Liver Failure

Question 1

What are the categories of liver failure. (6)

Answer 1

Acute hepatic failure. 
Acute on chronic hepatic failure. 
Fulminant hepatic failure. 
Hyperacute liver failure. 
Acute liver failure. 
Subacute liver failure.

Question 2

What is the aetiology of acute hepatic failure.

Answer 2

Sudden liver failure in a previously healthy liver.

Question 3

What is acute on chronic liver failure.

Answer 3

Liver failure as a result of decompensation of chronic liver disease.

Question 4

What is fulminant liver failure.

Answer 4

Clinical syndrome resulting from massive necrosis of liver cells leading to severe impairment of liver function, in a previously healthy liver.

Question 5

What is hyperacute liver failure.

Answer 5

Encephalopathy within 7days of onset of jaundice.

Question 6

What is acute liver failure.

Answer 6

Encephalopathy within 8-28days of jaundice.

Question 7

What is subacute liver failure.

Answer 7

Encephalopathy within 5-26weeks of jaundice.

Question 8

There is a _______ risk of _____ oedema as the onset of encephalopathy is increasingly ______.

Answer 8

Decreasing.
Cerebral.
Delayed.

Question 9

What are the categories of causes of liver failure. (5)

Answer 9

Infections. 
Drugs. 
Toxins. 
Vascular. 
Other.

Question 10

What are the infective causes of liver failure. (3)

Answer 10

Viral hepatitis.
Yellow fever.
Leptospirosis.

Question 11

What are the drug induced causes of liver failure. (3)

Answer 11

Paracetamol overdose.
Halothane.
Isoniazid.

Question 12

What are the toxic causes of liver failure. (2)

Answer 12

Amanita phalloides mushroom.

Carbon tetrachloride.

Question 13

What are the vascular causes of liver failure. (2)

Answer 13

Budd-Chiari syndrome.

Veno-occlusive disease.

Question 14

What are the other causes of liver failure. (9)

Answer 14

Alcohol. 
Primary biliary cirrhosis. 
Haemochromatosis. 
Autoimmune hepatitis. 
Alpha1 antitrypsin deficiency. 
Wilson's disease. 
Fatty liver of pregnancy. 
HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low Platelets - associated with pre-eclampsia).

Question 15

What are the clinical signs of liver failure. (6)

Answer 15

Jaundice. 
Hepatic encephalopathy. 
Small liver.
Fetor hepaticus. 
Asterixis/flap. 
Constructional apraxia. 
Signs of chronic liver disease. 
Ascites and splenomegaly are rare in fulminant liver failure.

Question 16

What are the complications of liver failure. (6)

Answer 16

Cerebral oedema. 
Ascites. 
Bleeding. 
Infections. 
Low blood glucose. 
Encephalopathy.

Question 17

What factors indicate a worse prognosis for patients with liver failure. (6)

Answer 17

Grade 3-4 encephalopathy.
Age >40.
Albumin

Question 18

What percentage of patients with fulminant hepatic failure develop cerebral oedema.

Answer 18

80%.