Curbside Consultation of the Liver

49 Clinical Questions
Herausgeber: Shiffman, Mitchell

• Broschiertes Buch

Produktbeschreibung

Curbside Consultation of the Liver: 49 Clinical Questions provides quick and direct answers to the thorny questions commonly posed during a "curbside consultation" between colleagues.

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Produktdetails

• Verlag: CRC Press
• Seitenzahl: 266
• Erscheinungstermin: 15. April 2008
• Englisch
• Abmessung: 254mm x 178mm x 14mm
• Gewicht: 507g
• ISBN-13: 9781556428159
• ISBN-10: 1556428154
• Artikelnr.: 23067542

Autorenporträt

Mitchell L. Shiffman, MD received his MD degree from the State University of New York, Upstate Medical Center in Syracuse, NY. He then completed internship and residency training in Internal Medicine at the Medical College of Virginia (now the Virginia Commonwealth University Medical Center) in Richmond, VA. He remained at this institution for fellowship training in Gastroenterology and Hepatology, which included two years of research training funded by a National Institutes of Health training grant. After completing his training, Dr. Shiffman joined the faculty of the Virginia Commonwealth University as an Assistant Professor of Medicine and has remained at this institution throughout his academic career. He is currently a Professor of Medicine, and has been the Chief of the Hepatology Section and Medical Director of the Liver Transplant Program at the VCU Medical Center for over a decade. Dr. Shiffman has authored or coauthored over 200 original articles, editorials, reviews, and/or book chapters. His clinical research has focused on improving our understanding and developing better treatments for viral hepatitis B and C. He is a member of the Board of Trustees of the American College of Gastroenterology, and has served on numerous NIH grant review committees and is a member of the Editorial Boards of Liver Transplantation and Liver International.

Inhaltsangabe

CONTENTS Dedication Acknowledgments About the Editor Contributing Authors
Preface Section I: VIRAL HEPATITIS C Question 1: What Is the Likelihood
That My Patient With Chronic Hepatitis C Will Develop Cirrhosis,
Heaptocellular Carcinoma, and/or Hepatic Decompensation? Question 2: How
Should a Patient Who Tests Positive for Chronic Hepatitis C but Has
Persistently Normal Serum Liver Amino-Transaminases Be Evaluated? Question
3: Do All Patients With Chronic Hepatitis C Virus Require a Liver Biopsy?
Question 4. How Often Should I Measure HCV RNA While Treating a Patient
With Peginterferon and Ribavirin? Question 5: When A Patient Receiving
Peginterferon and Ribavirin Therapy Develops Anemia Should I Prescribe
Epoetin Alfa or Reduce the Dose of the Ribavirin? Question 6: Is There
Anything I Can Do to Improve the Chance That an African American With
Chronic Hepatitis C Will Respond to Peginterferon and Ribavirin? Question
7: Is It Safe to Treat Patients With Chronic Hepatitis C and Cirrhosis With
Peginterferon and Ribavirin? Question 8: How Often Should I Follow a
Patient Who Had Chronic Hepatitis C After He Achieved a Sustained Virologic
Response? Section II: Viral Hepatitis B Question 9: Which Patients With
Chronic Hepatitis B Require a Liver Biopsy? Question 10: How Do I Decide
Which Medication to Utilize in a Patient With Hepatitis B Virus? Question
11: Can I Ever Stop Treatment in a Patient With Chronic Hepatitis B
Receiving an Oral Antiviral Agent? Question 12: How Do I Know When a
Patient Receiving an Oral Antiviral Agent Has Developed Resistence and What
Do I When This Happens? Question 13: How Do I Treat a Patient Who Is
Coinfected With Chronic Hepatitis B and C Viruses? Section III: LIVER
DISEASE IN PATIENTS WITH HIV INFECTION Question 14: How Does Having HIV
Affect the Likelihood That My Patient With Chronic HCV Will Develop
Cirrhosis? Question 15: Which Patients With Chronic HCV and HIV Coinfection
Should Be Treated With Peginterferon and Ribavirin? Question 16: Is There a
Simple Way to Treat a Patient Who Is Coinfected With Hepatitis B Virus and
HIV? Question 17: What Things Could Cause My Patient With HIV to Develop
Jaundice? Question: 18 Should I Stop HIV Medications in a Patient Who Has
Developed an Elevation In Serum Liver Transaminases? Section IV: GENETIC
DISORDERS THAT CAUSE CHRONIC LIVER DISEASE Question 19: What Is the Best
Screening Test for Genetic Hemochromatosis? Question 20: How Frequently
Should I Have a Patient With Genetic Hemochromatosis Undergo Phlebotomy?
Question 21: What Is the Best Screening Test for Wilson's Disease? Question
22: What Should I Tell My Patient Who Is a Carrier for Alpha-1-Antitrypsin
Deficiency? Question 23: Do All Patients With Autoimmune Hepatitis Require
Immune Suppressive Medications? Question 24: My Patient With and Autoimmune
Hepatitis Cannot Take Corticosteroids. Are There Any Other Medications I
Could Use? Question 25: Do I Need to Perform a Liver Biopsy in All Patients
With Autoimmune Hepatitis Prior To Initiating Steroids? Section V: FATTY
LIVER DISEASE Question 26: Which Patients With Fatty Liver Disease on
Ultrasound Require a Liver Biopsy? Question 27: An Obese Patient With
Hypercholesterolemia Was Recently Started on a Statin and Is Now Found to
Have Elevated Serum Liver Transaminases. Do I Need to Stop This Medication?
Question 28: What Is the Best Medication to Utilize In a Patient With Fatty
Liver Disease and Type 2 Diabetes Mellitus? Question 29: My Patient With
Chronic Hepatitis C Also Has Evidence of Nonalcoholic Steatohepatitis
(NASH) on His Liver Biopsy. What Can I Do to Increase His Chance of
Responding to Peginterferon and Ribavirin Treatment? Question 30: Can A
Patient of Normal Body Weight, a Normal Serum Cholesterol Level, and No
History of Diabetes Have Fatty Liver Disease? Section VI: CHOLESTATIC LIVER
DISEASES Question 31: When Should I Initiate Treatment With Ursodeoxycholic
Acid and What Dose Should I Utilize In My Patient With Primary Biliary
Cirrhosis? Question 32: What Type of Testing Does My Patient With Primary
Biliary Cirrhosis Require? Question 33: Is Ursodeoxycholic Acid Effective
for the Treatment of Primary Sclerosing Cholangitis? Question 34: Should I
Be Screening My Patient With Primary Sclerosing Cholangitis for
Cholangiocarcinoma? Question 35: Should All Patients With Suspected
Sclerosing Cholangitis Undergo an ERCP to Confirm This Diagnosis? Question
36: My Patient With Ulcerative Colitis Recently Underwent a Total Colectomy
for Severe Dysplasia. Does This Reduce The Risk That He Will Get Primary
Sclerosing Cholangitis? Section VII: CIRRHOSIS Question 37: Which
Asymptomatic Patients With Cirrhosis Should Undergo an Upper Endoscopy To
Determine If They Have Esophageal Varices? Question 38: I Just Banded
Actively Bleeding Varicies in a Patient With Known Cirrhosis. The Patient
Is Now Hemodynamically Stable. Is There Anything Else I Should Recommend?
Question 39: Which Patients With Chronic Liver Disease Should I Screen For
Hepatocellular Carcinoma? Question 40: Should I Vaccinate My Patients With
Cirrhosis for Viral Hepatitis A and B? Question 41: A Healthy Patient Not
Known to Have Chronic Liver Disease, With Normal Liver Chemistries and
Liver Function Was Found to Have a 4-Centimeter Liver Mass on Ultrasound.
Should I Biopsy This? Question 42: I Was Asked to See a Patient With Tense
Ascites. How Much Ascites Is Safe to Remove at Any One Time? Question 43: I
Have Been Increasing the Dose of Diuretics in My Patient With Ascites Over
Several Weeks. He Still Has Ascites but Has Now Developed an Elevation in
Serum Creatinine to 2.0 Mg/dl. What Should I Do? Question 44: My Patient
With Cryptogenic Cirrhosis Was Recently Hospitalized With Spontaneous
Bacterial Peritonitis. How Long Should She Be Treated With Antibiotics?
Question 45: My Patient With Cirrhosis Has an Elevated Serum Ammonia but No
Symptoms of Hepatic Encephalopathy. How Much Lactulose Should I Recommend?
Question 46: My Patient With Hepatic Encephalopathy Continues to Be Mildly
Confused Despite Taking Lactulose Twice Daily And Having Multiple Episodes
Of Diarrhea Daily. Should I Increase The Dose Further? Section VIII: LIVER
TRANSPLANTATION Question 47: My Patient With Cirrhosis Suffers From Severe
Fatigue but Has Normal Liver Function and Has Never Had a Major
Complication of Cirrhosis. Should I Refer This Patient For a Liver
Transplant? Question 48: What Should I Recommend for My Patient With
Cirrhosis Who Was Recently Found To Have A New 2-Centimeter Liver Mass By
Ultrasound Screening? Question 49: I Have Been Asked to See a Patient Who
Had a Liver Transplant 5 Years Ago In Another State. He Has Not Been Seen
by His Liver Transplant Center In 2 Years. His Serum Creatinine Is 2.5
mg/dl but His Liver Enzymes and Liver Function Tests are Normal. He Does
Not Want to Go Back To His Transplant Center. What Should I Do? Index