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Hepatic Failure

- 80% - 90% of hepatic functional capacity loss Q
  1. Causes:         
  1. Massive hepatic necrosis: Fulminant viral hepatitis, drugs and chemicals (acetaminophen, halothane, ATT(Rifampicin, IN H) MAO inhibitors, CCI4. Amanita phalloides) Q
  2. Chronic Liver disease - chronic hepatitis, cirrhosis
  3. Hepatic dysfunction without overt necrosis Q: Reye syndrome, tetracycline toxicity, acute fatty liver of pregnancy
  1. Clinical features – 
  2. Life threatening complications –
    1. Multiple organ failure esp. lung and kidney
    2. Coagulopathy due to impaired hepatic synthesis of factors II, VII, IX, & X resulting in bleeding tendency
    3. Hepatic encephalopathy: EEG-N, specific Asterixis - characteristic' Q
D. Cause –
  1. Disorder of neurotransmission in the CNS and neuromuscular system due to increased levels of ammonia that impairs neuronal function and promotes brain edema.
  2. Hepatorenal Syndrome     
  3. Renal failure in severe liver disease with no cause for renal failure
  4. Hepatocellular carcinoma

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