cause Deposits Anywhere"
Hypogonadism
Cancer (hepatocellular)
Cirrhosis
Cardiomyopathy
Diabetes mellitus
Arthropathy

Hepatic encephalopathy precipitating factors : "ABCDEFI"
Alcohol withdrawal
Bleeding (GI)
Constipation
Drugs: withdraw any sedatives/narcotics
Electrolyte imbalances
Fluid depletion: stop diuretics
Infections: treat vigorously
Alternatively
"HEPATICS"
H - Hemorrhage in GIT/Hyperkalemia
E - Excess protein in diet
P - Paracentesis
A - Acidosis/Anemia
T - Trauma
I - Infection
C - Colon surgery
S - Sedatives

Hepatomegaly 3 common causes, 3 rarer causes: Common Causes are
"3 Cs"
Cirrhosis
Carcinoma
Cardiac failure
Rarer Causes are
"3 Cs"
Cholestasis
Cysts
Cellular infiltration

Liver failure (chronic) signs of Liver Failure found on the arms : "CLAPS"
C - Clubbing
L - Leukonychia
A - Asterixis
P - Palmar erythema
S - Scratch marks

Liver failure : Decompensating chronic liver failure differential : "HEPATICUS"
H - Haemorrhage
E - Electrolyte disturbance
P - Protein load/Paracetamol
A - Alcohol binge
T - Trauma
I - Infection
C - Constipation
U - Uraemia
S - Sedatives/Shunt/Surgery

Liver Screen Blood Tests : "A LIVE CATCH"
A - Autoantibodies
L - Liver function tests (LTFs)
I - Immunoglobulins and protein electrophoresis
V - Viral inc. CMV, EBV
E - Ethanol
C - Coagulation inc. INR, APTT
A - Alpha-feto protein
T - Total iron binding and ferritin
C - Copper (serum), ceruloplasmin
H - Hepatitis serology e.g. A, B and C

Pancreatitis criteria : "PANCREAS"
P - PaO2 below 8
A - Age > 55
N - Neutrophils: WCC > 15
C - Calcium below 2
R - Renal: Urea > 16
E - Enzymes: LDH > 600; AST > 200
A - Albumin below 32
S - Sugar: Glucose > 10 (unless diabetic patient)

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