Gastroenterology

Hepatology

Questions discussed in this category

How do you manage anticoagulation/antiplatelet therapies with strong indications for uninterrupted therapy in setting of urgent procedures?

For example, anticoagulation for recent, significant PE or dual antiplatelet therapy for recent MI, but requiring urgent procedures such as biopsy of ...

4 Answers available

Do you avoid peritoneal dialysis in cirrhotic patients with ascites?

3 Answers available

How do you determine whether to limit volume removal during therapeutic paracentesis in a patient without acute or chronic kidney disease?

3 Answers available

In patients with MASLD and F2–F3 fibrosis, would you initiate Resmetirom even if they are not making active lifestyle changes?

And for how long?

2 Answers available

What is your approach to the management of post-TIPS hepatic encephalopathy?

1 Answer available

How do you approach the workup for a patient with imaging showing features suggestive of cirrhosis?

2 Answers available

How do you approach dosing beta blockers for variceal prophylaxis when the standard dose doesn’t achieve the target heart rate?"

1 Answer available

In a patient with Zieve's Syndrome and alcohol related cirrhosis which antibiotic regimen is safe to treat H. pylori?

Most antibiotics used to treat the H. pylori are contraindicated in cirrhosis.

2 Answers available

Is there a serum ammonium level for which you recommend initiation of dialysis in a patient with hepatic encephalopathy?

3 Answers available

How do you incorporate other pharmacologic bariatric/appetite suppressants in the context of their clinical care plan for MASLD?

1 Answer available

What clinical scenario do you consider screening for hepatitis delta?

1 Answer available

At what BMI or waist-circumference threshold do you opt to move from Fibroscan to other NILDA for fibrosis assessment?

And what would be your choice?

1 Answer available

What is your strategy in the management of patients with autoimmune hepatitis who failed azathioprine therapy and what parameters do you monitor with what frequency?

1 Answer available

What is your approach to perioperative risk stratification and optimization in patients with cirrhosis?

Do you find risk scores such as VOCAL-Penn to be helpful?

1 Answer available

What kind of monitoring do you choose in patients at risk for reactivation of hepatitis B who are on immunosuppression?

1 Answer available

When do you pursue liver biopsy for assessment of DILI?

1 Answer available

How do you approach HCC screening in patients with advanced fibrosis e.g., F3 on FibroScan?

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

Do you recommend starting naltrexone at discharge for alcohol use disorder in patients with decompensated cirrhosis secondary to alcohol use?

2 Answers available

Do you avoid terlipressin for patients with hepatorenal syndrome who have an elevated bilirubin level?

2 Answers available

Is there benefit to aggressively treating hemochromatosis in a patient who has already progressed to cirrhosis at the time of diagnosis?

2 Answers available

When would you consider use of EUS guided liver biopsy over percutaneous and/or transjugular?

2 Answers available

If you do not have easy access to shear wave elastography (aka Fibroscan), what do you recommend for non-invasive tests to determine if a MASLD patient has clinically significant portal hypertension and risk-stratify them?

1 Answer available

Can fatty liver disease present with elevations in alkaline phosphatase without other liver enzyme elevations (AST and ALT)?

1 Answer available

How does presence of clinically significant portal hypertension change patient prognosis in MASLD?

1 Answer available

Would you consider long term avatrombopag use in patients with cirrhosis requiring higher platelet counts for medical therapy?

For example, someone needing a higher platelet count for dual antiplatelet agent use after coronary stent placement.

1 Answer available

How do you rule out spontaneous bacterial peritonitis in a patient with minimal ascites that is not amenable to paracentesis?

1 Answer available

How do you manage fatty liver disease in patients on olanzapine who are reluctant to change meds?

I have several forensic patients who have elevated LFTs and fatty liver on ultrasound, at least in part due to long-term olanzapine use. They are all ...

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

How do you choose between resmetirom and semaglutide in the treatment of MASH?

1 Answer available

Do you recommend the use of SGLT2 inhibitors to reduce the risk of liver cirrhosis in patients with Type 2 diabetes mellitus?

1 Answer available