Author Archives: thebileflow


If you know how to write right, write. – Cohen Advertisements

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Clinical Pearl

You are screening your cirrhotic patient for varices with an EGD and you detect a long segment of salmon-colored esophageal mucosa.  Instinct tells you to biopsy it and document Barrett’s esophagus.  Careful.  Is there an esophageal varix beneath that tongue … Continue reading

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Hepatitis B virus

Question: All of the following are true statements about the treatment of hepatitis B virus (HBV) except: A. advanced fibrosis can be reversed by giving entecavir B. the risk for cancer can be reduced C. tenofovir and entecavir are associated … Continue reading

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Clinical Pearl

Remember that kidney failure in the hepatitis C cirrhotic patient might be related to the virus itself! Cryoglobulinemia, membranous glomerulonephritis, MPGN and polyarteritis nodosa are all associated with HCV, and therefore you might entertain a serologic workup that includes a … Continue reading

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Definition: cold ischemic time

Cold ischemic time begins when the organ is taken from the donor cadaver and placed in solution for transport and ends after the tissue reaches physiological temperature during implantation procedures.  More than six hours of cold ischemic time puts the … Continue reading

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Haiku: portopulmonary hypertension

High right heart pressures Vasoactive drugs might help- To allow transplant

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Terrorism, liver; Venezuelan equine encephalitis

Venezuelan equine encephalitis is a mosquito -borne viral pathogen that can cause a flu-like human illness with headache and fever.  It can be associated with elevated transaminases.

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