ACUTE LIVER FAILURE, 4TH MBBS, ESUCOM

A 3-month-old infant presents with jaundice, poor feeding, and coagulopathy. PT is 22 seconds not corrected by vitamin K. There is no clinical evidence of hepatic encephalopathy. Which of the following best supports a diagnosis of acute liver failure according to the pediatric ALF study group definition?

1. PT >15 seconds with clinical encephalopathy
2. PT >20 seconds regardless of encephalopathy
3. Elevated transaminases with encephalopathy
4. PT >15 seconds with jaundice

Which of the following is the single most common cause of acute liver failure during the first month of life?

1. Galactosemia
2. Herpes simplex virus infection
3. Gestational alloimmune liver disease (neonatal hemochromatosis)
4. Tyrosinemia type 1

A 14-year-old with acute liver failure due to acetaminophen overdose is being managed in the ICU. On day 3, arterial blood gas shows pH 7.25. The patient is adequately hydrated. What does this finding indicate?

1. The need for immediate liver transplantation
2. A poor prognosis with 90% mortality
3. Hepatorenal syndrome
4. Hyperventilation secondary to encephalopathy

Which drug is the most common cause of acute liver failure associated with medication use?

1. Valproic acid
2. Isoniazid
3. Acetaminophen
4. Diclofenac

Which of the following plasma ammonia concentrations is associated with a 5-fold increased risk of death in acute liver failure?

1. >50 µmol/L
2. >100 µmol/L
3. >150 µmol/L
4. >200 µmol/L