Liver infection and liver failure Flashcards
1
Q
Define liver failure and what it’s commonly associated issues are?
A
- an inability of the liver to perform it’s synthetic and metabolic functions. This happens when the liver can no longer successfully regenerate.
- associated with - ascites, hepatic encephalopathy, abnormal bleeding and jaundice
2
Q
What are the 3 types of liver failure?
A
- acute fulminant - 8 weeks of onset from it’s underlying cause beginning
- late-onset - 8-25 weeks post onset of underlying cause
- decompensated chronic liver failure - 6/12 delay
3
Q
Broad sweeping causing of liver failure?
A
- toxins
- viral
- metabolic
- neoplastic
- misc other
4
Q
What are some toxin causes of liver failure?
A
- alcohol
- paracetamol
- ABx - co-amox, mycins
- illicit drugs
- poisoning
5
Q
What are viral causes of liver failure?
A
- viral hepatitis
- EBV
- CMV
- adeno
6
Q
What are the metabolic causes of liver failure?
A
- wilson’s
- A1AT deficiency
- haemochromatosis
7
Q
what are the neoplastic causes of liver failure?
A
- HCC
- metastatic disease
8
Q
What are the miscy other causes of liver failure?
A
- NAFLD
- pregnancy related fatty liver disease
- vascular - budd-charri
9
Q
Presentation of liver failure?
A
- hepatic encephalopathy - drowsiness, confusion, agitation
- increased circulating volume w/ end organ failure
- abdominal swelling - ascities
- flapping tremor
10
Q
What bloods would you do in liver failure? expected results too plz.
A
- FBC - thrombocytopenia
- clotting - INR raised Vit k metabolism interupted
- increased bili
- LFTs - wonky dependent on cause
- amonia high
- glucose low
ABG - metabolic acidosis
11
Q
What imaging may you do for ?liver failure?
A
- USS - hepatic vein patency
- CT scan - malignancy or other structural pathology
- EEG- encephalopathy
12
Q
How do you treat liver failure?
A
- Tx underlying cause
- LACTULOSE for encephalopahty increased excretion of amonia/reduces it’s production
- associated Sx control - itching - cholestyramine
- monitor glucose
- liver transplant
13
Q
4 complications of liver failure
A
- malnutrition - due to decreased bile production
- bleeding
- endocrine disturbance - amenorrhoea, gynaecomastia , ED
- hypoglycaemia
14
Q
3 causes of coma in liver failure?
A
- hepatic encephalopathy - reduced ammonia processing
- hypoglycaemia
- hyponatraemia - sodium lost in ascites
15
Q
What might precipitate hepatic encephalopathy?
A
- constipation
- Drugs - analgesia
- GI bleed
- Trans-jugular intrahepatic portosystemic shunt
- infection
- renal failure
- hypokalaemia
