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GI System > Alcohol Related Disease > Flashcards

Alcohol Related Disease Flashcards

1
Q

What effects can alcohol have on the liver and the human body?

A

Encephalopathy
Sponatenous Bacterial Peritonitis
Alcoholic Hepatitis

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2
Q

What is a fatty liver and what can it be seen on?

A

Excessive fat accumulation in the liver

Ultrasound

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3
Q

Why can alcohol cause trouble in the liver in different ways?

A

Alcohol affect several different pathways

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4
Q

What are the signs of Chronic Liver Disease (CLD)? (8)

A 
Spider naevi
Gynaecomastia
Loss of axillary hair
Palmar erythema
Ascites
Encephalopathy
Jaundice
Muscle wasting
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5
Q

What lab results will indicate CLD?

A

AAT > ALT (Ratio>2)
Raised GGT
Macrocytosis
Thrombocytopenia - Low platelets

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6
Q

What is hepatic encephalopathy?

A

A state of confusion coming from liver failure

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7
Q

Is hepatic encephalopathy a specific sign to liver failure?

A

Yes, but it isn’t unique to alcohol

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8
Q

What are the causes of hepatic encephalopathy?

A 
Drugs
Infection
Constipation
GI Bleed
Electrolyte imbalance
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9
Q

What should you exclude when considering hepatic encephalopathy?

A

Infection
Hypoglycaemia
Intra-Cranial bleed

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10
Q

What are the treatment options for hepatic encephalopathy?

A

Bowel wash out - First line of treatment when patient is admitted
Antibiotics
Supportive - ITU

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11
Q

How does a patient with spontaneous bacterial peritonitis usually present?

A

Skinny with a distended abdomen due to ascites

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12
Q

What are the symptoms of spontaneous bacterial peritonitis?

A

Abdominal pain
Fever
Rigors
Renal impairment

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13
Q

What are the signs of spontaneous bacterial peritonitis?

A

Sepsis
Tachycardia
Temperature changes

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14
Q

What are the investigations done for spontaneous bacterial peritonitis?

A

Fluid protein (Protein 0.25x10^9/L

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15
Q

What is the treatment for spontaneous bacterial peritonitis?

A

IV Antibiotics
Ascitic fluid drainage
IV Albumin infusion (20% ALBA)

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16
Q

What is alcoholic hepatitis?

A

Inflammation of the liver typically caused by excessive alcohol consumption over a long period of time

17
Q

How does alcoholic hepatitis present?

A

Jaundice
Encephalopathy
Infection common
Decompensated hepatic function - Low albumin and raised prothrombin time/INR

18
Q

What lab results will diagnose alcoholic hepatitis?

A

Raised bilirubin
Raised GGT & Alk phos
Alcohol hx
Exclude other causes

19
Q

What is the mortality rate for alcoholic hepatitis?

A

40%

90% if the case is severe

20
Q

How should alcoholic hepatitis be treated?

A 
Supportive
Treat infection
Treat alcohol withdrawal
Protect against GI bleeding
Airway protection - ITU
21
Q

What grading scale scores alcoholic hepatitis and above what number should steroids be given?

A

Glasgow Alcohol Hepatitis Score

Score >9

22
Q

What percentage of patients are malnourished with alcoholic hepatitis and how many are severely affected?

A

100%

Severe- 33%

23
Q

What is the prognosis of alcoholic hepatitis?

A

Dependent on abstinence or ongoing alcohol consumption
Steatohepatitis leads to cirrhosis
Mortality is 70% in 5 years for those with decompensating liver disease
Encephalopathy presentation = 64% of patients have a 1 year mortality

24
Q

What is steatohepatitis and is it symptomatic or asymptomatic?

A

Fatty liver with inflammation
ASymptomatic
aka Fatty Liver Disease

25
Q

What is steatosis?

A

The infiltration of liver hepatocytes with fat

Looks like alcohol related but it isn’t

26
Q

What is a causes of fatty liver?

A

NAFLD

27
Q

What are possible causes of steatosis?

A 
Pregnancy
Malnutrition
Obesity
Hepatitis C
Some drugs
28
Q

What is it if there is steatosis but alcohol is related and what is the prognosis?

A

Not NAFLD

Worse prognosis

29
Q

What does steatohepatitis show on blood tests?

A

Increased AAT (Alanine amino transferase)

30
Q

What does steatohepatitis require?

A

A biopsy

31
Q

What percentage of steatohepatitis patients develop cirrhosis?

A

25%

32
Q

What is the treatment for steatohepatitis?

A

Weight loss
Exercise
This is on the rise

33
Q

What does neutrophil infiltration lead to?

A

Inflammation & Cirrhosis

34
Q

What method should be used when taking a history on how alcohol dependent someone is?

A

FAST/AUDIT

GI System (38 decks)

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