Acute Liver Failure – Post Test

An 18-year-old girl presents with right upper quadrant pain gradually appearing over the past day. She denies past medical history and the use of any drugs. She appears well and is haemodynamically normal. On clinical examination she is tender over her right upper quadrant but she has no signs of peritonism.

Which of the following describe the most appropriate initial management in the emergency department (ED)?

The pain has improved but is still present. The blood results are mostly normal but you notice a markedly raised ALT at 7000 and a glucose of 3.4, and suspect a diagnosis of acute liver injury. There is no change in the history

What is the most appropriate next step in this patient’s management?

The arterial blood gas shows a pH of 7.33. Her INR is 4.8 and her paracetamol levels are not detected. You also notice that she appears mildly confused. What do you do?

In the intensive care unit she becomes increasingly drowsy and requires intubation. Which of the following management options are most appropriate?

What is the most common cause of acute liver failure worldwide?

Which of the following statements regarding acute liver failure is true?

Which of the following indicates a poorer prognosis?

Which of the following signs may you elicit on physical examination of the patient with acute liver failure (as opposed to acute-on-chronic liver failure)? (Select all that apply)

Which of the following statements is correct with regard to N-acetylcysteine in patients with acute liver failure?

Which of the following treatments improve survival in all causes of acute liver failure?