Alcohol related Liver Disease Flashcards
What is fatty liver called?
steatosis
What is a fatty liver with inflammation called?
steatohepatitis
History if considering alcohol problem?
Cut
Annoyed (criticism)
Guilty
Eye opener
CAGE
Signs of chronic liver disease? (7)
spider naevi palmar erythema gynaecomastia loss of axillary and pubic hair ascites jaundice muscle wastage
Labs in alcohol related disease (3)?
Aspartate amino transferase (AAT)
Raised gamma glutamyl transferase
thrombocytopenia (low platelets)
what is hepatic encephalopathy?
liver not working affecting brain, 1 to 4, mild confusion to coma
treatment for hepatic encephalopathy?
bowel clear out (enema)
antibiotics
supportive (NG tube, ITU airway if req.)
what is spontaneous bacterial peritonitis?
investigations?
infection of ascitic fluid
ascitic tap
symptoms in spontaneous bacterial peritonitis?
Treatment?
ascites abdo pain fever/rigors renal impairment signs of sepsis (tachycardia, temperature)
IV antibiotics
Ascitic fluid drain
IV albumin infusion (improve kidney function)
Alcohol hepatitis symptoms?
pain swelling
jaundice
encephalopathy
infection
Diagnosis of alcohol hepatitis?
history
raised bilirubin
raised gamma glutamyl transferase (GGT)
raised AlkP
poor prognosis
Treatment of alcohol hepatitis?
treat infection, withdrawal, encephalopathy
protect against GI bleeding
supportive
steroids if Glasgow hepatitis score >9 (prednisolone) !!!
nutrition important - thiamine
