Monthly Archives: December 2011

Hepatitis C treatment

Question: To which of the following patients will you most likely offer Ribavirin and PegInterferon for their HCV? A. 57 M with stage II fibrosis and congestive heart failure, EF 35% B. 66 M with cirrhosis and hepatic encephalopathy C. … Continue reading

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Monthly Conference Calendar: JANUARY 2012

All Lectures and Journal Clubs will be held at 2:30 PM in the East campus pathology conference room; they will follow the weekly 1:30 hepatopathology conference. Monday, Jan. 2: No conference Monday, Jan. 9: Attending Lecture Series- Amy Evenson, MD … Continue reading

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Expectation

Since the approval of telaprevir for use in hepatitis C virus, there is the expectation of only 24 weeks of therapy for genotype 1 (versus the traditional 48).  However, this shortened duration is only if viral load is undetectable at week 4, … Continue reading

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Equilibration

The reason we start to diurese ascites with spironolactone and not furosemide is for its site of action, at the (distal) collecting tubule.  If you begin with a loop diuretic instead (like furosemide) and create a sodium gradient more proximally, … Continue reading

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The Sunday Chronicles

Stacks of joy to all on this wondrous day! (…and an e antibody around the corner)

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Definition: small for size syndrome

Small for size syndrome can follow liver transplantation when the allograft is too small to handle the high volume of portal inflow after portal vein/hepatic artery are anastamosed.  The only autoregulatory mechanism to decrease blood flow is constriction of the muscular hepatic artery, … Continue reading

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Sirolimus side effects

Question: A 43 year old male is six months out from liver transplant for hepatitis C and hepatocellular carcinoma.  He devloped renal insufficiency from tacrolimus (a calcineurin-inhibitor, well known for its nephrotoxicity and neurotoxicity).  You decide to transition him to … Continue reading

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