New Graduate Guide to Management of Acute Liver Failure
Dr Philip Judge BVSc MVS PG Cert Vet Clin Stud MACVSc (Vet. Emergency and Critical Care; Medicine of Dogs)
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In a dog with acute severe hepatic necrosis, which of the following patterns of enzyme elevation is expected with Zone 3 acute severe injury?
a) Isolated marked ALT increase with normal ALP
b) Isolated AST increase with normal GGT
c) Concurrent elevations of ALP, GGT, and transaminases
d) Normal enzymes despite severe hepatocellular impairment
Correct answer: (c)
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For a euvolemic patient with deteriorating hepatic encephalopathy due to acute liver failure, which intervention should be considered?
a) Antibiotics with metronidazole
b) Mannitol at 0.25 g/kg IV over 10–20 minutes
c) Fresh frozen plasma at 30 ml/kg
d) Activated charcoal administration
Correct answer: (b)
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Which of the following is a negative prognostic indicator in dogs and cats with acute liver failure?
a) Hyperalbuminemia
b) Development of clinical bleeding or ascites during hospitalization
c) Hyperglycaemia
d) Isolated ALT elevation without hyperbilirubinemia
Correct answer: (b)
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In a dog with acute liver failure and suspected critical illness-related corticosteroid insufficiency, which treatment may be trialled according to the document
a) High-dose methylprednisolone
b) Physiological dose of corticosteroids
c) Fludrocortisone
d) Dexamethasone at 2 mg/kg
Correct answer: (b)
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In a septic patient with acute liver failure and encephalopathy, which antibiotic combination is recommended in the document?
a) Amoxicillin 20 mg/kg IV q 8 hrs + metronidazole 10 mg/kg IV q 12 hrs
b) Enrofloxacin 10 mg/kg IV q 12 hrs + clindamycin 15 mg/kg q 12 hrs
c) Doxycycline 10 mg/kg q 12 hrs + rifampin 5 mg/kg q 8 hrs
d) Cefazolin 22 mg/kg IV q 8 hrs
Correct answer: (a)
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