GIT J club Acute Liver failure from NEJM.
Upcoming SlideShare
Loading in...5
×
 

GIT J club Acute Liver failure from NEJM.

on

  • 806 views

GIT J club Acute Liver failure from NEJM.

GIT J club Acute Liver failure from NEJM.

Statistics

Views

Total Views
806
Views on SlideShare
806
Embed Views
0

Actions

Likes
0
Downloads
15
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • This template can be used as a starter file for a photo album.

GIT J club Acute Liver failure from NEJM. GIT J club Acute Liver failure from NEJM. Presentation Transcript

  • Acute Liver Failure William Bernal, M.D., and Julia Wendon, M.B., Ch.B. Kurdistan Board GEH Journal club
  • 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.
  • 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.
  • 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: 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. Indomethacin D. 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. Indomethacin D. Thiopentone. E. IV hypotenic saline.