HEPATOBILIARY SYSTEM PATHOLOGY MNEMONICS

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HEPATOBILIARY SYSTEM PATHOLOGY MNEMONICS

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

Biliary tract Lesions: Pain - Cholelithiasis
Pain + Pyrexia - Acute Cholecystitis
Pain + Jaundice - Choledocholithiasis
Pain + Pyrexia + Jaundice (Charcot's triad) - Ascending Cholangitis

Common Causes Of Increased levels of Bilirubin: "HOT Liver"
Hemolysis
Obstruction
Tumor
Liver disease

Charcot's triad (gallstones) : "Charge a FEE"
Charcot's triad is:
Fever
Epigastric & RUQ pain
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 , Differential Common and Rarer : Common causes are
"ABC"
Alcohol
B (Hepatitis)
C (Hepatitis)
Rarer are also
"ABC"
Autoimmune
Biliary cirrhosis
Copper (Wilsons)

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)

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

Hepatocellular carcinoma: aetiology, features : "ABC"
Aetiology:
Aflatoxins
Hep B
Cirrhosis
Features:
AFP increased (classic marker)
Bile-producing (DDx from cholangiocarcinoma)
Commonest primary liver tumor

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

Liver failure (chronic) Signs 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 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)
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

Portal Hypertension Features : "ABCDE"
Ascites
Bleeding (haematemesis, piles)
Caput medusae
Diminished liver
Enlarged spleen

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