Acute Liver FailureWilliam Bernal, M.D., and Julia Wendon, M.B., Ch.B.

Kurdistan Board GEH Journal club

IT IS A RARE LIFE-THREATENING CRITICAL ILLNESSOCCURS MOST OFTEN IN PATIENTS WHO DO NOT HAVE PREEXISTING LIVER DISEASE. INCIDENCE <10 CASES PER MILLION PERSONS PER YEAR SEEN MOST COMMONLY IN 30S IT PRESENTS UNIQUE CHALLENGES IN CLINICAL MANAGEMENT.THE CLINICAL PRESENTATION USUALLY INCLUDES HEPATIC DYSFUNCTION, ABNORMAL LIVER BIOCHEMICAL VALUES, COAGULOPATHY; ENCEPHALOPATHY MAY DEVELOP, WITH MULTIORGAN FAILURE& DEATH OCCURRING IN UP TO 50%THE RARITY ,SEVERITY& HETEROGENEITY, HAS RESULTED IN A VERY LIMITED EVIDENCE BASE TO GUIDE SUPPORTIVE CARE. SURVIVAL HAVE IMPROVED SUBSTANTIALLY IN RECENT YEARS THROUGH ADVANCES IN CRITICAL CARE MANAGEMENT & EMERGENCY LIVER TRANSPLANTATION.

Introduction:

“A SEVERE LIVER INJURY, POTENTIALLY REVERSIBLE IN NATURE WITH ONSET OF HEPATIC ENCEPHALOPATHY WITHIN8 WEEKS OF THE FIRST SYMPTOMS IN THE ABSENCE OF PRE-EXISTING LIVER DISEASE,”. IN HYPERACUTE CASES, THIS INTERVAL IS A WEEK OR LESS& THE CAUSE IS USUALLY ACETAMINOPHEN TOXICITYOR A VIRAL INFECTION. MORE SLOWLY EVOLVING, OR SUBACUTE, CASES:MAY BE CONFUSED WITH CHRONIC LIVER DISEASE.OFTEN RESULT FROM IDIOSYNCRATIC DRUG-INDUCED LIVERINJURY OR INDETERMINATE CAUSE. DESPITE HAVING LESS MARKED COAGULOPATHY & ENCEPHALOPATHY, HAVE A CONSISTENTLY WORSE OUTCOMEWITH MEDICAL CARE ALONE.

Definition:

The most common cause of viral-induced Acute Live Faliure is:A. Hepatitis A.B. Hepatitis B.C. Hepatitis C.D. Hepatitis E.E. A&D.

BO5s:

The most common cause of viral-induced Acute Live Faliure is:A. Hepatitis A.B. Hepatitis B.C. Hepatitis C.D. Hepatitis E.E. A&D.

BO5s:

Subacute compared with acute acute Live Failure is characterized by all except:A. Simulates chronic liver disease.B. Has better prognosis.C. Caused more by idiosyncratic drug reaction.D. Has less encephalopathy.E. Has less coagulopathy.

BO5s:

Subacute compared with hyperacute acute Live Failure is characterized by all except:A. Simulates chronic liver disease.B. Has better prognosis.C. Caused more by idiosyncratic drug reaction.D. Has less encephalopathy.E. Has less coagulopathy.

BO5s:

Encephalopathy in acute liver failure differs from that in chronic liver disease by:A. Antibiotics has clear beneficial role.B. Lactulose has deleterious effects.C. Intra-cranial hypertension plays no important role.D. Hypothermia has no any benefits.E. Grading is different.

BO5s:

Encephalopathy in acute liver failure differs from that in chronic liver disease by:A. Antibiotics has clear beneficial role.B. Lactulose has deleterious effects.C. Intra-cranial hypertension plays no important role.D. Hypothermia has no any benefits.E. Grading is different.

BO5s:

Management of intra-cranial hypertension in acute liver failure include the following except:A. IV Manitol.B. Hypothermia.C. IndomethacinD. Thiopentone.E. IV hypotenic saline.

BO5s:

Management of intra-cranial hypertension in acute liver failure include the following except:A. IV Manitol.B. Hypothermia.C. IndomethacinD. Thiopentone.E. IV hypotenic saline.

BO5s: