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Gastroenterology: hepatitis — viral, alcoholic; cirrhosis and complications

General Medicine · MBBS

Study notes

Yellow eyes, shrunken liver, ascites — cirrhosis; band ligation prevents the fatal bleed. Cirrhosis (fibrosis — alcohol, Hep B/C: jaundice, ascites, varices, encephalopathy — asterixis): complications — variceal bleed (band ligation + propranolol), ascites (SAAG ≥1.1 — salt restriction, spironolactone, paracentesis), encephalopathy (lactulose, rifaximin), HCC surveillance (6-monthly ultrasound + AFP). Viral — A/E (fecal-oral — acute, supportive), B (vaccine; tenofovir if chronic), C (DAAs — sofosbuvir — curable), D (with B). Alcoholic (AST:ALT >2:1 — abstinence). The shrunken liver is the end-stage — transplant is the cure.

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