Hello, med students. My name is Zach Olson and thank you for downloading this week's episode of the EM Clerkship Podcast.

You'll remember a while back we did an episode on right upper quadrant pain, billiary disorders, going through some terms, some important diagnoses, and this episode is going to be very similar to that.

This week we're talking about the complications of advanced liver disease, of cirrhosis, that type of

thing, something that we see all the time. It's much, much more common than acute liver failure,

actually. Lots of chronic liver disease cases out there.

People with cirrhosis coming in with different complications.

The cause of their cirrhosis is usually going to be hepatitis C, followed closely by alcohol use.

But there are lots of other causes out there as well, like Nash and fatty liver disease.

You might see some acute liver failure during your clerkship or residency.

Most commonly, that's going to be Tylenol overdose, followed by some of the other

hepatitises and alcohol.

But again, today we're talking about the complications of chronic liver disease, which is much more

common and much more high yield for your rotation than the acute stuff. Trust me. And what I want

you to take away are the big five diagnoses, the real bad players in chronic liver disease.

There's two kind of organ failure complications.

There's two complications that are resulting from that portal hypertension.

And then there's one other complication that is from the liver function itself failing.

And those five bad diagnoses are hepatorenal syndrome and hepatic encephalopathy,

varices, acetes with spontaneous bacterial peritonitis, and the fifth one is coagulopathy.

Hepatorenal syndrome, hepatic encephalopathy, varicesees, ascites with spontaneous bacterial

peritonitis, and coagulopathy. We're going through each of these today, starting with our first

organ failure complication, renal failure, which is called hepatotrenal syndrome when it happens.

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