Acute Liver Failure/Transplant Flashcards
Drug that can be used to ease symptoms that occur in acute liver failure (ALF).
N-acetylcysteine (mainly for Tylenol overdose)
Major concern with hepatic encephalopathy.
Cerebral edema —> increased IC pressure—> brainstem herniation —–> death
Cushing Triad
- Hypertension
- Bradycardia
- Irregular respirations
Indicates immanent brainstem hemorrhage
What causes hypoglycemia in ALF?
Inadequate degradation of insulin
-with high insulin, cells will always be taking up glucose from the blood.
Lack of glycogenolysis in the diseased liver
-can’t liberate glucose from its glycogen store
Most common infectious agents in ALF.
Gram (+)s
- Staph
- Strep
Why does lactic acidosis occur in ALF?
Liver loses its ability to clear lactate
Most common cause of renal dysfunction leading to electrolyte imbalance in ALF.
Acetaminophen overdose
How does ALF affect the PT time, what is a complication, and how is it treated?
- PT time increases
- Lack of clotting leads to GI bleeds
- Treat with H2 antagonists (antihistamines)
What is King’s College Criteria?
Model to predict ALF outcome and predict optimum liver transplant time.
Why is lactulose used in ALF?
Doesn’t treat ALF but may aid in preventing cerebral edema
Goal of Stage III Encephalopathy treatment.
Maintain ICP to prevent cerebral edema
What are the treatments for complications of ALF?
- Dextrose IV to treat hypoglycemia
- Fibrinogen and platelets to treat bleeding
- Liver transplant if available (treats complication but not always the problem)
What is the purpose of the United Network of Organ Sharing classification system?
Decide who is in most need for liver transplant.
Similar to MELD score (Model for End stage Liver Disease)
