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King's College criteria for potential liver transplant following paracetamol overdose include:

True / False

Serum creatinine > 300 µmol/L Correct

Bilirubin > 120 µmol/L Correct

pH < 7.3 Correct

INR > 5 Incorrect answer selected

Pre-existing cirrhosis Correct

Explanation

King's College Hospital criteria following paracetamol overdose includes:

pH < 7.3 (or <7.25 if previously given N-acetyl cysteine)

Grade III-IV encephalopathy

Creatinine > 300 µmol/L

INR >6.5

Different criteria existing for non-paracetamol induced liver failure.

The Child-Pugh scoring system uses serum bilirubin and albumin, INR, presence of ascites and grade of encephalopathy whilst the MELD score calculation uses bilirubin, INR and creatinine. There is also a Glasgow score of alcoholic hepatitis.

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