Hep/HPB

Question 1

Create a list of the different questions to ask when someone’s presents following an overdose?

Answer 1

Date of ingestion: is there a delay?
Single overdose or staggered
Time since last ingestion(even staggered)
Pregnancy?
Total amount ingested and of what? With alcohol? Mixed overdose?
Any regular medications?
Method of administration: are they at risk of other diseases?

Question 2

If a patient presents within 1h of a single paracetamol overdose, what can you give the patient to help prevent absorption?

Answer 2

Activated charcoal

Question 3

For a single overdose, what time post ingestion should you measure paracetamol overdose?

Answer 3

4 hours

Question 4

What is the main drug used in those presenting with high levels of paracetamol and lie above the line on the reference graph? How long should the initial treatment last?

Answer 4

N-acetylecyteine.

21 hours

Question 5

What is the name of the criteria used to assess whether a patient should have a liver transplant? List the criteria as best as you can. Is it not essential to remember this but understating what is assessed is important

Answer 5

King’s college criteria

Arterial pH: <7.3 after resuscitation and >24 h since ingestion
Lactate: >3 mmol/L
 OR
The 3 following criteria:
Hepatic encephalopathy >grade 3
Serum creatinine >300 umol/L
INR >6.5

Question 6

The double-duct sign is an imaging finding in the diagnosis of pancreatic cancer. Why is it called this?

Answer 6

Dilation of both the pancreatic and common bile ducts