Rheumatology

Rheumatology What you need to know for your ambulatory medicine experience
Presentation by Kevin Latinis, M.D./Ph.D.
Division of Rheumatology
Dept. of Internal Medicine

This Rheumatology presentation covers the following topics.

* Arthritis
-Inflammatory (RA, spondyloarthropathies)
-Mechanical (OA)
* Lupus
* Fibromyalgia
* Low back pain and other peri-articular complaints
* General musculoskeletal exam

Mechanical vs. Inflammatory Arthritis
Osteoarthritis-Background
Osteoarthritis-Distribution
Osteoarthritis-Diagnosis
* Clinical
* Supported by X-rays
* Non-inflammatory lab data, if any

Osteoarthritis-Treatment
Clinical Pearl:
Arthritis of the DIP joint
OA (non-inflammatory)
Psoriatic Arthritis (inflammatory)
Inflammatory Arthritis
Systemic Lupus Erythematosus-Background
Clinical features, classification criteria
Treatment of SLE
Steroids in Lupus
Fibromyalgia-Background -Diagnosis
Fibromyalgia-Treatment
General Musculoskeletal Exam

* Underutilized by primary care providers
* Should be simple and quick
* Goal is to recognize signs of rheumatological diseases and determine if it is appropriate to refer to a rheumatologist or manage independently

Rheumatology.ppt

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Drug Induced Liver Injury

Drug Induced Liver Injury
Presentation by:Robert J. Fontana, MD
University of Michigan Medical Center

Drug Induced Liver Injury
Hepatic Adverse Event Nomenclature
Liver Injury Classification
DILI Population based study
DILI Diagnosis
Clinicopathologic forms of DILI
DILI: A Diagnosis of exclusion
Acute Hepatocellular: Differential Dx
Ultrasound/ CT
DILI: Causality Assessment
RUCAM
RUCAM limitations
Prognosis in DILI with jaundice
Spectrum of DILI
ALT monitoring and DILI
DILI pathogenesis
DILIN: Sphere of Influence
Idiosyncratic Liver Injury Associated with Drugs (ILIAD)
New agent signals
Drug
Human genome
DILIN Genotyping Initiative
Acetaminophen: Friend or foe ?
Glucuronyl transferases sulfotransferases
Acetaminophen
ACM-cysteine adducts
Biomarker for ACM hepatotoxicity
Implications of ACM related ALF
Acetaminophen advice
Acetaminophen toxicity in severe acute HAV/ HBV
Prospective Study Design
DILI Causality Instrument
Prognosis in DILI with jaundice

Drug Induced Liver Injury.ppt

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Viral Hepatitis Medicine Student Lecture

Viral Hepatitis Medicine Student Lecture
Presentation by:David R Nelson, M.D.

Associate Professor of Medicine
Director, Hepatology and Liver Transplantation
University of Florida

Causes of Acute Hepatitis

Acute Hepatitis
Viral Hepatitis
A, B/D, C, E
EBV
CMV & HSV
Drugs
Ethanol
Tylenol
Halothane
Toxins
Jamaica Bush Tea
Mushrooms
Vascular
Hypotension
Budd-Chiari
Autoimmune
Hepatitis
Metabolic
Wilson's Disease
A1AT

Causes of Chronic Hepatitis
Chronic Hepatitis
Viral Hepatitis
Drugs
MTX
INH
Amiodarone
Alcohol
NAFLD
Autoimmune
AIH
PBC
PSC
Metabolic
A1AT
HHC

Hepatitis A Virus
Nucleic Acid: 7.5 kb ssRNA
HAV Prevalence
Global Prevalence of Hepatitis A Infection
Hepatitis A Prevention - Immune Globulin

ACIP Recommendations MMWR 1999; 48(RR12):1
Hepatitis A: Pre-exposure Vaccination
Persons at increased risk or danger of infection
Hepatitis E

Clinical Characteristics
Hepatitis B Virus
HBsAg
HBV DNA
HBcAg
HBV Sources of Infection
Signs and Symptoms of Acute Hepatitis B

Hepatitis B - Clinical Features
Progression to Chronic Hepatitis B Virus Infection
Typical Serologic Course
Recovery from acute hepatitis B
Chronic HBeAg + disease
Chronic HBeAG – disease
Successful Vaccination
Resistance to antiviral agents
Hepatitis B: Disease Progression
Acute Infection
Chronic HBV is the 6th leading cause of liver transplantation in the US
Higher in HIV, immune suppressed
Targeted Surveillance for HCC
Hepatitis B Carriers
Non-hepatitis B Cirrhosis
Prevention of Transmission of Hepatitis B

and much more are discussed in this presentation.
Viral Hepatitis Medicine Student Lecture.ppt

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