Lecturio: Study for Medical School, USMLE, MCAT & MBBS

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Cirrhosis is a late stage of hepatic parenchymal necrosis and scarring (fibrosis) most commonly due to hepatitis C infection and alcoholic liver disease. Patients may present with jaundice, ascites, and hepatosplenomegaly. Complications of cirrhosis include hepatic encephalopathy, portal hypertension and ascites, and hepatorenal syndrome. Diagnosis is based on clinical, laboratory, and imaging findings. Management requires treating the underlying cause and complications; liver transplantation may be required in some cases.

Wilson Disease (Clinical)

Wilson disease (hepatolenticular degeneration) is an autosomal recessive disorder caused by various mutations in the ATP7B gene, which regulates copper transport within hepatocytes. Dysfunction of this transport mechanism leads to abnormal copper accumulations in the liver, brain, eyes, and other organs, with consequent major and variably expressed hepatic, neurologic, and psychiatric disturbances. Liver involvement may manifest as hepatitis, liver failure, or cirrhosis, while basal ganglia involvement causes the extrapyramidal signs. Most patients are diagnosed between the ages of 5 and 35 years (mean: 13 years). Diagnosis is established if the patient has low plasma ceruloplasmin, corneal deposits of copper (Kayser-Fleischer rings), and elevated copper levels in the urine. However, other tests are often needed since not all patients will have all these findings. The prognosis is good for patients without advanced liver disease and for those who are treated with the chelating agents penicillamine or trientine. Untreated Wilson disease is ultimately fatal, with patients dying from cirrhosis, acute liver failure, or complications due to progressive neurologic disease.

Hepatic Encephalopathy (Clinical)

Hepatic encephalopathy is a reversible condition in which elevated ammonia levels cause impaired brain function in patients with advanced liver disease. Hepatic encephalopathy can be precipitated by conditions that affect the normal absorption, metabolism, or clearance of ammonia, including dehydration, renal failure, infections, and gastrointestinal bleeding. Patients present with a progression of symptoms, from minimal confusion and asterixis to stupor and coma. Diagnosis is clinical and requires the exclusion of alternative diagnoses. Management involves addressing the causative factor and decreasing the systemic absorption of ammonia with lactulose or rifaximin.

Hepatorenal Syndrome (Clinical)

Hepatorenal syndrome (HRS) is a “functional” type of acute kidney injury (AKI) in patients who have portal hypertension, usually due to cirrhosis. HRS may also be caused by other liver diseases which are associated with portal hypertension, which causes decreased systemic arterial blood volume and activation of neurohormonal mechanisms, including the renin-angiotensin-aldosterone system. The resulting vasoconstriction and reduced renal perfusion trigger the release of vasodilatory substances like nitric oxide, which induces splanchnic arterial vasodilatation, leading to a decrease in systemic vascular resistance and effective circulating volume, thereby exacerbating renal hypoperfusion. HRS is a diagnosis of exclusion, and is associated with a poor prognosis. Without treatment, most patients die within weeks of the onset of AKI. Patients typically present with a progressive rise in serum creatinine, a benign urine sediment, no (or minimal) proteinuria, and a low urine sodium concentration. Ascites is often present, and severe cases are associated with oliguria. Treatment is aimed at improving liver function, if possible. Medical therapy includes increasing the systemic blood pressure with norepinephrine and albumin infusions, and administering agents that cause splanchnic vasoconstriction (e.g., terlipressin). Transjugular intrahepatic portosystemic shunt (TIPS) may be successful, and dialysis is a temporizing solution while waiting for liver transplant. The prognosis of patients with HRS is highly dependent upon reversal of the hepatic failure, whether spontaneous, following medical therapy, or following transplantation.

Hereditary Hemochromatosis (Clinical)

Hereditary hemochromatosis (HH) is an autosomal recessive disorder most often associated with HFE gene mutations. Patients have increased iron intestinal absorption and iron deposition in several organs, such as the liver, heart, skin, and pancreas. The clinical presentation is usually with nonspecific symptoms and signs such as fatigue and joint pain in patients over 40, abnormal liver function tests, and hypogonadism in men. Diagnosis is made by laboratory testing showing high transferrin saturation or ferritin indicative of iron overload. Other testing includes genetic testing for HFE variants and MRI to quantify liver or heart iron overload. If untreated, HH can lead to cirrhosis, type 2 diabetes, and bronze-colored skin. Other findings depend on the organ(s) involved. Genetic screening is recommended for family members. Management requires phlebotomy (or iron chelation therapy in some cases) to prevent disease progression. The prognosis depends on the severity of iron overload and organ injury at the time of diagnosis and the extent of iron removal. The presence of hepatic fibrosis is a poor prognostic factor.

Acute Cholangitis (Clinical)

Acute cholangitis refers to acute inflammation in the bile duct system; it is a life-threatening condition characterized by fever, jaundice, and abdominal pain. This condition develops as a result of stasis and infection of the biliary tract. Septic shock, liver abscess, and multi-organ dysfunction are potential serious complications. The diagnosis is confirmed with ultrasound (or other hepatobiliary imaging studies) showing dilation of the common bile duct (CBD) or gallstones, elevated liver function tests, and leukocytosis. Treatment includes hemodynamic stabilization, broad-spectrum antibiotics, urgent biliary drainage, and addressing the underlying etiology (e.g., cholecystectomy for gallstones).

Cholecystitis (Clinical)

Cholecystitis is the inflammation of the gallbladder (GB) usually caused by the obstruction of the cystic duct (acute cholecystitis). Mechanical irritation by gallstones can also produce chronic GB inflammation. Cholecystitis is one of the most common complications of cholelithiasis (calculous cholecystitis) but inflammation without gallstones (acalculous cholecystitis) can occur in a minority of patients. The acute type usually presents with right upper quadrant (RUQ) pain, fever, and leukocytosis. The diagnosis is made clinically and confirmed via ultrasound (US). The definitive management is cholecystectomy, preferably performed within 72 hours. This condition can present as a mild condition or as a severe disease (with complications such as gallbladder gangrene, perforation, empyema) which require emergent intervention.

Cholelithiasis (Clinical)

Cholelithiasis (gallstones) is the presence of stones in the gallbladder. Most gallstones are cholesterol stones, while the rest are composed of bilirubin (pigment stones) and other mixed components. Patients are commonly asymptomatic but may present with biliary colic (intermittent pain in the right upper quadrant). The diagnosis is established by ultrasound. Management options include supportive care to prevent and control associated symptoms. When indicated, cholecystectomy is the definitive treatment. Gallstones may lead to complications such as choledocholithiasis (a stone trapped in the common bile duct), cholecystitis (inflammation of the gallbladder), or cholangitis (biliary sepsis). These conditions require urgent medical attention.

Primary Sclerosing Cholangitis (Clinical)

Primary sclerosing cholangitis (PSC) is an inflammatory disease that causes fibrosis and strictures of the intrahepatic and extrahepatic bile ducts. The exact etiology is unknown, but there is a strong association with inflammatory bowel disease (IBD). Patients typically present with an insidious onset of fatigue, pruritus, and jaundice, which can progress to cirrhosis and complications related to biliary obstruction. The diagnosis is established with magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Liver transplantation is the only definitive treatment and is indicated in patients with advanced liver disease.

Primary Biliary Cholangitis (Clinical)

Primary biliary cholangitis (PBC) is a chronic disease resulting in autoimmune destruction of the intrahepatic bile ducts. The typical presentation is that of a middle-aged woman with pruritus, fatigue, and right upper quadrant abdominal pain. Elevated liver enzymes and antimitochondrial antibodies (AMAs) establish the diagnosis. Medical management includes ursodeoxycholic acid as the 1st-line treatment and for symptom management. Definitive treatment is liver transplantation, which is performed in late stages (cirrhosis).

Drug-Induced Liver Injury (Clinical)

Drug-induced liver injury (DILI) is the most common cause of acute liver failure (ALF). Hepatotoxic drugs can cause dose-dependent, direct liver injury or idiosyncratic reactions mediated by immune or metabolic processes. This injury can result in hepatitis, cholestasis, steatosis, or overlapping changes. The presentation can be acute or chronic, with severe toxicity manifesting as fulminant liver failure. The diagnosis of DILI requires a thorough history, liver function tests, and drug levels, if available. Management consists of discontinuing the drug, supportive therapy, and monitoring for complications. Acetaminophen is the most common cause of DILI and is treated with a specific therapy, N-acetylcysteine (NAC).

Liver and Biliary Tract Imaging

The hepatobiliary system is composed of the liver, gallbladder, and bile ducts (within the liver and external to the liver). The liver produces bile, which is a fluid made of cholesterol, phospholipids, conjugated bilirubin, bile salts, electrolytes, and water. Bile, which assists in digestion and helps eliminate waste products, is stored in the gallbladder. The hepatobiliary system can be affected by infections, cysts, solid masses, ischemia, and mechanical flow obstruction, which mandate the presence of reliable imaging tests to determine the etiology. The methods that evaluate structural changes in the liver and biliary tract include ultrasonography, CT scan, and MRI (including magnetic resonance cholangiopancreatography). Additionally, cholescintigraphy, a functional imaging study, helps identify gallbladder pathology by tracking the biliary pathway.

Liver Function Tests

Liver function tests, also known as hepatic function panels, are one of the most commonly performed screening blood tests. Such tests are also used to detect, evaluate, and monitor acute and chronic liver diseases. Liver function tests assess the levels of various hepatic proteins and enzymes to determine the state of liver metabolic activity, homeostasis, bile metabolism, and protein synthesis capacity. The standard hepatic panel includes the levels of total protein, bilirubin, albumin, ALT, AST, AST/ALT ratio, and alkaline phosphatase (ALP).

Portal Hypertension

Portal hypertension is increased pressure in the portal venous system. This increased pressure can lead to splanchnic vasodilation, collateral blood flow through portosystemic anastomoses, and increased hydrostatic pressure. There are a number of etiologies, including cirrhosis, right-sided congestive heart failure, schistosomiasis, portal vein thrombosis, hepatitis, and Budd-Chiari syndrome. Most individuals are asymptomatic until complications arise, including esophageal varices, portal hypertensive gastropathy, ascites, and hypersplenism. The diagnosis is clinical, but it can be supported by ultrasound findings (and hepatic venous pressure gradient measurement in unclear cases). Management requires treating the underlying etiology and managing the complications. This can include nonselective beta blockers to prevent bleeding from varices, diuretics and sodium restriction for ascites, and transjugular intrahepatic portosystemic shunt for refractory complications.

Hepatitis C Virus

Hepatitis C is an infection of the liver caused by the hepatitis C virus (HCV). Hepatitis C virus is an RNA virus and a member of the genus Hepacivirus and the family Flaviviridae. The infection can be transmitted through infectious blood or body fluids and may be transmitted during childbirth or through IV drug use or sexual intercourse. Hepatitis C virus can cause both acute and chronic hepatitis, ranging from a mild to a serious, lifelong illness including liver cirrhosis and hepatocellular carcinoma (HCC). Hepatitis C infection is diagnosed by testing for the presence of HCV antibodies and HCV RNA. Management is supportive but includes direct antiviral agents (DAAs) if infection does not resolve spontaneously.

Hepatitis B Virus

Hepatitis B virus (HBV) is a partially double-stranded DNA virus, which belongs to the Orthohepadnavirus genus and the Hepadnaviridae family. Hepatitis B virus is transmitted by exposure to infectious blood or body fluids. Examples of types of exposure include sexual intercourse, IV drug use, and childbirth. The virus can cause potentially life-threatening liver disease. Most individuals with acute HBV infection are asymptomatic or have mild, self-limiting symptoms. Chronic infection can be asymptomatic or create hepatic inflammation, leading to liver cirrhosis and hepatocellular carcinoma (HCC). Management of acute hepatitis is typically supportive. Administration of antivirals or liver transplantation may be necessary in fulminant and chronic cases.

Jaundice

Jaundice is the abnormal yellowing of the skin and/or sclera caused by the accumulation of bilirubin. Hyperbilirubinemia is caused by either an increase in bilirubin production or a decrease in the hepatic uptake, conjugation, or excretion of bilirubin. Etiologies often involve the liver and can be prehepatic, intrahepatic, or posthepatic. Other symptoms of hyperbilirubinemia include pruritus, pale stools, and darkened urine. The diagnosis is made based on liver function tests and imaging. Management is focused on treatment of the underlying condition.

Cirrhosis

Cirrhosis is a late stage of hepatic parenchymal necrosis and scarring (fibrosis) most commonly due to hepatitis C infection and alcoholic liver disease. Patients may present with jaundice, ascites, and hepatosplenomegaly. Cirrhosis can also cause complications such as hepatic encephalopathy, portal hypertension, portal vein thrombosis, and hepatorenal syndrome. Diagnosis is clinical. Management requires treating the underlying disease, managing complications, and, if required, liver transplantation.

Primary Biliary Cholangitis

Primary biliary cholangitis (PBC) is a chronic disease resulting in autoimmune destruction of the intrahepatic bile ducts. The typical presentation is that of a middle-aged woman with pruritus, fatigue, and right upper quadrant abdominal pain. Elevated liver enzymes and antimitochondrial antibodies (AMAs) establish the diagnosis. Medical management is limited to using ursodeoxycholic acid, a disease-modifying agent. Definitive treatment is liver transplantation, which is performed in late stages (cirrhosis).

Acute Cholangitis

Acute cholangitis is a life-threatening condition characterized by fever, jaundice, and abdominal pain which develops as a result of stasis and infection of the biliary tract. Septic shock, liver abscess, and multi-organ dysfunction are potential serious complications. The diagnosis is confirmed with ultrasound showing dilation of the common bile duct (CBD) or gallstones, elevated liver function tests, and leukocytosis. Treatment includes hemodynamic stabilization, broad-spectrum antibiotics, urgent biliary drainage, and cholecystectomy to prevent recurrence.

Benign Liver Tumors

The most common benign liver tumors include hepatic hemangiomas, focal nodular hyperplasia, and hepatic adenomas. These tumors are mostly asymptomatic and/or found incidentally on abdominal imaging. While these tumors are benign, large lesions can cause symptoms such as upper abdominal pain, or produce complications such as bleeding. Malignant potential is a concern for hepatic adenoma, depending on risk factors. The diagnosis is based on imaging studies, with characteristic findings defining the tumor. Biopsy generally is reserved for equivocal cases. Management is observation for most small, asymptomatic, and non-growing tumors. However, high-risk factors, symptoms, increasing tumor size, and complications dictate the need for surgical intervention.

Rare Malignant Liver Tumors

Although hepatocellular carcinoma (HCC) is by far the most common malignant liver tumor, there are several rare malignant tumors that are important to keep in mind when making a differential diagnosis. These tumors include cholangiocarcinoma; hepatoblastoma and mesenchymal tumors, such as epithelioid hemangioendothelioma (EHE); and angiosarcoma. While these conditions differ in their etiology and pathology, they often present similarly, with nonspecific symptoms such as fatigue, weight loss, and abdominal discomfort. Diagnosis is by imaging, which can be supported by a biopsy. Surgical excision is the only curative approach for these tumors.

Hepatocellular Carcinoma (HCC) and Liver Metastases

Hepatocellular carcinoma (HCC) typically arises in a chronically diseased or cirrhotic liver and is the most common primary liver cancer. Diagnosis may include ultrasound, CT, MRI, biopsy (if inconclusive imaging), and/or biomarkers. Treatment options include resection and chemo-/radiotherapy, and liver transplantation in select cases. Liver metastases are much more common than primary liver cancers and usually originate from colorectal, lung, breast, and pancreatic primary sites. Metastases are most commonly diagnosed by CT or PET scans. Management depends on the type and stage of primary cancer.

Alcoholic Liver Disease

Alcoholic liver disease is a spectrum of disorders ranging from fatty liver to cirrhosis secondary to chronic alcohol abuse. Excessive and prolonged consumption of alcohol results in impairment of the lipolysis pathway, causing inflammatory changes within the hepatocytes. Patients typically present during the hepatitis stage with jaundice, fever, and abdominal pain. Diagnosis is based on a history of alcohol abuse and confirmed by laboratory derangement with an AST/ALT ratio > 2. Alcoholic liver disease carries a high mortality rate if patients present with severe hepatitis. Management aims at alcohol abstinence for reversal (at certain stages) and addressing contributing factors (such as viral infections or drugs) to minimize damage to the hepatocytes. Approximately 10% of patients regress with alcohol abstinence during the hepatitis stage. Cirrhosis is frequently irreversible.

Primary Sclerosing Cholangitis

Primary sclerosing cholangitis (PSC) is an inflammatory disease that causes fibrosis and strictures of the bile ducts. The exact etiology is unknown, but there is a strong association with inflammatory bowel disease (IBD). Patients typically present with an insidious onset of fatigue, pruritus, and jaundice, which can progress to cirrhosis and complications related to biliary obstruction. The diagnosis is established with magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Liver transplantation is the only definitive treatment and is indicated in patients with advanced liver disease.

Drug-induced Liver Injury

Drug-induced liver injury (DILI) is the most common cause of acute liver failure (ALF). Hepatotoxic drugs can cause injury to the hepatocytes directly in a predictable dose-dependent way or through idiosyncratic reactions (which may be mediated by immune or non-immune processes). The injury mechanisms can have the following effects: hepatitis, cholestasis, vascular lesions, or overlapping changes. The presentation can be acute or chronic, with severe toxicity manifesting as fulminant liver failure. The diagnosis of DILI requires a thorough history and laboratory tests including liver function tests (LFTs) and drug levels, if available. Management consists of discontinuing the drug, supportive therapy, and monitoring for complications. Acetaminophen, 1 of the most common causes of DILI, has a specific treatment, N-acetylcysteine (NAC).

Hereditary Hemochromatosis

Hereditary hemochromatosis (HH) is an autosomal recessive disorder most often associated with HFE gene mutations. Patients have increased iron intestinal absorption and iron deposition in several organs, such as the liver, heart, skin, and pancreas. The clinical presentation includes the triad of cirrhosis, diabetes, and skin bronzing. Other findings depend on the organ(s) involved. Diagnosis consists of iron studies, showing transferrin (Tf) and ferritin elevation. Genetic screening is recommended among family members. Imaging and invasive studies are performed depending on the associated complications. Management requires phlebotomy (or iron chelation therapy in some cases) to prevent disease progression. The prognosis is good for patients who are early in the disease and undergoing treatment. The presence of hepatic fibrosis is a poor prognostic factor.

Cholecystitis

Cholecystitis is the inflammation of the gallbladder (GB) usually caused by the obstruction of the cystic duct (acute cholecystitis). Mechanical irritation by gallstones can also produce chronic GB inflammation. Cholecystitis is one of the most common complications of cholelithiasis (calculous cholecystitis) but inflammation without gallstones (acalculous cholecystitis) can occur in a minority of patients. The acute type usually presents with right upper quadrant (RUQ) pain, fever, and leukocytosis. The diagnosis is made clinically and confirmed via ultrasound (US). The definitive management is cholecystectomy, preferred to be performed within 72 hours. This condition can present as a mild condition or as a severe disease (with complications such as gallbladder gangrene, perforation, empyema) which require emergent intervention.

Cholelithiasis

Hepatic Encephalopathy

Hepatorenal Syndrome

Hepatorenal syndrome (HRS) is a potentially reversible cause of acute kidney injury that develops secondary to liver disease. The main cause of HRS is hypovolemia, often as a result of forced diuresis or drainage of ascites. This leads to renal vasoconstriction resulting in hypoperfusion of the kidneys. Patients typically present with edema, oliguria or anuria, and ascites in the setting of acute or chronic liver injury. Hepatorenal syndrome is considered a diagnosis of exclusion. Treatment is with agents that cause systemic vasoconstriction and, therefore, improve renal perfusion. This includes octreotide and midodrine. Most cases of hepatorenal syndrome have a poor prognosis.

Wilson Disease

Wilson disease (hepatolenticular degeneration) is an autosomal recessive disorder caused by various mutations in the ATP7B gene, which regulates copper transport within hepatocytes. Dysfunction of this transport mechanism leads to abnormal copper accumulations in the liver, brain, eyes, and other organs, with consequent major and variably expressed hepatic, neurologic, and psychiatric disturbances. Liver involvement may manifest as hepatitis, liver failure, or cirrhosis, while basal ganglia involvement causes the extrapyramidal signs. Most patients are diagnosed between the ages of 5 and 35 years (mean: 13 years). Diagnosis is established if the patient has low plasma ceruloplasmin, corneal deposits of copper (Kayser-Fleischer rings), and elevated copper levels in the urine. However, other tests are often needed since not all patients will have all these findings. The prognosis is good for patients without advanced liver disease and who are treated with the chelating agents penicillamine or trientine. Untreated Wilson disease is ultimately fatal, with patients dying from cirrhosis, acute liver failure, or complications due to progressive neurologic disease.

Autoimmune Hepatitis

Autoimmune hepatitis (AIH) is a rare form of chronic liver disease in which the immune system attacks the liver causing inflammation. It predominantly affects women. Clinical presentation ranges from asymptomatic cases to patients that present with symptoms of acute liver failure (jaundice, right upper quadrant pain). Because AIH has a 40% mortality in 6 months without treatment, early diagnosis and treatment are imperative. Diagnosis is established by detecting anti-smooth muscle antibodies and performing a confirmatory liver biopsy. Treatment includes corticosteroids and azathioprine. If treatment is initiated early in the disease course, the prognosis is favorable.

Hepatitis B Infection with Case 12:04 min

Hepatitis B Infection with Case 6 quiz questions

Hepatitis B Infection with Case 1 concept page
Hepatitis C Infection with Case 03:42 min

Hepatitis C Infection with Case 2 quiz questions

Hepatitis C Infection with Case 1 concept page
Alcohol-induced Liver Disease with Case 03:04 min

Alcohol-induced Liver Disease with Case 2 quiz questions

Alcohol-induced Liver Disease with Case 1 concept page
Autoimmune Hepatitis with Case 03:13 min

Autoimmune Hepatitis with Case 2 quiz questions

Autoimmune Hepatitis with Case 1 concept page
Acute Liver Failure with Case 05:16 min

Acute Liver Failure with Case 3 quiz questions

Acute Liver Failure with Case 2 Concept Pages
Metabolic Liver Disease with Case 04:40 min

Metabolic Liver Disease with Case 2 quiz questions

Metabolic Liver Disease with Case 2 Concept Pages
Wilson's Disease with Case 03:57 min

Wilson's Disease with Case 2 quiz questions

Wilson's Disease with Case 4 Concept Pages
Hereditary Hemochromatosis with Case 04:40 min

Hereditary Hemochromatosis with Case 2 quiz questions

Hereditary Hemochromatosis with Case 2 Concept Pages
Cirrhosis with Case 07:49 min

Cirrhosis with Case 4 quiz questions

Cirrhosis with Case 3 Concept Pages
Decompensated Cirrhosis with Case 04:53 min

Decompensated Cirrhosis with Case 2 quiz questions

Decompensated Cirrhosis with Case 3 Concept Pages
Hepatic Encephalopathy with Case 03:31 min

Hepatic Encephalopathy with Case 2 quiz questions

Hepatic Encephalopathy with Case 4 Concept Pages
Spontaneous Bacterial Peritonitis (SBP) with Case 05:27 min

Spontaneous Bacterial Peritonitis (SBP) with Case 3 quiz questions

Spontaneous Bacterial Peritonitis (SBP) with Case 2 Concept Pages
Hepatorenal Syndrome with Case 04:29 min

Hepatorenal Syndrome with Case 2 quiz questions

Hepatorenal Syndrome with Case 4 Concept Pages
End-stage Liver Disease with Case 03:44 min

End-stage Liver Disease with Case 2 quiz questions

End-stage Liver Disease with Case 2 Concept Pages
Cholelithiasis vs. Choledocholithiasis with Case 05:00 min

Cholelithiasis vs. Choledocholithiasis with Case 2 quiz questions

Cholelithiasis vs. Choledocholithiasis with Case 3 Concept Pages
Acute Cholecystitis with Case 06:24 min

Acute Cholecystitis with Case 3 quiz questions

Acute Cholecystitis with Case 3 Concept Pages
Choledocholithiasis vs. Ascending Cholangitis with Case 05:29 min

Choledocholithiasis vs. Ascending Cholangitis with Case 3 quiz questions

Choledocholithiasis vs. Ascending Cholangitis with Case 5 Concept Pages
Biliary Disorders: Review 02:02 min

Biliary Disorders: Review 1 quiz question

Biliary Disorders: Review 4 Concept Pages
Primary Biliary Cholangitis with Case 04:02 min

Primary Biliary Cholangitis with Case 2 quiz questions

Primary Biliary Cholangitis with Case 3 Concept Pages
Primary Sclerosing Cholangitis with Case 04:26 min

Primary Sclerosing Cholangitis with Case 2 quiz questions

Primary Sclerosing Cholangitis with Case 3 Concept Pages
Approach to Patients with Jaundice with Case 08:51 min

Approach to Patients with Jaundice with Case 4 quiz questions

Approach to Patients with Jaundice with Case 1 concept page
Gilbert Syndrome with Case 02:01 min

Gilbert Syndrome with Case 1 quiz question

Gilbert Syndrome with Case 0 Concept Pages
Hepatocellular Carcinoma (HCC) with Case 07:16 min

Hepatocellular Carcinoma (HCC) with Case 4 quiz questions

Hepatocellular Carcinoma (HCC) with Case 2 Concept Pages
Cholangiocarcinoma with Case 05:04 min

Cholangiocarcinoma with Case 3 quiz questions

Cholangiocarcinoma with Case 2 Concept Pages
Other Hepatobiliary Malignancies 02:22 min

Other Hepatobiliary Malignancies 1 quiz question

Other Hepatobiliary Malignancies 2 Concept Pages

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Disorders of the Hepatobiliary Tract

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Your Educators of course Disorders of the Hepatobiliary Tract

Kelley Chuang, MD

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