Liver failure Flashcards

1
Q

what are causes of acute liver failure?

A

paracetamol overdose
alcohol
acute fatty liver of pregnancy
viral hepatitis B

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2
Q

what are features of acute liver failure?

A

coagulopathy: bruising, petechiae
hypoalbuminaemia: ascites, pleural effusion, peripheral oedema
conjugated jaundice
hepatic encephalopathy: confusion, irritability, coma

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3
Q

what is the first line treatment of hepatorenal syndrome?

A

terlipressin

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4
Q

what’s the difference between type 1 and type 2 hepatorenal syndrome?

A

type 1

  • occurs within 14 days
  • doubling serum creatinine to > 221 or halving of creatinine clearance to < 20ml/min
  • poor prognosis

type 2

  • slowly progressive
  • prognosis poor but patients may live longer
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5
Q

what are management options for hepatorenal syndrome?

A

vasopressin anologues drugs i.e. terlipressin
volume expansion 20% albumin
TIPSS

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6
Q

what’s the underlying pathology of hepatorenal syndrome?

A

vasoactive mediators cause splanchic dilatation which decreases systemic peripheral vascular resistance
= under perfusion of kidneys which trigger juxtoglomuerlar apparatus activating RAAS
= renal vasoconstriction

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