Teaching Point

• Common etiologies
  • Alcohol
  • Hepatitis C and B
  • NAFLD
• Complications
  • Ascites: spironolactone 100mg/lasix 40mg
  • SBP: ceftriaxone 2gm IV q24h
  • Hepatic encephalopathy: lactulose, neomycin/rifaximin

Thank you Dr. Reynolds for an excellent presentation on drug-induced liver injury

Teaching Points

• Patterns of abnormal LFTS
  • Hepatocellular: high AST/ALT w/mild elevation in alk phos
  • Cholestatic: High alk phos w/ mild AST/ALT
• Causes of hepatocellular injurry
  • Alcohol: AST elevation greater than ALT
  • Viral: ALT elevation greater than AST
  • NAFLD/NASH: AST to ALT ratio typically 1
  • Toxins: NSAIDS, abx, statins, anti-epileptic drugs
  • Hereditary/autoimmune: hemochromatosis, autoimmune hepatitis, alpha-1-antitrypsin deficiency, Wilson’s disease
  • Shock: high elevations in AST/ALT
  • Non-hepatic causes: muscle disorders, thyroid issues, celiac disease, adrenal insufficiency, anorexia

Here is the power point from today’s case conference on the diagnosis and management of Community Acquired Pneumonia. Intern Report 7.6.16

Thank you Dr. Tu for an excellent presentation of ischemic stroke due to septic emboli from infective endocarditis Teaching Points: CNS complications of infective endocarditis can occur in 20-40% patients Etiology: occlusion of cerebral arteries by septic emboli, cerebral hemorrhage, meningitis,…

Thank you Dr. Janoian for a great presentation on the progression of myocardial infarction. Teaching Points: pathologic outcomes of MI: arrhythmia, ischemic cardiomyopathy with or without cardiogenic shock, mechanical dysfunction/complications, pericarditis mechanical complications: papillary muscle rupture, ventricular free wall rupture,…

Thank you Dr. Layoun for an excellent presentation on arrhythmogenic right ventricular cardiomyopathy/dysplasia

Teaching Points:

• ARVD is a genetic cardiomyopathy with mutations in desmoglein-2, desmoplakin, desmocollin-2, plakophilin, etc
• Characterized by life-threatening ventricular arrhythmias (monomorphic VT)
• ECG: QRS prolongation (in right precordial leads), RBBB morphology, Epsilon Wave (distinct wave between QRS and T waves, seen in precordial leads, V1 is the best spot)
• Treatment: refrain from high intensity exercise, low dose beta-blocker, ICD for secondary prophylaxis in patients with history of VT or VF