Acute Liver Disease Flashcards
what is it
Any insult to the liver causing damage in the absence of previous disease
Less than 6 months duration
what is acute liver failure
Acute liver failure defined as causing encephalopathy and prolonged coagulation
what are the symptoms?
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
what are the viral causes of acute liver disease
Viral A,B,C,D,E,CMV EBV & Toxoplasmosis
what are the other common causes of acute liver disease?
- Drugs
- Shock liver
- Cholangitis - bile duct infection
- Alcohol
- Malignancy
- Chronic Liver Disease
what is shock liver?
- 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
what are the rare causes of ALD?
Budd chiari
AFLP
Cholestasis of pregnancy
what is budd chiari?
- venous infarction of the hepatic veins - they have a very low flow so can get a thrombus
what is specifically of interest in the history
Drugs including OTC, herbal and ‘food supplements’
Possible toxins
Alcohol history
what other investigations do you want to do?
LFTs (including albumin and bilirubin)
- prothrombin time
- USS
- Virology
- investigation for chronic liver disease
- rarely liver biopsy
what does a VERY high ALT signify?
paracetamol
what is the treatment
rest , fluids, no alcohol
increase calories
- monitor K, PO4 and Mg
what is the treatment for the itch?
sodium bicarbonate bath, cholestryamine or Uresodeoxycholic acid
which antibiotics can cause acute liver disease?
Co-amoxiclav
Flucloxacillin
NSAID