Liver Failure Flashcards
Define liver failure. Classify according to the time since symptom onset.
What is Cirrhosis?
Gold standard dx of cirrhosis?
Is cirrhosis and liver failure the same?
What are the causes of acute liver failure?
What are the causes of chronic liver failure?
What are the causes of acute and chronic liver failure?
List the RFs for liver failure
Describe the pathogenesis of cirrhosis.
Describe the pathogenesis of portal HTN.
List the ddx for liver failure
The causes are also ddx
List the symptoms/RFs you would like to ellict from a liver failure history.
How would you grade hepatic encephalopathy
Outline the exam findings you would expect in a liver failure case.
What are the diagnostic investigations for liver failure.
How would you assess for synthetic function of the liver?
Alcoholic hepatitis on LFT will show
What is the cause of a 2:1 ALT:AST?
What does the liver autoimmune screen test for?
Autoimmune hep - anti-LKM1, IgG4, ASMA
PBC - AMA
What is the tumour marker for HCC?
AFP
What is the use of an U/S liver in Liver failure?
What is the use of a fibroscan in Liver failure? What imaging is it based on
What is the ideal timeframe in which an ascitic tap should be performed in liver failure?
What information would the tap provide?
What are the findings on liver biopsy in cirrhosis (4)
What test can be to detect alcohol consumption within the last 30 days?
What are the supportive investigations for liver failure?(justify)
What are ALL the investigations for liver failure?(justify)
What is the use of the following classification systems:
1.Child-Pugh?
2. MELD?
3. Maddrey’s Discriminant Function for Alcoholic Hepatitis?
4. King’s College Criteria for Liver Transplant?
1.Child-Pugh - cirrhosis severity.
2. MELD - 3 month mortality of end-stage liver disease.
3. Maddrey’s Discriminant Function for Alcoholic Hepatitis - predicts prognosis and steroid benefit in alcoholic hepatitis.
4. King’s College Criteria for Liver Transplant - used to list patients for acute urgent liver transplant.
How would you grade prognosis of end stage liver disease?
Outline the grading system used to list patients for an acute liver transplant.
Outline the grading system that predicts prognosis and steroid benefit in alcoholic hepatitis.
In the setting of a paracetamol OD, when would you prescribe activated charcoal over NAC and vice versa. How are they given?
High risk patients may develop toxicity to paracetamol at lower plasma levels. WHat are these high risk groups?
Outline the management of acute liver failure secondary to paracetamol OD
Describe to preventative measures to decrease risk of liver failure?
How would you treat the symptoms of hepatic encephalopathy?
lactulose - prevention and treatment
Rifaximin - for recurrent encephalopathy
How is a therapeutic abdominal paracentesis performed?
What is the TIPSS procedure and what is its main risk?
What is the definitive management for liver failure?
Transplant ttek
Outline the pharmacological management for chronic liver failure.
Outline the non-pharmacological management for chronic liver failure. Describe them.
What are the S+S of decompensated liver disease?
What are the S+S of hepatopulmonary syndrome?
What is the treatment of SBP?
What are the S+S of Wernicke’s Encephalopathy?
How often in screening for HCC done in CLD patients? How is it done?
What are the S+S of Korsakoff’s psychosis?
Describe the possible complications of liver failure.
Describe this image.
Compare the prognosis of compensated vs decompensated liver failure.
