Acute liver failure

Question 1

Define acute liver failure

Answer 1

Acute liver failure (ALF) is a rapid decline in hepatic function characterised by jaundice, coagulopathy (INR >1.5), and hepatic encephalopathy in patients with no evidence of prior liver disease

Question 2

What are causes of acute liver failure

Answer 2

Infection: Hep B/C, CMV
Drugs: paracetamol and alcohol
Vascular: Budd-Chiara syndrome

Question 3

What is presentation of acute liver failure?

Answer 3

Jaundice
Hepatomegaly
Hepatic foetor and falp
Constructional apraxia
Signs of CLD

Question 4

What are differentials of acute liver failure?

Answer 4

Severe hepatitis (no encephalopathy)
Cholestasis (no raised INR either)
Haemolysis

Question 5

Investigations in ALF?

Answer 5

LFTS: raised bilirubin and transaminases

INR > 1.5

Investigations for the cause