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Goals of a Liver Failure Physical Findings Staged Evaluation of Associated With Liver Infants Who Have Jaundice Neonates and Infants Disease Infections: herpesviruses, echo/ Recognize cholestasis (versus adenoviruses, sepsis Infants unconjugated, “physiologic” Microcephaly: congenital hyperbilirubinemia) Metabolic disorders: hereditary fructose intolerance, cytomegalovirus, rubella, Assess severity of the liver mitochondrial illnesses, toxoplasmosis harm tyrosinemia, galactosemia, Characteristic facies: Separate particular entities neonatal iron storage illness arteriohepatic dysplasia (eg, metabolic versus viral Ischemia/shock: congenital (Alagille syndrome) versus anatomic) cardiac illness, myocarditis, Cataracts: galactosemia Differentiate biliary atresia extreme hypotension Retinal pigmentation and from idiopathic neonatal Drugs/toxins: valproate, posterior embryotoxon: hepatitis acetaminophen Alagille syndrome Differentiate idiopathic Children and Adolescents Abnormal auscultation of neonatal hepatitis from Infections: hepatitis, lungs: cystic fibrosis progressive familial herpesviruses, echo/ intrahepatic cholestasis and Neuromuscular abnormalities adenoviruses, sepsis bile duct paucity (tremors, flaccidity): lipid Drugs/toxins: valproate, storage disease, Wilson acetaminophen, mushrooms illness, problems of oxidative (Amanita) phosphorylation serum and urinary bile acid ranges Malignancy will help in eliminating the likelihood Children of an inborn error of bile acid Ischemia/shock: congenital Pruritus: persistent cholestasis metabolism. 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