Alcohol Related Liver Disease Flashcards
What does an encephalopathy score of 1 and 4 mean?
1=mild confusion
4=coma, unresponsive to pain
RFs for encephalopathy
Infection Drugs Constipation GI bleed Electrolyte disturbance
Tx for encephalopathy
Bowel clear out, lactulose, enemas Antibiotics Supportive : -ITU -airway support -NG tube for meds
S+S for spontaneous bacterial peritonitis
Abdominal pain
Fever, rigors
Renal impairment
Signs of sepsis, tachycardia and temperature
Tx for spontaneous bacterial peritonitis
IV antibiotics
Ascitic fluid drainage
IV albumin infusion
S+S of alcoholic hepatitis
Jaundice Encepalopathy Infection common Decompensated hepatic function -low albumin and raised prothrombin time
Ix alcoholic hepatitis
Raised bilirubin
Raised GGT and AlkP
Alcohol history
Exclude other causes
Mortality of alcoholic hepatitis
40%
If severe, up to 90% mortality
Tx for alcoholic hepatitis
Treat infection Treat encephalopathy Treat alcohol withdrawal Protect against GI bleeding Airway protection/ITU care
What can cause steatohepatitis?
Fatty liver with inflammation
Neutrophil inflammation
Fibroisis, cirrhosis (fro I’m drinking most days for years)
What does CAGE mean?
Have you ever felt the need to CUT down?
Have you ever been ANNOYED by criticism of your drinking?
Have you ever felt GUILT about your drinking?
Do you need an EYEOPENER?
What numerical value which is required for a fast positive score? (Scored 0-4 on 4 questions)
3 to more
How may questions are there in the total audit?
10
6 new ones plus the FAST score 4
Which numerical values are assigned to the increasing risk of alcohol dependence on the audit score?
8-15
Which values are categorised as higher risk on the audit score?
16-19
