General Internal Medicine

General Hepatology

Questions discussed in this category

How do you counsel patients on the risks vs benefits of naltrexone for alcohol use disorder with persistently elevated liver enzymes?

Is there an absolute cutoff for AST/ALT that you use where the risks outweigh the potential harm reduction benefits of using the medication? &nbs...

2 Answers available

In patients with MASLD, would you consider management with off-label metformin, pioglitazone (despite weight gain risk), GLP-1 RA, or simply intensify lifestyle and monitor?

If you prefer monitoring strategy, how frequently do you repeat labs and what is your referral thresholds to hepatology if you're practicing in primar...

1 Answer available

When giving albumin challenge, for acute kidney injury with suspected hepatorenal syndrome, do you administer a single dose daily or split the dose of albumin?

1 Answer available

What parameters would you use to monitor and interpret iron levels in a hemochromatosis patient where ferritin is unreliable due to underlying chronic inflammation?

How would your recommendation change if the patient has H63 homozygous mutation?

2 Answers available

Do you obtain liver biopsy to confirm the diagnosis of cirrhosis if cirrhotic liver morphology is noted on imaging?

2 Answers available

Would you consider sotalol to be a suitable non-selective beta blocker for primary prevention of variceal bleeding in a patient who requires sotalol for treatment of arrhythmia in the setting of Fontan-associated liver disease and clinically significant portal hypertension?

1 Answer available

How do you approach the treatment of Crohn's colitis in the setting of immunosuppression for liver transplant?

1 Answer available

Would you anticoagulate an SMV thrombosis caused by malignant obstruction in the setting of metastatic colorectal cancer?

For what duration and is there a preferred anticoagulation agent?

1 Answer available

Is there a risk of hepatitis C activation with rituximab in a patient who has a history of HCV treated with antivirals and who is in sustained viral response?

1 Answer available

How would you manage a patient with highly active ankylosing spondylitis, iritis and Crohn’s, controlled with weekly adalimumab with co-morbid IgG4RD and intolerance of azathioprine due to elevated LFTs?

IgG4 manifestations include autoimmune pancreatitis and periaortic soft tissue mass.

2 Answers available

Does hepatitis B vaccination reduce the risk of HBV reactivation associated with immunosuppressive therapy?

For example, in patients who are HbSAg negative, anti-HBc positive and HbSAb negative, does vaccination reduce reactivation risk?

2 Answers available

How long do you anticoagulate for cirrhosis patients who have portal vein thrombosis extending to the mesenteric veins?

2 Answers available

What is your approach to management of elevated liver enzymes in patients who recently started treatment with tocilizumab?

1 Answer available

To what extent does the degree of thrombocytopenia correlate with the severity of cirrhosis?

1 Answer available

How would you approach asymptomatic hepatic sarcoid?

Multiple lesions on PET

1 Answer available

Do you routinely start anticoagulation for a patient with newly diagnosed hepatocellular carcinoma presenting with a portal venous thrombosis?

3 Answers available

How do you assess transaminitis in a patient with sarcoidosis with known liver involvement being treated with methotrexate?

1 Answer available

How do you manage patients who are Hepatitis B core antibody positive/surface antigen negative and starting a biologic DMARD (other than rituximab)?

1 Answer available

Papers discussed in this category

Arthritis Rheumatol, 2016 Jan

2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis.

Blood, 2020 Sep 10

Anticoagulant therapy for splanchnic vein thrombosis: A systematic review and meta-analysis.

Blood Adv,

American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer.

Seminars in respiratory and critical care medicine, 2002-12

Hepatic, splenic, and gastrointestinal involvement with sarcoidosis.

Clinics in liver disease, 2019-05

Sarcoidosis and the Liver.

Eur J Gastroenterol Hepatol,

Natural history of hepatic sarcoidosis and its response to treatment.

Neth J Med,

Sarcoidosis of the liver: to treat or not to treat?

Semin Respir Crit Care Med, 2020 Aug 10

Hepatic Sarcoidosis: Current Concepts and Treatments.

Blood, 2014 Oct 15

How I treat splanchnic vein thrombosis.

Journal of thrombosis and haemostasis : JTH, 2024 Oct 21

Splanchnic vein thrombosis: management for the thrombosis specialist.

Lancet (London, England), 2019 Mar 22

β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial.

The New England journal of medicine, 2021 Mar 04

A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis.

JHEP reports : innovation in hepatology, 2024 Apr 10

Safety of naltrexone in patients with cirrhosis.

General Internal Medicine

General Hepatology

Questions discussed in this category

Papers discussed in this category

Related Topics in General Internal Medicine