The Curbsiders Internal Medicine Podcast

#100: Cirrhosis: Initial Evaluation and Management

June 18, 2018
48 min

Cirrhosis. Finally. Take your liver game to the next level with tips from @liverprof, Scott Matherly MD, Assistant Professor of Medicine at Virginia Commonwealth University. Topics include: exam findings in cirrhosis, interpreting liver function tests, incidental cirrhosis on imaging, fatty liver disease, steatohepatitis, hep c, shear wave elastography, screening for varices and hepatocellular carcinoma, pathophysiology, and lifestyle measures for initial management. This episode is sponsored for CME-MOC credit by the American College of Physicians. ACP members can claim free credit at (goes live at 9am on release date).

Full show notes available at

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  • Written by: Cyrus Askin MD
  • CME questions by: Cyrus Askin MD
  • Produced by: Cyrus Askin MD and Matthew Watto MD
  • Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
  • Guest: Scott Matherly MD

Time Stamps

  • 00:00 Announcements
  • 00:45 Disclaimer
  • 01:19 Intro to the show and our guest
  • 04:15 Guest one liner, books recommendations, and career advice
  • 09:04 Cyrus’ pick of the week
  • 10:14 Clinical case of abnormal liver functions tests
  • 11:12 Seven hand findings of cirrhosis
  • 13:28 Should we screen for NASH?
  • 15:28 Incidental finding of cirrhosis on imaging
  • 17:47 Next steps after diagnosis of cirrhosis
  • 20:36 Non-invasive scoring systems to predict cirrhosis
  • 23:55 Liver biopsy
  • 25:33 Shear wave elastography
  • 29:10 Recap of what we learned so far
  • 31:58 Three ways cirrhosis can kill you
  • 33:56 Counseling patients about cirrhosis
  • 36:05 Management of NASH and early  cirrhosis
  • 42:55 Screening for varices and hepatocellular carcinoma
  • 46:28 Outro

Tags: cirrhosis, liver, function, shear, wave, elastography, fibroscan, imaging, fatty, liver, disease, nash, nafld, steatohepatitis, hepatitis, hep c, hcv, screening, varices, hepatocellular, carcinoma, pathophysiology, lifestyle, management, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

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