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LC Gastroenterology Week 6 > Acute Liver Disease and Fulminant Hepatic Failure > Flashcards

Acute Liver Disease and Fulminant Hepatic Failure Flashcards

1
Q

What is acute liver disease?

A

Rapid development of hepatic dysfunction without prior liver disease

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2
Q

What are some functions of the liver?

A 
Bile production
Plasma proteins 
Bilirubin metabolism 
Hormone and drug metabolism 
Immunological defence
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3
Q

What are the different LFTs?

A

ALT/AST
Alkaline phosphatase (ALP)
GGT
Bilirubin

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4
Q

What are the true liver function tests?

A

Bilirubin
Albumin
Prothrombin time

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5
Q

What is the duration to be classed as acute liver disease?

A

Less than 6 month duration

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6
Q

What does acute liver failure cause?

A

Encephalopathy and prolonged coagulation

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7
Q

What might be some clinical features of acute liver disease?

A 
none
Jaundice 
Lethargy 
Nausea 
Anorexia 
Pain 
Itch 
Arthralgia

Abnormal LFTs

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8
Q

What might cause acute liver disease?

A 
Drugs 
Shock liver 
Alcohol 
Malignancy 
Chronic liver disease 
Cholangitis
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9
Q

What best investigation in acute liver disease will almost always give you the diagnosis?

A

History

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10
Q

What investigations might you do for acute liver disease?

A 
LFTs 
Prothrombin time 
History and exam 
Ultrasound 
Virology
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11
Q

What is the treatment for acute liver disease?

A

Resut - up to 3 months, for recovery, maybe 6
Fluids, NO alcohol
Increase calories, hight fat food poorly tolerated
For itch - sodium bicarb bath, cholestryamine or Uresodeoxycholic acid
Observation for FHF

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12
Q

What would you treat an itch in ALF with?

A

Uresodeoxycholic acid
Sodium bicarb bath
Cholestryamine

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13
Q

What might be required in acute liver failure when considering hyper metabolic patients?

A

May require oral or NG feeding as there are complication in malnourished patients

Need to monitor and supplement K, PO4 and Mg

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14
Q

What drugs might induce liver disease?

A

Antibiotics - co-amoxiclav, fluclocacillin, NSAID

Paracetamol as an ingredient

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15
Q

What is fulminant hepatic failure?

A

Jaundice and encephalopathy in a patient with a perviously normal liver.

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16
Q

What are the causes of FHF?

A

Paracetamol
Fulminant viral
Drugs
HBV

17
Q

What are some clinical causes of FHF and complications?

A 
Encephalopathy
Hypoglycaemia
Coagulopathy
Circulatory failure
Renal Failure
Infection
18
Q

What are the treatment options for FHF?

A

Supportive
Inotropes and fluids
Renal replacement
Management of raised ICP

Transplantation

19
Q

What is encephalopathy?

A

a disease in which the functioning of the brain is affected by some agent or condition (such as viral infection or toxins in the blood).

20
Q

Describe Albumin?

A

It is a plasma protein made in the liver
It has oncotic properties - it draws fluid into the vessels
Insulin stimulates its production
Carries - fatty acids, bilirubin, Ca, Na, thyroid hormones

LC Gastroenterology Week 6 (8 decks)

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