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Acute liver failure — SCE Acute Medicine MCQ

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HardAcute GI PresentationsAcute liver failureSCE Acute Medicine

A previously well 37-year-old woman develops jaundice, hypoglycaemia and confusion. INR is 3.8, ALT 3,200 IU/L and ultrasound shows no chronic liver disease. Initial resuscitation and cause-directed blood tests are underway. Which disposition is most appropriate now?

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Correct answer: D — Discuss transfer now with a liver centre and continue acetylcysteine

Encephalopathy plus coagulopathy in a patient without established cirrhosis defines acute liver failure. Discuss immediately with a specialist liver centre before cerebral oedema or multiorgan failure makes transfer unsafe. Intravenous acetylcysteine, critical-care support and cause-specific treatment proceed in parallel; referral is not deferred until transplant criteria are fulfilled.

Reference: https://www.bsg.org.uk/clinical-resource/adult-liver-transplantation