Hepatocellular carcinoma, liver cancer. Diagnostic criteria. Combined criteria: one imaging technique associated with AFP.
Focal lesion >2 cm with arterial hypervascularization.
AFP levels >400 ng/mL
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Significant elevations of serum lipase not caused by pancreatitis: a systematic review. Drugs, alcohol, type 1 diabetes mellitus. ...Read more | Lipase elevation
Hepatitis b. hepatitis e antigen determines treatment course. Hep b e antigen positive which turns negative can stop treatment.
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Hepatitis b. eight different genotypes. Rarely affects treatment. Hbv replication serologies are hbeag antihbe hbv DNA.
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Autoimmune hepatitis presents with ast and alt elevations greater than fifteen times upper limit of normal. Check spep, then check ana and anti smooth muscle antibody.
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Xifaxan 550 mg PO BID for hepatic encephalopathy. Rifaximin.
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Hepatitis B "treated with telbivudine were therefore significantly more likely to show HBeAg seroconversion than those receiving entecavir"
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Hepatitis B "interval between HCC surveillance tests is 6–12 months"
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Hepatitis C Labs for therapy - genotype, rna viral load, cbc, cmp, pt/inr, fibrosure. Ultrasound.
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Epclusa for 12 weeks genotype 2 hepatitis C 99 percent cure rate. December 2017. Add ribavirin for Child Pugh B and C for 12 weeks.
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Check viral load 12 weeks after Epclusa therapy for hepatitis C. Can check viral load at 4 weeks.
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Alcoholic cirrhosis - ascites, hepatic encephalopathy. Ordered cirrhosis panel, ascites panel, and AFP. Lactulose titrated to 3 bowel movements per day. Discharge on spironolactone 100 mg PO qday and Lasix 40 mg PO qday. Can follow up with me in clinic to discuss EGD with possible variceal banding. Gastroenterology will sign off. Please call with questions.
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