1. Describe the relevant biochemical abnormalities
Elevated bilirubin – jaundice (require direct vs indirect)
Markedly elevated ALT >> GGT/ALP – transaminitis, indicating hepatocellular damage
Normal Albumin – marker of synthetic function Normal FBC/UEC
2. What is the most likely diagnosis?
Acute hepatitis (obstructive picture/ similar not acceptable)
3. Give 4 most likely causes
Infection – Viral especially Hepatitis A, B, C, other EBV, HSV, CMV, HIV
Toxins/ Drugs – Paracetamol, antibiotics
4. What are the markers of synthetic function of the liver?
Prothrombin time – measures Vit K dependant clotting factors (II, VII, IX, X)
Ammonia – does not correlate well and is not a good marker of synthetic function
5. List 3 immediate complications of acute liver failure
At least two of:
Accept one of: