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Flashcards in Liver failure Deck (12):
1

Fulminant hepatic failure

massive necrosis of liver cells --> severe impairment of liver function

2

Hepatic encephalopathy a.k.a postosystemic encephalopathy

Toxic substances normally detoxified by the liver bypass the liver via the collaterals and gain access to the brain.

Pt becomes increasingly drowsy + eventually comatose

(excess glutamine --> cerebral oedema)

3

causes
(categories)

infections
drugs e.g. paracetamol overdose
toxins e.g. tetrachloride
vascular e.g. budd-chiari syndrome, veno-occlusive disease
others e.g. autoimmune

4

presentation

jaundice
hepatic encephalopathy
fetor hepaticus - foul breath/like pear drops
flapping tremor

5

what causes acute-on-chronic hepatic failure?

decompensation of chronic liver disease

6

what is hepatic failure that occurs suddenly in a previously healthy liver?

acute hepatic failure

7

what imagining investigations would you perform

AXR - abnormal
Doppler flow studies of portal vein

8

what does neutrophils >250 on an ascitic tap indicate?

spontaneous bacterial peritonitis

9

Tx cerebral oedema

ITU
20% mannitol
hyperventilate

10

Tx ascites

restrict fluid
low salt diet
weigh daily
diuretics

11

what drugs do you want to avoid?

sedatives
drugs with hepatic metabolism
those that constipate (opiates, diuretics- increased risk of encephalopathy)

12

hepatotoxic drugs

include paracetamol
methotrexate
isoniazid
azathioprine