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acute liver disease Flashcards

1
Q

what is acute liver disease?

A

rapid development of hepatic dysfunction without prior liver disease

<6 months duration

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2
Q

why liver so important?

A
  • only have 1
  • massive regeneration potential
  • no artificial replacement
  • multiple functions
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3
Q

how is oxygen rich blood transported to the liver?

A

through hepatic artery

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4
Q

how is nutrient rich blood transported to the liver?

A

through the portal vein

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5
Q

how does blood flow out the liver?

A

-through 3 hepatic veins into inferior vena cava

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6
Q

liver functions? (7)

A
  • protein metabolism
  • carbohydrate metabolism
  • lipid metabolism
  • bile acid metabolism
  • bilirubin metabolism
  • hormone and drug metabolism
  • Immunological defence
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7
Q

what can acute liver failure cause?

A

encephalopathy and prolonged coagulation

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8
Q

symptoms?

A
  • can be asymptomatic
  • jaundice
  • lethargy
  • nausea
  • anorexia
  • pain
  • Itch
  • arthralgia
  • abnormal LFTs
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9
Q

what are the liver function tests?

A

True Liver function tests

  • bilirubin
  • albumin
  • prothrombin time

LFTs

  • ALT/AST
  • alkaline phosphatase
  • GGT
  • bilirubin
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10
Q

causes?

A
  • Hepatitis
  • drugs
  • shock liver
  • cholangitis
  • alcohol
  • malignancy
  • chronic liver disease
  • paracetamol
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11
Q

investigations?

A
  • history & examination
  • LFTs (albumin and bilirubin)
  • USS
  • Virology
  • investigations of chronic liver disease
  • prothrombin time
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12
Q

acute liver disease treatment?

A
  • rest up to 3 months, for recovery may need 6
  • no alcohol
  • lots of fluids
  • Increase calories, high fat foods are poorly tolerated though
  • sodium bicarbonate for the itch
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13
Q

what is a serious clinical sign of acute liver disease?

A

hypoglycaemia

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14
Q

how long does it usually take for drugs to effect the liver?

A

6 weeks

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15
Q

what drugs are especially harmful for liver?

A
  • Antibiotics (co amoxiclav, flucloxacillin)
  • NSAID
  • Statins
  • paracetamol as an ingredient
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16
Q

what is fulminant hectic failure?

A

jaundice and encephalopathy in patient who has previously normal livre

17
Q

common causes of FHF?

A

paracetamol
Fulminant viral
Drugs
HBV

18
Q

rare causes of FHF?

A 
AFLP
Mushrooms
Malignancy
Wilsons
Budd chiari 
HAV
19
Q

FHF complications?

A
  • encephalopathy
  • hypoglycaemia
  • coagulopathy
  • circulatory failure
  • renal failure
  • Infection
20
Q

FHF Treatment

A
  • supportive
  • Inotropes and fluids
  • management of raised ICP
  • renal replacement
21
Q

liver damage test?

A
  • ALT/AST
  • alkaline phosphatase
  • GGT
  • bilirubin

GI (34 decks)

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