5.2. Alcohol Symposium - Alcohol and the Liver

Question 1

What has happened to Alcohol-Related Liver Disease in the past 20 years?

Answer 1

It has increased by 500%

Question 2

What are the Central Nervous System Complications of Alcohol Dependency?

Answer 2

1. Seizures
2. Atrophy
3. Ataxia
4. Headaches
5. Blurring / Change in Colour / Loss of Vision
   Note - Alcohol crosses the Blood-Brain Barrier and is Toxic

Question 3

What are the Immunlogical Complications of Alcohol Dependency?

Answer 3

1. Increased Cancers

2. Impaired Immune Response

Question 4

What are the Musculoskeletal Complications of Alcohol Dependency?

Answer 4

1. Subdural Haematomas
2. Suppressed Marrow / Iscaemic Necrosis / Bone/Skull Fractures
3. Arthalgias / Inflammation / Gout
4. Myalgia / Cramps / Weakness / Myopathy / Muscle Wasting

Question 5

What are the Cardiovascular Complications of Alcohol Dependency?

Answer 5

1. Cardiomyopathy
2. Arrhythmias
3. Increased Angina
4. Congestive Heart Failure / Oedema
5. Hypertension
6. Stroke

Question 6

What are the Gastrointestinal Complications of Alcohol Dependency?

Answer 6

1. Gastritis
2. Malabsorption
3. Diarrhoea
4. Ulcers
5. Irritable Bowel
6. Pancreatitis

Question 7

What are the Sexual / Reproductive Complications of Alcohol Dependency?

Answer 7

1. Lack of Sexual Interest
2. Erectile Dysfunction / Decreased Performance
3. Anorgasmia
4. Teratogenic / Foetal Alcohol Syndrome

Question 8

What are the Peripheral Nervous System Complications of Alcohol Dependency?

Answer 8

1. Paraesthesia
2. Extrapyramidal Symptoms
3. Neuropathy
4. Pain

Question 9

What are the Haematological Complications of Alcohol Dependency?

Answer 9

1. Leucopenia
2. Iron Deficiency Syndrome
3. Macrocytic Anaemia
4. Thrombocytopenia
5. Coagulopathies

Question 10

What are the Liver Complications of Alcohol Dependency?

Answer 10

1. Inflammation
2. Fatty Infiltrates - Fatty Liver Disease
3. Hepatitis - Alcoholic Hepatitis
4. Cirrhosis - Alcoholic Cirrhosis
   Note - 85% of those dying with Cirrhosis is as a result of Alcohol

Question 11

From when can a Diseased Liver (Due to Alcohol Dependency) go back to being a Normal Liver?

Answer 11

1. Alcoholic Fatty Liver (Most Heavy Drinkers) - Disappears after 6 weeks of abstinence
2. Alcoholic Hepatitis
   Note - Alcoholic Cirrhosis is Irreversible

Question 12

Which is worse for developing Liver Cirrhosis, Binge vs Constant Drinking?

Answer 12

Daily Drinkers:

1. Daily Drinkers Cirrhosis Rates (after 13 years) = 16/1%
2. Binge Drinkers Cirrhosis Rates (after 13 years) = 7.5%

Question 13

What does the Alcohol intake need to be to develop Alcoholic Hepatitis?

Answer 13

> 6 units per day

Question 14

What is the Score used to measure Alcoholic Hepatitis?

Answer 14

The Glasgow Alcoholic Hepatitis Score:
Age - <50 / >50 / -
WCC - <15 / >15 / - 
Urea - <5 / >5 / -
INR - <1.5 / 1.5-2.0 / >2.0
Bilirubin - <125 / 125-250 / >250
Note - Left = 1 / Middle = 2 / Right = 3

Question 15

If there is a Glasgow Alcoholic Hepatitis Score > 9, what is the:

1. 30 day mortality without steroids?
2. 30 day mortality with steroids?
3. 84 day mortality without steroids?
4. 84 day mortality with steroids?

Answer 15

1. 48%
2. 22%
3. 62%
4. 41%

Question 16

What is the treatment of Hepatocellular Cancer?

Answer 16

1. Surgical Resection
2. Liver Transplant
3. Radiofrequency / Microwave Ablation
4. Transarterial Chemoembolisation
5. Chemotherapy