Chronic liver failure

Question 1

3 criteria defining chronic liver failure

Answer 1

• high INR
• encephalopathy
• jaundice

Question 2

Drug causes

Answer 2

• paracetamol overdose
• MDMA
• alcohol

Question 3

Genetic condition characterised by xs copper build up that leads to chronic liver failure

Answer 3

Wilson’s disease

Question 4

Explain the jaundice in CLF

Answer 4

++ unconjugated bilirubin

Question 5

Explain how hepatic encephalopathy leads to cerebral oedema in CLF

Answer 5

• toxins build up
• go thru BBB
• glutamine —> c oedema

Question 6

Explain the asterixis in CLF

Answer 6

++ ammonia

Question 7

Explain the abnormal bleeding in CLF

Answer 7

++ INR

Question 8

Explain the hepatosplenomegaly in CLF

Answer 8

Portal hptn

Question 9

Explain the spider naevi (& palmar erythema) in CLF

Answer 9

Telengiestasia of Arterioles

Question 10

Manifestations of CLF in males

Answer 10

• gynecomastia

- testicular atrophy

Question 11

What causes the caput medusae seen with ascites

Answer 11

Distended paraumbilical veins due to portal hptn

Question 12

LFT changes in CLF

Answer 12

• hypoalbuminemia
• ++ bilirubin
• ALT>AST

Question 13

How do lactulose & IV mannitol relieve encephalopathy

Answer 13

• lactulose —> nitrogenous waste loss thru bowel

- IV mannitol —> cerebral oedema

Question 14

2 agents given for coagulopathy

Answer 14

• vitK

- fresh frozen plasma

Question 15

clinically, what two markers are looked at to assess liver failure

Answer 15

• INR (bleeding)

- albumin