Liver Failure

Causes

100

What are the 2 most common causes of chronic liver disease in the United States?

Alcohol liver disease and Non-alcoholic steatohepatatis (NASH)

200

What is the most common cause of acute liver failure in the US?

Acetaminophen overdose

300

Name 2 of the 3 most common genetic causes of liver failure

Alpha1-antitrypsin disease

Wilson disease

Hereditary hemochromatosis

Miscallaneous

100

Of the hepatitis virus infections, which one is least likely to progress to chronic liver disease?

Hepatitis A

200

What class of medication is contraindicated for cirrhotic pts? 

NSAIDS, Tylenol is safe for use up to 2g per day

300

Explain the underlying pathophysiology of hepatorenal syndrome in patients with liver failure

Renal vasoconstriction (activation of RAAS) in the setting of splanchnic vasodilation (from portal HTN progression, NO/PG mediated)

Interventions/

100

What medication can be used in liver failure to improve portal HTN by decreasing splanchnic vasodilation and blood flow?

Octreotide

200

What needs replaced following a large volume paracentesis and how many liters must be pulled off to be considered large volume? (Double points if dosage is named correctly)

Albumin must be replaced if 5L or greater is removed, dosing at 6-8g/L of fluid removed at 25% albumin concentration ex. 6L of fluid removed would warrant a 36-48g of 25% albumin replacement

300

What scoring system is used to stratify patients for liver transplant needs? (Double points if you can name the components of the scoring system)

MELDA-Na score (Dialysis status, Na level, Bilirubin, INR, Creatinine)