Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal > 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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

arterial supply of liver

A

hepatic artery

portal hepatic vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

venous drainage of the liver

A

3 hepatic veins into the inferior vena cava

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

functions of the liver

A 
metabolism of;
protein
carbohydrate 
lipid
bile acid
bilirubin 
hormone and drug
immunological defence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

liver function tests

A

LFTs

true liver function tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

true liver function tests

A

bilirubin
albumin
prothrombin time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

LFTs

A

ALT/AST
ALP
GGT
bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

onset of acute liver disease

A

<6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does acute liver disease cause

A

encephalopathy

prolonged coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

diagnosis of Wilson’s disease

A

may allow classification of an acute presentation as acute liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

signs of acute liver disease

A 
may be asymptomatic 
jaundice 
lethargy 
nausea 
anorexia 
pain 
itch
arthralgia (pain in a joint)
abnormal LFTs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

causes of acute liver disease

A 
hepatitis viruses
drugs - paracetamol!!! and antibiotics
shock liver
cholangitis 
alcohol 
malignancy
chronic liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

rare causes of acute liver disease

A

budd chiari
acute fatty liver of pregnancy (AFLP)
cholestasis of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

factors for liver damage

A

direct toxicity
immunologic
genetic predisposition
nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

direct toxicity causing liver damage

A

drugs
alcohol
viruses
hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

immunologic causes liver damage

A

PBC

AIH

17
Q

genetic predisposition causing liver disease

A

Wilsons’s

haemochromatosis

18
Q

nutritional causes of liver disease

A

NASH

malnutrition

19
Q

tests for acute liver disease

A 
history!!!
LFT's - &amp; albumin and bilirubin 
prothrombin time 
ultrasound 
virology
liver biopsy - rare
20
Q

treatment for acute liver disease

A 
rest 3-6 months 
fluids - NO alcohol 
diet modification 
itch treatment 
observe for fulminant hepatic failure
21
Q

describe diet modifications in acute liver disease

A

increase calories and protein due to hypermetabolic state - high far foods are poorly tolerated
NG feeding or supplements

22
Q

itch treatment for acute liver disease

A

sodium bicarbonate bath
cholestyramine
ursodeoxycholic acid

23
Q

complications of acute liver disease

A

hypoglycaemia

24
Q

cellular damage due to hepatic drug reactions

A 
oxidase stress
mitochondrial damage 
bile acid accumulation 
endoplasmic reticulum stress
cell death (apoptosis or necrosis)
DNA damage, epigenetics
25
Q

why is paracetamol bad for the liver

A

metabolising product NAPQI is toxic

26
Q

antibiotics causing liver injury

A

co-amoxiclav
flucoloxacillin
NSAID

27
Q

what is fulminant hepatic failure (FHF)

A

acute episode of severe liver dysfunction (jaundice and encephalopathy) in a patient with previous normal liver

28
Q

causes of FHF

A 
paracetamol - most common
fulminant viral
drugs
HBV
non A-E
29
Q

rare causes of FHF

A 
AFLP
mushrooms 
malignancy
Wilsons 
budd chiari 
HAV
30
Q

complications of FHF

A 
encephalopathy 
hypoglycaemia 
coagulopathy 
circulatory failure
renal failure
infection
31
Q

treatment for FHF

A 
supportive 
inotropes and fluids
renal replacement 
management of raised intracranial pressure
liver transplant
32
Q

considerations for liver transplant in FHF

A

prediction of survival without transplant
survival potential after transplant
is patient too sick for transplant

33
Q

indictions for urgent transplant for acute liver failure - paracetamol

A

low pH
PT>100 + creatinine>300 + grade 3/4 encephalopathy
high lactate
life-threatening deterioration without sepsis

34
Q

indications for urgent transplant for acute liver failure - non-paracetamol

A 
PT>100 or INR>6.5
any 3 from 5;
unfavourable aetiology (not hep A or B)
age>40
jaundice to encephalopathy >7 days
PT>50 
bilirubin>300

Wilsons or budd-chiari

Gastrointestinal (71 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions