Acute liver injury/ failure

Question 1

Acute hepatic injury is manifested by acute _________ elevation

Answer 1

aminotransferase

Question 2

Hepatic failure is defined as failure of synthetic function manifested by elevations in ___________

Answer 2

serum total bilirubin and INR

Question 3

_________ is the most common cause of fulminant hepatic failure in the United States

Answer 3

acetaminophen overdose

Question 4

Acute hepatic injury is sudden onset ________ damage in a previously healthy liver

Answer 4

hepatocellular

Question 5

What is acute hepatitis?

Answer 5

Acute hepatitis: Acute inflammatory injury associated with acute hepatic injury

Question 6

What distinguishes acute hepatic failure from fulminant hepatic failure

Answer 6

hepatic encephalopathy

Question 7

List classes of factors that can cause acute hepatic injury

Answer 7

• viral
• toxic/ medications- acetaminophen, alcohol
• ischemia
• autoimmune hepatitis
• metabolic (Wilson’s)

Question 8

Acetaminophen hepatotoxicity is mediated by the formation of toxic ______ which overwhelms the ability of the liver to conjugate it to glutathione and excrete it

Answer 8

NAPQI

Question 9

What should be given in any case of suspected acetaminophen overdose?

Answer 9

NAC (glutathione replacement)

Question 10

Autoimmune hepatitis is associated with what autoantibodies?

Answer 10

Antinuclear Antibody

Anti-smooth muscle antibody

Question 11

List factors that portend poor prognosis in fulminant hepatic failure

Answer 11

slower onset
extremes of age
drug induced (EXCEPT acetaminophen)
idiopathic
acidosis 
severity of global liver failure