Alcohol and the liver

Question 1

What is steatosis?

Answer 1

fatty liver

Question 2

What is steatohepatitis?

Answer 2

inflammation of fatty liver

Question 3

What conditions/diseases of the liver are related to alcohol?

Answer 3

1. fatty liver
2. cirrhosis
3. alcoholic hepatitis

Question 4

What are some physical signs of chronic liver disease?

Answer 4

• ascites
• spider naevi
• palmar erythema
• loss of axially hair and pubic hair
• jaundice
• muscle wasting

Question 5

What is spider naevi?

Answer 5

collection of swollen blood vessels found close to the skin

Question 6

What is hepatic encephalopathy?

Answer 6

a range of neurodisorders related to hepatic insufficiency

Question 7

What is portal hypertension?

Answer 7

increase blood pressure in the portal system

Question 8

What is spontaneous bacterial peritonitis?

Answer 8

this is an acute complication of liver cirrhosis and is due to an infection of ascitic fluid in the abdomen.

Question 9

What are the signs of SBP (spontaneous bacterial peritonitis)

Answer 9

• recurring bowel distention
• fever
• rigors
• abdominal pain/tenderness
• altered mental state
• GI bleed

Question 10

Treatment/management for SBP?

Answer 10

• ascitic drainage
• IV antibiotics
• IV albumin

Question 11

What Is alcoholic hepatitis?

Answer 11

inflammation of the liver due to alcohol

Question 12

How does alcoholic hepatitis present?

Answer 12

• jaundice
• altered mental state
• encephalopathy
• infection

Question 13

What is albumin and why is it important?

Answer 13

a protein made by liver and it helps keeps fluid in blood stream so it doesn’t leak to other tissues

we can use this to treat to to test.

IV albumin if PT is low in such

Question 14

What are the functions os the liver?

Answer 14

protein synthesis
fat metabolism
breakdown and detox of drugs/toxics
regulates blood glucose and lipids

Question 15

What are the most common pathologies presented in relation to

1. liver
2. gallbladder
3. extra hepatic bile ducts

Answer 15

1. jaundice, cirrhosis, tumors
2. inflammation
3. obstruction

Question 16

What are the most presented causes of acute liver injury?

Answer 16

1. Hepatitis (inflammation of the liver)
2. bile obstruction
3. alcohol

Question 17

what is jaundice?

Answer 17

discolouration of mucosal membrane, skin, sclera

Question 18

What is jaundice due to?

Answer 18

abnormal accumulation of bilirubin

Question 19

What are the 3 categories/normal pathway of jaundice

note that this is also the classification for abnormality

Answer 19

1. pre-hepatic (takes place In spleen)
2. Hepatic (intra-hepatic)
3. Post- hepatic

Question 20

What is cholestasis

Answer 20

accumulation of bile within hepatocytes or bile ducts/caniliculi

Question 21

What are the cases of intra-hepatic bile duct obstruction that lead to jaundice?

Answer 21

1. primary biliary cholangitis
2. primary sclerosing cholangitis
3. Tumors of liver

Question 22

What is PBC?

Answer 22

an inflammatory (granulotomous inflammation) of bile ducts.

An autoimmune disease that affects F>M

this can lead to cirrhosis of the liver

Question 23

What is the key diagnostic test that should be performed in relation to PBC?

Answer 23

An alkaline phosphatase test

Question 24

What are the hepatic causes of jaundice

Answer 24

1. cholestasis

2. intra-hepatic bile duct obstruction

Question 25

What is PSC?

Answer 25

a condition in which the intra or extra hepatic ducts become strictured and fibrotic

Question 26

what other condition is PSC linked to?

Answer 26

Ulcerative colitis

Question 27

What are the causes of liver cirrhosis

Answer 27

1. alcohol
2. hepatitis B,C
3. immune mediated liver disease
4. metabolic conditions (Primary haemochromatosis, Wilson’s disease)

Question 28

What are post hepatic causes of jaundice?

Answer 28

1. Cholelithiasis (gallstones)
2. Diseases of gall bladder (acute and chronic Cholecystitis)
3. Extra-hepatic duct obstruction