Rewind, Revise, Refine Pre-Reading Puzzle 2026

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Across
  1. 3. Mnemonic used to remember causes of HAGMA
  2. 6. Life-threatening organ dysfunction caused by dysregulated infection response
  3. 7. Procedure used for refractory ascites or variceal bleeding
  4. 12. Clotting abnormality that is a defining feature of acute liver failure
  5. 15. Prominent ECG finding seen in hypokalaemia
  6. 16. Neurotoxin that accumulates in liver failure and crosses the blood-brain barrier
  7. 19. Successful depolarisation of cardiac tissue following a pacing stimulus
  8. 20. Anticoagulant protein synthesised by the liver, reduced in ALF
  9. 23. Infection type seen in Type I necrotising fasciitis
  10. 25. Compound formed when ammonia is metabolised in astrocytes, causing cerebral swelling
  11. 26. Soft tissue infection characterised by rapid necrosis along fascial planes
  12. 27. Cerebral swelling caused by glutamine accumulation in astrocytes
  13. 28. Scarring process that progresses to cirrhosis in chronic liver disease
  14. 29. Metabolic marker of tissue hypoperfusion and anaerobic metabolism
  15. 30. Fluid that accumulates in the abdomen in chronic liver failure
  16. 32. Death of liver tissue that triggers the ALF cascade
  17. 33. Anion subtracted alongside bicarbonate in the anion gap formula
  18. 34. Normal waste product the liver produces from ammonia breakdown
  19. 37. Brain dysfunction caused by accumulation of neurotoxins in liver failure
  20. 38. First-line vasopressor in Australian ICUs for ALF
Down
  1. 1. Medication used to reduce ammonia absorption in encephalopathy
  2. 2. Blood sugar that drops dangerously when the liver fails
  3. 4. Phase of the cardiac action potential where potassium moves out of the cell
  4. 5. Metabolic disturbance caused by lactate accumulation in liver failure
  5. 8. Hormone used to shift potassium into cells during hyperkalaemia
  6. 9. Deep, laboured breathing seen in metabolic acidosis
  7. 10. Score used to quantify organ dysfunction in sepsis
  8. 11. Yellowing used as the starting point in the O'Grady classification
  9. 13. First ECG sign of hyperkalaemia
  10. 14. Waste product normally converted to urea by a healthy liver
  11. 17. End-stage scarring of the liver from chronic damage
  12. 18. Pacing mode used for temporary transvenous pacing
  13. 21. Buffer depleted as acids accumulate in metabolic acidosis
  14. 22. Renal replacement used to remove potassium and correct uraemic acidosis
  15. 23. Most common cause of acute liver failure in Australia
  16. 24. Electrolyte given as gluconate to stabilise cardiac membranes in hyperkalaemia
  17. 30. Brain cells where ammonia is metabolised to glutamine
  18. 31. Beta-2 agonist that shifts potassium intracellularly as a side effect
  19. 35. Electrolyte shifted by insulin, salbutamol, and acidosis
  20. 36. O'Grady classification where jaundice to encephalopathy occurs within 7 days