Liver Failure
Acute Liver Failure
Acute Fulminant Liver Failure (ALF) -progression of acute liver disease within 6 months.
Hepatic Encephalopathy due to impaired function.
causes of and
Coagulopathy liver
·
onset
occur due to reduced ammonia breakdown
and increased Prothrombin time / INR respectively. Characteristics:
Hyperacute:Jaundice to Encephalopathy within 1week. Renal Failure
-
Acute: Jaundice to Encephalopathy from 1-4 weeks. -
Metabolic acidosis
sub-acute:Jaundice to Encephalopathy 4-12 weeks.
Hypoglycaemia
-
Peripheral Vasodilation
-
-
·Causes: Distributive Shock
Encephalopathy, GCS
-
change
Chronic Liver Failure (Acute on Chronic liver Failure) -
Jaundice
No
Coagulation
-
Paracetamol Overdose: -
most common
-
Ascites
Poor consider for Increased Prothrombin time
prognosis, transplantation.
-
·
Treatment:Iv N-acetylcysteine for 21hours.
·
Hepatitis A/B
Hep HAV-IgM present, Serum ALT raised, detectable in stool.
·
A:
Hep B:more common, HBsAg present, Serum ALTraised.
·
Wilson Disease:
Hereditary, recessive.
·
causes
build-up in tissue
·
copper
Diagnosis:kFrings in bw serum genetic sequencing.
·
eye, copper,
complications:haemolytic Cirrhosis,
hepatitis, parkinsonism.
·
other anaemia,
Treatment:Penicillamine.
·
Seronegative:
all other causes excluded
I
dio athic,
·
·
could be viral, autoimmune, drug-induced.
Management:
·
Catheterise/monitor of distributive shock.
·
urine
output in case
Fluid resucitation with colloid, then Crystalloid.
·
a
Give to avoid
glucose hypoglycaemia.
·
IV
Treat
encephalopathy with lactulose.
·
Renal Failure with
Treat
Haemodialysis.
·
Treat cause
·
transplant if necessary.
·
Liver
Acute Liver Failure
Acute Fulminant Liver Failure (ALF) -progression of acute liver disease within 6 months.
Hepatic Encephalopathy due to impaired function.
causes of and
Coagulopathy liver
·
onset
occur due to reduced ammonia breakdown
and increased Prothrombin time / INR respectively. Characteristics:
Hyperacute:Jaundice to Encephalopathy within 1week. Renal Failure
-
Acute: Jaundice to Encephalopathy from 1-4 weeks. -
Metabolic acidosis
sub-acute:Jaundice to Encephalopathy 4-12 weeks.
Hypoglycaemia
-
Peripheral Vasodilation
-
-
·Causes: Distributive Shock
Encephalopathy, GCS
-
change
Chronic Liver Failure (Acute on Chronic liver Failure) -
Jaundice
No
Coagulation
-
Paracetamol Overdose: -
most common
-
Ascites
Poor consider for Increased Prothrombin time
prognosis, transplantation.
-
·
Treatment:Iv N-acetylcysteine for 21hours.
·
Hepatitis A/B
Hep HAV-IgM present, Serum ALT raised, detectable in stool.
·
A:
Hep B:more common, HBsAg present, Serum ALTraised.
·
Wilson Disease:
Hereditary, recessive.
·
causes
build-up in tissue
·
copper
Diagnosis:kFrings in bw serum genetic sequencing.
·
eye, copper,
complications:haemolytic Cirrhosis,
hepatitis, parkinsonism.
·
other anaemia,
Treatment:Penicillamine.
·
Seronegative:
all other causes excluded
I
dio athic,
·
·
could be viral, autoimmune, drug-induced.
Management:
·
Catheterise/monitor of distributive shock.
·
urine
output in case
Fluid resucitation with colloid, then Crystalloid.
·
a
Give to avoid
glucose hypoglycaemia.
·
IV
Treat
encephalopathy with lactulose.
·
Renal Failure with
Treat
Haemodialysis.
·
Treat cause
·
transplant if necessary.
·
Liver
