Liver failure

Question 1

Causes

Answer 1

Paracetamol overdose

Alcohol

Viral hepatitis (usually A or B)

Acute fatty liver of pregnancy

Question 2

Features

Answer 2

Jaundice

Coagulopathy (raised PT time)

Hypoalbuminaemia

Hepatic encephalopathy

Renal failure

Question 3

Paracetamol overdose management

Answer 3

Within 1 hour may benefit from activated charcoal

Acetylcysteine if
- high plasma paracetamol concentration
- staggered overdose

Question 4

Paracetamol overdose liver transplant criteria

Answer 4

Arterial pH <7.3 24 hours after ingestion or all of

• PT time >100 seconds
• creatinine >300umol/l
• grade III or IV encephalopthy