#FirstTweet! We will be sharing hepatology #Twearls from this morning's res report led by GI fellow extraordinaire @JacquelineChuMD!
2/5💡"Not all cirrhotics are created equal"-> It's important to distinguish compensated from decompensated cirrhosis! The latter indicates a much worse prognosis.
Some hallmarks of decompensated cirrhosis:
▪️ascites
▪️hepatic encephalopathy
▪️variceal bleed.
Some hallmarks of decompensated cirrhosis:
▪️ascites
▪️hepatic encephalopathy
▪️variceal bleed.
3/5💡Hepatic encephalopathy is not a stand-alone diagnosis. It's a sign of an underlying issue & you need to find the cause!
For that, you can turn to VIBES!
For that, you can turn to VIBES!
4/5 VIBES is a general mnemonic we use to approach patients with cirrhosis & keep track of their complications. Stands for:
💧V= Volume (ascites/HRS)
🦠 I= Infection (mainly SBP)
🩸 B= Bleeding (Variceal)
😖 E= Hepatic Encephalopathy "HE"
🦀 S= Screening (for HCC) & Transplant
💧V= Volume (ascites/HRS)
🦠 I= Infection (mainly SBP)
🩸 B= Bleeding (Variceal)
😖 E= Hepatic Encephalopathy "HE"
🦀 S= Screening (for HCC) & Transplant
5/5 You can use the same mnemonic to think of causes of HE in broad buckets:
💧V= hypovolemia, electrolyte imbalance (hypoK)
🦠 I= SBP & any other infection
🩸 B= Bleed, portal vein thrombosis, recent TIPS
😖 E= Missed meds(lactulose), toxin(alcohol), hypoglycemia
🦀 S= New HCC
💧V= hypovolemia, electrolyte imbalance (hypoK)
🦠 I= SBP & any other infection
🩸 B= Bleed, portal vein thrombosis, recent TIPS
😖 E= Missed meds(lactulose), toxin(alcohol), hypoglycemia
🦀 S= New HCC
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