Alcohol related liver disease

Question 1

Alcoholic Fatty Liver

Answer 1

Most Heavy drinkers will have Fatty Liver

20% progress to cirrhosis

Alcohol Abstinence improves Fatty Liver to normal

Question 2

Acute Alcoholic Hepatitis
aetiology

Answer 2

Alcohol intake > 8u / day

Jaundice with Bilirubin > 80mg/dl

No other aetiology for Liver inflammation

Very high Mortality / No specific treatment yet

Question 3

grading of acute Alcoholic Hepatitis

Answer 3

Question 4

GAHS ≥ 9 mortality with and without steroids

Answer 4

30 day mortality
Without steroids 48%
With steroids 22%

84 day mortality
Without steroids 62%
With steroids 41%

Question 5

ARLD & Hospital admission figures

Answer 5

1 person admitted with ARLD / day
Age at presentation is going down
Mean length of stay is 9 days
1 death every 4.5 days at ARI
Mean age at dying 58

Question 6

alcohol and its link to malnutrition and associated symptoms

Answer 6

60 % of chronic abusers have malnutrition

Most of the calories is from Alcohol

Total energy intake is reduced
Nausea & Vomiting
Abdominal pain
Diarrhoea

Question 7

Mortality in Alcoholic Cirrhosis

Answer 7

75% die of Liver decompensation

20-25% Hepatocellular cancer sequelae

Question 8

alcohol related liver disease link to transplantation

Answer 8

ARLD is the most common indication

Resistant complications of Cirrhosis
Jaundice
Ascites
Encephalopathy
Coagulopathy
Hepatocellular Cancer

Question 9

what age range is most associated with liver cirrhosis

Answer 9

Deranged LFTs are common especially in Obese teenagers

Exposure to Alcohol <14 yrs
Strongly associated with later alcohol abuse & dependence
(RR 2.3-4.0)

Question 10

raised gamma gt and mcv - history of alcohol

Answer 10

ARLD

Question 11

ABC in bloods for normal liver

Answer 11

albumin
bilirubin
clotting INR