Alcohol and the Liver Flashcards
What are the LFTs for paracetamol and vascular insult?
v high AST and ALT
What are the LFTs for excess alcohol?
AST>ALT, increased GGT
What are the LFTs for NAFLD?
ALT> AST, increased GGT and ferritin
What are the LFTs in cholestatic derangement?
elevation of ALP and GGT
What are the extrahepatic causes of cholestatic derangement?
biliary obstruction - stones, sludge and strictures
What are teh intrahepatic causes of cholestatic derangement?
primary and secondary cholangitis
primary sclerosing cholangitis
vascular
fibrosis
What is the mechanism of ascites in liver damage?
- cirrhosis causes portal hypertension
- reduced albumin production decreases oncotic pressure causing transudation of fluid
- reduced aldosterone metabolism causing RAAS system and salt and water retention
How do you manage alcohol excess liver damage?
IV Pabrinex and benzodiazepines
What are the scoring systems for for ALD?
glasgow alcoholic hepatitis score
Maddrey’s discriminant function
Lille model
What is the management for alcoholic hepatitis?
if infection start antibiotix
prednisolone
How do you manage mild or moderate ascites?
restrict sodium intake
anti-mineralocorticoid and add furosemide if required
What are teh alcoholism screening questions?
CAGE
have you ever felt you should CUT the amount of alcohol you’re drinking?
have people ANNOYED you by criticising how much you drink?
have you ever felt GUILTY about your drinking?
have you ever had a drink first thing in the morning to steady your nerves of cure a hangover? (EYE opener)
