I forgot to include in the video that relative hypothermia is another classic physical finding in cirrhosis, though body temperature is rarely below 95.0 F from this diagnosis. The mechanism behind the hypothermia in liver failure is unknown, to the best of my knowledge.
You always make great videos. They're all clear and easy to understand. Recently I have studied ABGs and mechanical ventilation from your series. However the videos' sound volume are too small and they make me difficult to listen to. Can you remake those videos' sound? Anyway, I appreciate your time and effort creating great lectures. Best wishes.
Thanks for the feedback. I know that the sound on the mech vent series, and the earlier ABG videos is not very good. I was still figuring out the best system/software/workflow for these videos at the time. Unfortunately, there is enough echo and muffling on some of those earlier narrations that cranking up the volume doesn't help as much with the ease of understanding as it seems like it should. I have an ultimate goal of remaking the entire mech vent series with widescreen format, higher resolution video, simple animations, and clearer audio, but so far, new videos have taken priority. Your suggestion is definitely noted however, and I do hope to address this at some point in the future.
Could the hypotension in these patients be explained by "third spacing" as fluid is lost from the vascular compartment to the peritoneal cavity? That could also explain the tachycardia as a result of increased sympathetic tone in response to the decreased BP.
Hey! As you can see, I am still continuing to enjoy your videos. I noticed you left out some other sings, such as clubbing, or dupuytren's contracture, or the various cachectic signs. Thank you still for your videos, they are helping me a lot!
***** (Sorry RUclips won't let me directly reply to your comment). Thanks for the feedback. I will likely be posting a video on thyroid function tests to coincide with when this material is covered in the curriculum here at Stanford, which will be late Oct / early Nov.
Thank you for another great video, i have gone through your series on ABG's and EKG which i found most informative. If i may suggest, could you please make a video on the interpretation of thyroid function tests?. thanks again.
Thanks for the suggestion. I'm going to combine this with another recent suggestion of the cardiac cycle, bur realistically, won't be able to get to it for a while. I'm definitely putting it on my list of topics to cover though.
8:40 Could the hypotension seen in cirrhotic patients maybe be related to splanchnic blood pooling from vasodilation, similar to what happens in hepatorenal syndrome and its associated decreased “effective circulating volume”?
Excellent. I've been living with cirrhosis for over 6 years and am always interested in learning more about it. Your video was so well done, it seemed like it was over in 5 minutes and everything was well and clearly presented. Thanks so much!
ddd I'm very sorry, but it's unlikely I'm going to get to the hepatorenal syndrome video this month. There have been many more requests recently for hematology, so I'm working on those at the moment. I still plan on posting hepatorenal syndrome, variceal bleeding, and hepatic encephalopathy, but it may not be until after Jan 1.
Hi Can anyone offer or direct me to SELF HELP re: Decompensated Cirrhosis. My brother is 47 and has this. Interested in special diet and best natural medicine. Thank you from Australia. Bright light tip very helpful. Thankyou 👍😊🙏
Toni Smith Hi Toni you can find free monographs on cirrhosis on UpToDate. They are geared towards the patients of varying level of health literacy and free of charge.
I was told I had portal hypertension and liver disease before I began treatment for cancer but now almost 6 years later no doctor that I talk to will give me a referral to a hepatologist. What should I do?
I can't offer specific, individualized medical advice. However, it would be typical that a patient in the US would be seen by a gastroenterologist if they had liver disease severe enough to have developed portal hypertension. Perhaps the person who initially told you that you had portal hypertension was mistaken, and that your liver disease isn't as bad was originally told to you? Either way, you should ask your doctors to explain why they are declining to make a specialist referral. They may have a very good explanation which they just haven't done a good job at explaining.
Thank you Dr Strong, it is a wonderful lecture. I picked up more or new thing. Oh if the person with cirrhosis also has Hypertension, then suddenly his BP is in range and he wants to stop taking Norvase ? Or he does not need ?
For the patient with cirrhosis and hypertension, my BP targets would be the same as if they did not have hypertension. So if any patient on a BP med wants to consider a trial off it because they think that for whatever reason (e.g. weight loss, lower salt diet, worsening cirrhosis...) they don't need them any more, I'd be willing to try that as long as the patient knew that my recommendation is going to be to restart the med if their BP increases back up above target. But as a general phenomenon, yes, *some* patients with advanced cirrhosis who were previously on anti-hypertensives will no longer need them.
I forgot to include in the video that relative hypothermia is another classic physical finding in cirrhosis, though body temperature is rarely below 95.0 F from this diagnosis. The mechanism behind the hypothermia in liver failure is unknown, to the best of my knowledge.
☺️
Thank you
You always make great videos. They're all clear and easy to understand. Recently I have studied ABGs and mechanical ventilation from your series. However the videos' sound volume are too small and they make me difficult to listen to. Can you remake those videos' sound? Anyway, I appreciate your time and effort creating great lectures. Best wishes.
Thanks for the feedback. I know that the sound on the mech vent series, and the earlier ABG videos is not very good. I was still figuring out the best system/software/workflow for these videos at the time. Unfortunately, there is enough echo and muffling on some of those earlier narrations that cranking up the volume doesn't help as much with the ease of understanding as it seems like it should. I have an ultimate goal of remaking the entire mech vent series with widescreen format, higher resolution video, simple animations, and clearer audio, but so far, new videos have taken priority. Your suggestion is definitely noted however, and I do hope to address this at some point in the future.
Thank you very much for replying to my question. And I look forward to it.
Could the hypotension in these patients be explained by "third spacing" as fluid is lost from the vascular compartment to the peritoneal cavity? That could also explain the tachycardia as a result of increased sympathetic tone in response to the decreased BP.
Hey! As you can see, I am still continuing to enjoy your videos. I noticed you left out some other sings, such as clubbing, or dupuytren's contracture, or the various cachectic signs. Thank you still for your videos, they are helping me a lot!
***** (Sorry RUclips won't let me directly reply to your comment). Thanks for the feedback. I will likely be posting a video on thyroid function tests to coincide with when this material is covered in the curriculum here at Stanford, which will be late Oct / early Nov.
Thank you for another great video, i have gone through your series on ABG's and EKG which i found most informative. If i may suggest, could you please make a video on the interpretation of thyroid function tests?. thanks again.
Great video! If it possible could you make a vidoe about central venous pressure and its relation to the breath cycle? Thank you
Thanks for the suggestion. I'm going to combine this with another recent suggestion of the cardiac cycle, bur realistically, won't be able to get to it for a while. I'm definitely putting it on my list of topics to cover though.
Thank you very much. It took me back to memory lane long long time ago. You gave a much clarity. I thank you greatly.
8:40 Could the hypotension seen in cirrhotic patients maybe be related to splanchnic blood pooling from vasodilation, similar to what happens in hepatorenal syndrome and its associated decreased “effective circulating volume”?
Yes, certainly a major factor.
My dad died due to this.
Excellent. I've been living with cirrhosis for over 6 years and am always interested in learning more about it. Your video was so well done, it seemed like it was over in 5 minutes and everything was well and clearly presented. Thanks so much!
What stage and did you get spider angiomas?
My fiance was just diagnosed with cirrhosis. How are you doing?
@@robertamandab7932 good worried about having spider angiomas on arms don't have insurance scared don't have any other symptoms feel fine
@@augiesanchezgonzales1895 yeah it's awful scary to have health problems without insurance. Wish you the best.
Is there any chance that you will upload the hepatorenal syndrome video in the upcoming two weeks?
ddd I'm very sorry, but it's unlikely I'm going to get to the hepatorenal syndrome video this month. There have been many more requests recently for hematology, so I'm working on those at the moment. I still plan on posting hepatorenal syndrome, variceal bleeding, and hepatic encephalopathy, but it may not be until after Jan 1.
Hi
Can anyone offer or direct me to SELF HELP re: Decompensated Cirrhosis. My brother is 47 and has this.
Interested in special diet and best natural medicine.
Thank you from Australia. Bright light tip very helpful. Thankyou
👍😊🙏
Toni Smith Hi Toni you can find free monographs on cirrhosis on UpToDate. They are geared towards the patients of varying level of health literacy and free of charge.
Great explanation very helpful thank you so much🥰
I was told I had portal hypertension and liver disease before I began treatment for cancer but now almost 6 years later no doctor that I talk to will give me a referral to a hepatologist. What should I do?
I can't offer specific, individualized medical advice. However, it would be typical that a patient in the US would be seen by a gastroenterologist if they had liver disease severe enough to have developed portal hypertension. Perhaps the person who initially told you that you had portal hypertension was mistaken, and that your liver disease isn't as bad was originally told to you? Either way, you should ask your doctors to explain why they are declining to make a specialist referral. They may have a very good explanation which they just haven't done a good job at explaining.
thank you
Super
Excellent!
Thank you Dr Strong, it is a wonderful lecture. I picked up more or new thing. Oh if the person with cirrhosis also has Hypertension, then suddenly his BP is in range and he wants to stop taking Norvase ? Or he does not need ?
For the patient with cirrhosis and hypertension, my BP targets would be the same as if they did not have hypertension. So if any patient on a BP med wants to consider a trial off it because they think that for whatever reason (e.g. weight loss, lower salt diet, worsening cirrhosis...) they don't need them any more, I'd be willing to try that as long as the patient knew that my recommendation is going to be to restart the med if their BP increases back up above target. But as a general phenomenon, yes, *some* patients with advanced cirrhosis who were previously on anti-hypertensives will no longer need them.
@@StrongMed Thank you very much , for the advice.
Really a great video. Thanks a lot.
Thanks doctor Eric great video :)
social service..!! 😊😊 god bless u son
keep up the good work...