Acute Liver Failure Flashcards
What is Acute Liver Failure?
Rapid decline in hepatic function that may occur in patients with no known liver disease or with established hepatic impairment.
Acute liver failure can have a sudden onset and requires immediate medical attention.
What is the most common cause of Acute Liver Failure?
Paracetamol overdose (70%).
Paracetamol overdose is a leading cause due to its widespread use and potential for misuse.
List other causes of Acute Liver Failure.
- Alcohol abuse - binge
- Decompensation of Alcoholic Liver Disease (ALD)
- Viral hepatitis
- Autoimmune hepatitis
Each of these causes can significantly impact liver function and may require different management strategies.
What are the three main symptoms of Acute Liver Failure?
- Coagulopathy - failure to clot = high INR (1.5+)
- Encephalopathy
- Jaundice
Encephalopathy can present as confusion, drowsiness, and a sweet or fecal-smelling breath in late stages.
What is the first step in the overall management of Acute Liver Failure?
A-E Assessment - fluids, ventilation.
A-E Assessment refers to the initial assessment of Airway, Breathing, and Circulation.
What blood tests are important in managing Acute Liver Failure?
- Liver Function Tests (LFT)
- Clotting profile (INR)
- Urea & Electrolytes (U&E)
- Blood glucose
These tests help assess liver function and overall metabolic status.
When should a liver transplant be considered in Acute Liver Failure?
Consider liver transplant based on King’s College Criteria.
King’s College Criteria helps determine the prognosis and the need for transplantation.
What is the management for Paracetamol overdose within the last 4 hours?
Activated charcoal.
Activated charcoal can help reduce absorption of paracetamol if administered promptly.
What should be done for Paracetamol overdose after more than 4 hours?
IV N-acetylcysteine.
N-acetylcysteine acts by replenishing glutathione, which helps neutralize toxic metabolites.
What is NAPQI in the context of Paracetamol overdose?
NAPQI is a highly toxic metabolite that increases during paracetamol overdose.
Glutathione helps ‘mop up’ NAPQI, preventing liver damage.
