Sun14November1246PM 28

A 27-year-old girl presents to the Emergency Department following a paracetamol overdose.

Which of the following would be an indication for referral to a liver intensive care unit for transplant?

(Please select 1 option)

Lactate 3.5 on admission

pH 7.29 This is the correct answer

Grade 2 encephalopathy

Creatinine 210 Incorrect answer selected

INR 2.4

Explanation

King's College criteria state that an arterial PH less than 7.3 is indication for referral to liver transplant centre.

The other criteria are as follows:

INR> 6.5 is indication for referral or PT >100 seconds. Creatinine > 300

Grade 3/4 hepatic encephalopathy

Lactate>3.5after 4 hours fluid resuscitation Or >3.5 after 12 hours

Phosphate >1.2 at 48-96 hours

Answer Statistics

1

11%

2

54%

3

13%

4

8%

5

16%

Times answered: 286