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Acute liver failure — ABEM Board MCQ

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HardGI/Abdominal emergenciesAcute liver failureABEM Board

A 36-year-old woman arrives with vomiting, confusion, and jaundice after several days of acetaminophen use for influenza. Triage acuity is ESI 2; BP 104/66 mm Hg, HR 118/min. INR is 4.8, ALT is 6,200 U/L, and glucose is 54 mg/dL. She has no known cirrhosis. Which of the following is the most likely diagnosis?

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Correct answer: A — Acute liver failure

Coagulopathy and encephalopathy in a patient without cirrhosis define acute liver failure; acetaminophen is a common cause.

Reference: AASLD acute liver failure guidance