PulmPEEPs

91. Tylenol Toxicity and Acute Liver Failure

7 snips
Dec 10, 2024
Kalaila Pais, an internal medicine resident passionate about pulmonary care and medical education, and Hima Veeramachaneni, a skilled gastroenterologist and critical care fellow, dive deep into the complexities of Tylenol toxicity and acute liver failure. They analyze a riveting case of a patient with severe liver dysfunction, discuss critical diagnostic factors, and highlight management strategies including the use of N-acetylcysteine. The conversation also touches on the emotional challenges faced by healthcare providers when navigating patient recovery and transplant candidacy.
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INSIGHT

ALF vs. ALI

  • Acute liver failure (ALF) differs from acute liver injury (ALI) by speed of onset and encephalopathy.
  • ALF encephalopathy is from hepatocyte necrosis, unlike chronic liver failure's portosystemic shunting.
INSIGHT

ALF Prognosis

  • In acute liver failure (ALF), mental status is key for mortality risk and transplant urgency.
  • Cerebral edema is a major concern in ALF due to hyperammonemia, requiring close CNS monitoring.
ADVICE

Tylenol Levels

  • Interpret Tylenol levels cautiously without ingestion time, as they can be misleading.
  • Consider if elevated levels are due to chronic overuse or a recent acute ingestion.
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