Acute Liver Failure Flashcards
Toxic and Drug Induced Hepatitis =
DILI (Drug Induced Liver Injury)
What are 2 common causes of DILI?
- Dose dependent (direct hepatotoxins)
- Idiosyncratic
What is an example of a dose dependent direct hepatotoxin that causes DILI?
Acetaminophen
With Dose dependent direct hepatotoxins that cause DILI, when will the onset be?
Within 48 hours
DILI symptoms mimic?
Acute Cholecystitis
= RUQ pain, jaundice, N/V
DILI symptoms?
RUQ pain, jaundice, N/V
- may see eosinophilia, fever, rash
What is NOT (+) in DILI that IS (+) in Acute Cholecystitis?
Antimitochondrial antibodies (AMA)
What is NOT (+) in DILI that IS (+) in Acute Cholecystitis?
Antimitochondrial antibodies (AMA)
Treatment for DILI?
- Withdraw offending agent
Complications of DILI?
Fulminant liver failure
Healthy Acetaminophen level for healthy individuals?
3g/24 hours
Healthy Acetaminophen level for liver disease patients?
2g/24 hours
Symptoms of Acetaminophen overdose?
RUQ pain, N/V
Jaundice
ENCEPHALOPATHY (CNS issues)
Symptoms of Acetaminophen overdose?
RUQ pain, N/V
Jaundice
ENCEPHALOPATHY (CNS issues)
Treatment for Acetaminophen overdose?
N-Acetylcysteine
Liver transplant
Complications of Acetaminophen overdose?
Liver failure and death
Budd-Chiari Syndrome
Hepatic Vein Obstruction
Occlusion of flow to the hepatic vein or IVC?
Budd-Chiari Syndrome
When is Budd-Chiari Syndrome common?
Hypercoagulable states
- ex. Polycythemia vera
Symptoms of Budd-Chiari Syndrome?
RUQ pain, jaundice
Ascites
What tests should be done with Budd-Chiari Syndrome?
Contrast enhanced or pulsed doppler US
What will the US show with Budd-Chiari Syndrome?
Occlusion
What lobe is prominent in Budd-Chiari Syndrome?
Caudate lobe
If a liver biopsy is done with Budd-Chiari Syndrome, what will it show?
Nutmeg liver
= Centrilobar congestion
Nutmeg liver (centrilobar congestion) is seen with?
Budd-Chiari Syndrome liver biopsy
– occlusion of blood flow to hepatic vein
