ALF and ACLF
Definition of ACLF
syndrome in patients with chronic liver disease characterized by acute hepatic decompensation leading to liver failure in the form of jaundice and abnormal INR along with at least one extra hepatic organ failure
When are patients at highest risk for CAT?
First 6 months of diagnosis
What movie is the quote "Life is like a box of chocolates, you never know what you're gonna get" from?
Forrest Gump
What is Queen Anne's Sign and what condition is it seen in?
Loss of the outer 1/3 of eyebrows seen in hypothyroidism.
What was Walter White's codename in Breaking Bad?
Heisenberg
ALF Diagnostic criteria
acute insult to the liver resulting in hepatic synthetic dysfunction, encephalopathy, coagulopathy (INR >1.5), onset <26w, absence of cirrhosis
Which type of malignancies should we be wary to use DOACs to treat VTE in?
GI malignancies
Which camp does Friday the 13th take place at?
Camp Crystal Lake
List 5 causes of erythema nodosum
IBD (Crohn's, UC), idiopathic, drugs (sulpha, penicillins), pregnancy, OCP, sarcoidosis, Lofgrens, infections (rickettsia, strep, HBV,HCV, HIV, campylobacter, giardiasis, syphilis)
Which restaurant does Penny from the Bing Bang Theory work at?
Cheesecake Factory
List 3 potential disease processes that can present as ACLF
alcohol, HBV reactivation, Autoimmune hepatitis, Wilson's disease
List 5 factors that increase a patients risk of CAT
age, gender (F), obesity, CKD, type of cancer, metastasis, chemotherapy, hormonal therapy, surgery, immobility, leukocytosis, thrombocytosis,
On the set of what movie, did Miley Cyrus and Liam Hemsworth meet?
The last song
list 5 causes of fingernail clubbing
cyanotic heart disease, IE, lung abscess, bronchiectasis, CF, recurrent aspiration, empyema, lung cancer, Crohn's disease, ulcerative colitis, idiopathic, familial,
What state does family guy take place in?
Rhode Island
List 4 causes of treatable ALF and their management
Acetaminophen - NAC
AIH - steroids
HELLP or AFLP - delivery
HSV - acyclovir
CMV - ganciclovir
Mushroom - penicillin G IV silibinin
Budd Chiari - TIPS or thrombolysis
Out of the DOACs, which one showed the lowest bleed risk when compared to dalteparin?
Apixaban
List the three actors who have played Spiderman
List 4 exam findings in acromegaly and which valvular abnormality is seen?
macroglossia, prognathism, frontal bossing, widening of teeth spaces, large hands and feet
AR
What actor plays Marty Byrne in Ozark?
Jason Bateman
what is the most common cause of death in ALF patients, and what should we maintain their MAP at?
MAP 65-75, cerebral edema (ischemic brain injury +/- herniation)
Duration of treatment for CAT?
Provoked VTE, 3-6months then reassess
What country is the bobsled team from in the movie Cool Runnings? Based on the true story
Jamaica
What condition is heliotrope rash seen in?
Dermatomyositis
Who's sword in Game tf Thrones, is called "Needle"?
Arya