Acute Liver Disease Flashcards

1
Q

what is it

A

Any insult to the liver causing damage in the absence of previous disease
Less than 6 months duration

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2
Q

what is acute liver failure

A

Acute liver failure defined as causing encephalopathy and prolonged coagulation

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3
Q

what are the symptoms?

A
Can be none- and the person will just feel fluey 
Lethargy - but abnormal fatigue
Nausea
Jaundice 
Anorexia 
May complain of pain
Itchy
Arthralgia 
Abnormal LFTs
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4
Q

what are the viral causes of acute liver disease

A

Viral A,B,C,D,E,CMV EBV & Toxoplasmosis

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5
Q

what are the other common causes of acute liver disease?

A
  • Drugs
  • Shock liver
  • Cholangitis - bile duct infection
  • Alcohol
  • Malignancy
  • Chronic Liver Disease
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6
Q

what is shock liver?

A
  • this is ischaemic hepatitis caused by insufficient blood supply

Usually shock is due to low BP from sepsis as the liver is a very low pressure system anyway

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7
Q

what are the rare causes of ALD?

A

Budd chiari
AFLP
Cholestasis of pregnancy

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8
Q

what is budd chiari?

A
  • venous infarction of the hepatic veins - they have a very low flow so can get a thrombus
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9
Q

what is specifically of interest in the history

A

Drugs including OTC, herbal and ‘food supplements’
Possible toxins
Alcohol history

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10
Q

what other investigations do you want to do?

A

LFTs (including albumin and bilirubin)

  • prothrombin time
  • USS
  • Virology
  • investigation for chronic liver disease
  • rarely liver biopsy
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11
Q

what does a VERY high ALT signify?

A

paracetamol

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12
Q

what is the treatment

A

rest , fluids, no alcohol
increase calories
- monitor K, PO4 and Mg

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13
Q

what is the treatment for the itch?

A

sodium bicarbonate bath, cholestryamine or Uresodeoxycholic acid

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14
Q

which antibiotics can cause acute liver disease?

A

Co-amoxiclav
Flucloxacillin
NSAID

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