Gastroenterology: acute liver failure: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Gastroenterology: acute liver failure

Sample item

A 22-year-old develops jaundice, confusion and INR of 2.5 within 10 days. There is no earlier liver disease. Which is the most appropriate definition and action?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Acute liver failure; transfer to a transplant-capable centre and start N-acetylcysteine

Acute liver failure is coagulopathy (INR 1.5 or more) and encephalopathy within 26 weeks in a patient without prior cirrhosis. Management is intensive care, treating the cause, N-acetylcysteine (beneficial even in non-paracetamol cases) and early referral for transplantation. Cerebral oedema is the major cause of death.

Option by option

  • A. Hepatic encephalopathy is unrelated; give lactulose only

    Lactulose alone is inadequate in ALF.

  • B. Chronic liver disease; outpatient follow-up

    Rapid onset in a healthy person is not chronic disease.

  • C. Wilson disease excluded; observe

    Wilson disease must be considered, and observation alone is unsafe.

  • D. Acute liver failure; transfer to a transplant-capable centre and start N-acetylcysteine (correct)

    Correct. This meets criteria and needs urgent specialist care.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Acute liver failure; transfer to a transplant-capable centre and start N-acetylcysteine. Acute liver failure is coagulopathy (INR 1.

Why is "Hepatic encephalopathy is unrelated; give lactulose only" not the answer?

Lactulose alone is inadequate in ALF.

Why is "Chronic liver disease; outpatient follow-up" not the answer?

Rapid onset in a healthy person is not chronic disease.

Why is "Wilson disease excluded; observe" not the answer?

Wilson disease must be considered, and observation alone is unsafe.

What concept does this question test?

It tests Gastroenterology: acute liver failure in General Medicine. 5 or more) and encephalopathy within 26 weeks in a patient without prior cirrhosis. Management is intensive care, treating the cause, N-acetylcysteine (beneficial even in non-paracetamol cases) and early referral for transplantation. Cerebral oedema is the major cause of death.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gastroenterology: acute liver failure?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.