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Thrombocytopenia - sensitive finding for cirrhosis, indicates portal hypertension and splenomegaly leading to platelet sequestration
Posted 08/22/16 09:01:30 AM by Anna Krigel
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HCV screening - all adults born between 1945 and 1965 must be screened once for HCV (using HCV Ab)
- If positive - treat for HCV with novel therapies
- If not treated - HCV takes 20-30 years to progress to cirrhosis
- ETOH, HBV, and HIV can accelerate course of progression to cirrhosis
Posted 08/22/16 09:14:08 AM by Anna Krigel
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AASLD guidelines recommend screening for HCC in all patients with cirrhosis, starting when the diagnosis is made, with liver ultrasound every 6 months
- AFP has poor sensitivity and specificity, thus it should never be used alone for HCC screening
- AFP in combination with ultrasound for HCC screening is also not recommended by the AASLD (not cost effective, increases false-positives)
Posted 08/22/16 09:31:14 AM by Anna Krigel
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- First decide if resectable or unresectable
- If unresectable, decide if liver transplant candidate using Milan Criteria
- Single lesion less than or equal to 5cm
- Up to 3 lesions less than 3cm
- No evidence of vascular invasion
- No regional or nodal or extrahepatic distant metastases
- If not a transplant candidate, can attempt down-staging with TACE, stereotactic radiotherapy, etc.
- If extrahepatic metastases, management likely palliative but can do systemic therapy with sorafenib
Posted 08/22/16 09:50:57 AM by Anna Krigel
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For further reading...
Posted 08/22/16 09:56:34 AM by Anna Krigel
Created by Christopher Kelly
Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.