Acute Liver Failure is defined as the acute onset of severe liver injury with encephalopathy and ↓ synthetic function (INR ≥ 1.5 ) in a patient without cirrhosis or underlying known liver disease.
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Acute Liver Failure. |
Diagnostic triad: 1) elevated aminotransferases (often > 1000 U/L)
2) Hepatic encephalopathy
3) INR ≥ 1.5
Causes: mnemonic - Mr. Wilson Died In Vehicle Accident.
Malignant infiltration
Wilson's disease
Drugs (especially Acetaminophen overdose/ idiosyncratic)
Ischemia (Shock liver, Budd-Chiari syndrome)
Viral hepatitis (Hep. A, B, D, E; HSV; CMV)
Autoimmune hepatitis
Symptoms, signs: RUQ pain + tenderness, anorexia, nausea, vomiting, jaundice, fatigue, lethargy, flapping tremor (asterixis) and other signs of hepatic encephalopathy.
Also common in ALF: Raised portal pressure,
Decreased urine output due to low intravascular volume,
Hypoglycemia,
Reactive thrombocytopenia.
That's all!
(Happy studying :D)
2) Hepatic encephalopathy
3) INR ≥ 1.5
Causes: mnemonic - Mr. Wilson Died In Vehicle Accident.
Malignant infiltration
Wilson's disease
Drugs (especially Acetaminophen overdose/ idiosyncratic)
Ischemia (Shock liver, Budd-Chiari syndrome)
Viral hepatitis (Hep. A, B, D, E; HSV; CMV)
Autoimmune hepatitis
Symptoms, signs: RUQ pain + tenderness, anorexia, nausea, vomiting, jaundice, fatigue, lethargy, flapping tremor (asterixis) and other signs of hepatic encephalopathy.
Also common in ALF: Raised portal pressure,
Decreased urine output due to low intravascular volume,
Hypoglycemia,
Reactive thrombocytopenia.
That's all!
(Happy studying :D)
-Suneet
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