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Liver and Friends > Liver Failure > Flashcards

Liver Failure Flashcards

1
Q

How long does acute LF take to develop?

A

8-21 days

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2
Q

Is acute or chronic LF more common?

A

Chronic

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3
Q

What can cause LF?

A

Alcohol excess, Budd-Chiari syndrome, haemochromatosis, Wilson’s

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4
Q

How does encephalopathy develop?

A

Nitrogenous waste builds up as ammonia, astrocytes in the brain clear it, this produces glutamine, excess glutamine causes an osmotic imbalance, this causes cerebral oedema

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5
Q

How does acute LF present?

A

Malaise, nausea, anorexia, jaundice

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6
Q

What are symptoms of chronic LF?

A

Malaise, anorexia, pruritis

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7
Q

What is included in a LFT?

A

Serum bilirubin, serum albumin, prothrombin time/INR

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8
Q

What hepatic enzymes are there?

A

Aminotransferases (AST/ALT), Alkaline phosphate (ALP), GGT

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9
Q

What would you expect the blood results to show?

A

Increased PT, AST, ALT

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10
Q

What should you do if the patient has ascites?

A

Peritoneal tap with microscopy and culture

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11
Q

What drugs should you avoid?

A

Sedatives and other drugs with hepatic metabolism like paracetamol, methotrexate and oestrogen

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12
Q

What are some complications of liver failure?

A

Cerebral oedema, ascites, bleeding, hypoglycaemia, encephalopathy, sepsis

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13
Q

What is grade I encephalopathy?

A

Altered mood/behaviour, sleep disturbance, dyspraxia, poor arithmetic

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14
Q

What is grade II encephalopathy?

A

Increasing drowsiness, confusion, slurred speech, inappropriate behaviour/personality change

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15
Q

What is grade III encephalopathy?

A

Incoherent, restless, liver lap, stupor

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16
Q

What is grade IV encephalopathy?

A

Coma

17
Q

What are signs of chronic LF?

A

Ascites, oedema, Dupuytren’s contracture, palmar erythema, Xanthelasma, spider naevi, hepatomegaly, bleeding, hepatic encephalopathy, jaundice

18
Q

What conservative treatment would you start?

A

Fluids and analgesia

19
Q

How would you manage ascites?

A

Diuretics

20
Q

How would you manage cerebral oedema?

A

Mannitol

21
Q

How would you manage bleeding?

A

Vitamin K

22
Q

How would you manage encephalopathy?

A

Lactulose

23
Q

How would you manage sepsis?

A 
Sepsis 6
High-flow oxygen
Blood cultures
IV antibiotics
IV fluid resuscitation
Measure lactate
Measure urine output
24
Q

How would you manage hypoglycaemia?

A

Dextrose

25
Q

What surgical option is available?

A

Transplant

26
Q

How does liver failure present?

A

Asterixis, Dupuytren’s contractures, Leukonychia, Spider naevi

Liver and Friends (14 decks)

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