acute liver failure Flashcards
define liver failure
liver loses its ability to repair and regenerate leading to decompensation
when is a liver compensated?
when it can still function effectively and there are no, or few clinical symptoms
define acute liver failure
liver suddenly loses its ability to function in patients with previously normal liver
what is acute liver failure accompanied with?
- Hepatic encephalopathy
- jaundice
- coagulopathy (>1.5 INR)
- Ascites
what can acute liver failure be also known as?
Fulminant liver failure
what is fulminant liver failure?
rare syndrome of massive hepatocyte necrosis
what can be described as hyper acute?
HE within 7 days of jaundice
what can be described as acute?
HE within 8-28 days of jaundice
what can be described as sub acute?
HE within 5-26 weeks of jaundice
what is the most common cause of fulminant liver failure?
paracetamol overdose
define acute on chronic liver failure
abrupt decline in patient with chronic liver symptoms
define chronic failure
patient with progressive history of liver disease
what are the causes of acute liver failure?
- Viral
- Autoimmune Hep
- Drugs
- HCC
- Metabolic
- Obstruction
- Vascular
give examples of viral causes of acute liver failure
Hep A,B,E
CMV
EBV
give examples of drugs causing acute liver failure
Paracetamol, ecstasy, alcohol
give examples of metabolic causes of acute liver failure
Wilsons
AIATD ( alpha I anti trypisin)
Haemochromatosis
give an example of an obstruction that causes of acute liver failure
Budd Chian
give an example of a vascular cause of acute liver failure
ischaemia
what are some symptoms of acute liver failure?
- jaundice
-nausea
-anorexia
-malaise
what are some signs of acute liver failure?
- coagulopathy
-factor hepaticus - hepatic encephalopathy
- ascites
-cerebral oedema
what is coagulopathy treated with?
with vitamin K
what is hepatic encephalopathy treated with?
with lactulose
what signs are included in hepatic encephalopathy?
- altered mood
- liver flap, asterixis
what is ascites treated with?
diuretics
what is cerebral oedema treated with?
IV mannitol