Hepatitis and Liver Failure in Children

What this deck covers

Hepatitis and Liver Failure in Children in twelve illustrated clinical cases with worked explanations – case presentations built around clinical images, radiology, teaching illustrations and real laboratory data, with the reference range beside every value a case quotes. This visual, data-interpretation style of practice suits candidates preparing for MRCPCH AKP in particular, alongside Saudi and Gulf licensing examinations such as the Arab Board, DHA and OMSB. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong.

The twelve cases, in order

1. Dark urine after the school trip
2. Reading the hepatitis B panel
3. The enzymes are falling, and that is the bad news
4. Sixteen tablets at midnight
5. Rings around the iris
6. The girl whose liver attacks itself
7. Yellow only when he is ill
8. Fever, pain and yellow, all at once
9. Vomiting and confusion after the flu
10. Two years old, scratching, and an uncle with liver disease
11. A liver problem with a family history of emphysema
12. Hepatitis B in the mother, a plan for the baby

What this deck teaches

• The INR measures function, the ALT measures injury. A falling ALT with a rising INR is a liver running out of cells, not one recovering – acute liver failure is defined by the clotting, not the enzymes.
• Read a hepatitis B panel one marker at a time. Surface antigen means current infection, core IgM means acute, e antigen and viral load mean replication, and a normal ALT in a young child means tolerance – monitor, do not treat yet.
• Late paracetamol gets the antidote first. Beyond eight hours, or with an unknown time, acetylcysteine starts before the level is back; normal tests on day one mean nothing.
• Liver plus brain in a teenager is Wilson disease. Look at the cornea, measure the caeruloplasmin and the urinary copper, and screen the siblings.
• High IgG with autoantibodies is autoimmune hepatitis. Prednisolone induces remission and azathioprine keeps it; treatment runs for years and relapse on stopping is the rule.
• Unconjugated, normal enzymes, no haemolysis: Gilbert. A well teenager who turns yellow with illness needs reassurance, not a biopsy.

Exam pearls from this deck

• A jaundiced cluster after travel is hepatitis A – confirm with the IgM, and watch the INR rather than the ALT.
• Surface antigen with core IgG and a normal ALT is chronic infection being tolerated – monitor, do not treat yet.

The twelve worked cases in this deck, with the images and the full explanation of every option, are part of Pediatric Case Review membership. See what is included, or start with the free Pediatric Exam Review Sets.

More from this system: all gastroenterology illustrated case decks · gastroenterology board questions for bank-style drilling · the free Pediatric Exam Review Sets · pediatric reference values.