GIT J club Acute Liver failure from NEJM.

1,378 views
883 views

Published on

GIT J club Acute Liver failure from NEJM.

Published in: Health & Medicine
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,378
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
38
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide
  • This template can be used as a starter file for a photo album.
  • GIT J club Acute Liver failure from NEJM.

    1. 1. Acute Liver Failure William Bernal, M.D., and Julia Wendon, M.B., Ch.B. Kurdistan Board GEH Journal club
    2. 2. Introduction: IT IS A RARE LIFE-THREATENING CRITICAL ILLNESS OCCURS 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.
    3. 3. Definition: “A SEVERE LIVER INJURY, POTENTIALLY REVERSIBLE IN NATURE WITH ONSET OF HEPATIC ENCEPHALOPATHY WITHIN 8 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 TOXICITY OR A VIRAL INFECTION. MORE SLOWLY EVOLVING, OR SUBACUTE, CASES: MAY BE CONFUSED WITH CHRONIC LIVER DISEASE. OFTEN RESULT FROM IDIOSYNCRATIC DRUG-INDUCED LIVER INJURY OR INDETERMINATE CAUSE. DESPITE HAVING LESS MARKED COAGULOPATHY & ENCEPHALOPATHY, HAVE A CONSISTENTLY WORSE OUTCOME WITH MEDICAL CARE ALONE.
    4. 4. 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.
    5. 5. 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.
    6. 6. 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.
    7. 7. 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.
    8. 8. 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.
    9. 9. 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.
    10. 10. BO5s: Management of intra-cranial hypertension in acute liver failure include the following except: A. IV Manitol. B. Hypothermia. C. Indomethacin D. Thiopentone. E. IV hypotenic saline.
    11. 11. BO5s: Management of intra-cranial hypertension in acute liver failure include the following except: A. IV Manitol. B. Hypothermia. C. Indomethacin D. Thiopentone. E. IV hypotenic saline.

    ×