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Flashcards in Acute Liver Failure Deck (25):
1

Define acute liver failure

Failure of liver synthetic and metabolic function in the presence of encephalopathy and the absence of pre-existing liver disease

2

What are the 3 most common causes of death in ALF

Cerebral oedema
Infection
Multiorgan failure

3

What is the haemodynamic characteristics of ALF

High cardiac output and low systemic vascular resistance

4

What is the most common type of infection to develop in ALF

Pulmonary infection

5

What are the majority of pathogens found

Gram positive - staphylococci

6

What happens as encephalopathy progresses

There is an increased risk of Intracranial pressure developing

7

Describe the relationship between encephalopathy and prognosis

As the encephalopathy worsens, the prognosis worsens

8

What can raised ICP lead to

Brainstem herniation - most common cause of death

9

Why is prothrombin time measured

The liver has a major role in the production of coagulation factors, inhibitors of coagulation and components of the fibrinolytic system

10

What are the 2 common causes of renal failure in acute liver failure

Effects of liver cell failure
Acute tubular necrosis

11

What is the preferred indicator of renal function

Serum creatinine

12

What are some of the common complications of acute liver failure

Hypokalaemia
Hypophosphataemia
hypocalcaemia
hypomagnesaemia
hyponatraemia
acidosis

13

Why does acidosis commonly develop

Inadequate tissue perfusion causing lactic acidosis
Respiratory depression or pulmonary complications causing respiratory acidosis

14

What is hyperacute hepatic encephalopathy

Within 7 days

15

What is acute hepatic encephalopathy

between 8 and 28 days

16

What is subacute hepatic encephalopathy

More than 28 days

17

What typically precedes the onset of hepatic encephalopathy

Jaundice

18

How long after a paracetamol overdose would hepatic encephalopathy occur

2-3 days

19

What are 3 key features of the examination in ALF

Hard liver
Marked splenomegaly
spider naevi

20

What LFT indicates a poor prognosis in ALF

A low albumin

21

What is used to diagnose acute Hepatitis A

Serum IgM anti A antibodies

22

What is the management for ALF

Supportive - ITU, fluid balance, Vital signs

23

What are measured daily

Sputum and urine cultures

24

What should patients routinely receive

IV Vit K

25

What is the only proven therapy for ALF

Liver transplant