Acute Liver Disease and Fulminant Hepatic ailure Flashcards Preview

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Flashcards in Acute Liver Disease and Fulminant Hepatic ailure Deck (29):
1

What is acute liver disease and what can it cause

The rapid development of hepatic dysfunction without prior liver disease with less than 6 months duration
It can cause encephalopathy and prolonged coagulation

2

How quickly can acute liver disease present

Over a matter of hours, days or weeks

3

What is the main treatment of acute liver disease and why

Eating well, remove the cause of the failure - mostly supportive treatment with reassurance
The liver can repair itself with no scarring

4

How much of the liver's blood comes from the hepatic artery?

10-20%

5

What happens if the blood pressure of the liver drops

It can cause hepatic shock

6

Name 7 liver function

Protein metabolism
Carbohydrate metabolism
Lipid metabolism
Bile acid metabolism
Bilirubin metabolism
Hormone and drug metabolism
Immunological defence

7

What is the most pointless LFT and why?

GGT - it is a non specific test as lots of factors can cause it to be elevated

8

What is the significance of raised ALT/ AST

They should be held within the liver but they are released into the blood stream when the liver is stressed or damaged and the cells die

9

Where is alkaline phosphatase (ALP) also produced

In the bone

10

What is bilirubin made from

Processeed RBCs

11

What is albumin and when is it low

An acute phase protein
If the patient is malnourished

12

What does prothrombin time indicate

How long it takes for blood to clot in the lab
It is a test of how good the integral blood clotting factors are

13

What happens to the prothrombin time if the liver is not working properly

The coagulation time will be longer

14

What is the most important LFT

Prothrombin time

15

What are some clinical features of acute liver disease

Asymptomatic
Jaundice
Lethargy
Nauseated
Anorecia
Pain
Itch
Arthraligia
ABNORMAL LFTs

16

what are some causes of acute liver disease

Drugs (paracetamol)
Shock liver
Cholangitis
Alcohol
Malignancy
Chronic liver disease
Budd Chiaria AFLP
Cholestatsis of pregnancy

17

What is Budd Chiari and who is most likely to present with it

Clotting of the hepatic veins
young woman on the oral contraceptive

18

Why do we rarely do liver biopsies

Often it won't tell you anything - the hepatoytes are often dead due to the underlying cause so it is pointless

19

What is the treatment for Acute Liver DIsease

Rest for 3-6 months
Fluids
No alcohol
Increase calories
Sodium bicarbonate bath for itch
Reassurance

20

What should be monitored frequently during recovery of acute liver disease

Phosphate, potassium and magnesium

21

What is a very serious clinical sign in acute liver disease and what does this indicate

Hypoglycaemia - the liver is unable to movblise glycogen and therefore gluconeogenesis is impaired

22

When do hepatic drug reactions first appear

6 weeks after exposure

23

What drugs can cause drug induced liver disease

Co-amoxiclav
Flucloxacilin
NSAID
"Fat burners" - those with no label

24

What is fulminant hepatic failure

Fulminant hepatic failure (FHF) is usually defined as the severe impairment of hepatic functions or severe necrosis of hepatocytes in the absence of preexisting liver disease

25

What are the 2 main symptoms of fulminant hepatic failure

Jaundice and encephalopathy

26

What are 4 common causes of FHF

Paracetamol
Fulminant viral
Drugs
HBV

27

What are 4 rare causes of FHF

AFLP
mushrooms
malignancy
Wilson's
Budd Chiari

28

What are 6 complications of FHF

Encephalopathy
Hypoglycaemia
Coagulopathy
Circulatory failure
Renal Failure
Infection

29

What are the 5 ways to treat an FHF patient

Supportive
Inotropes and FLuids
Renal replacement
Managemnt of raised ICP
Transplantation

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