Alcohol Related Liver Disease and Acute General Hospital Flashcards
What can the damage of alcohol abuse cause on the liver?
Hepatic steatosis
Hepatic cirrhosis
Alcoholic hepatitis
How many people with alcoholic fatty liver progress to cirrhosis?
20%
Abstinence improves fatty liver to normal
Describe acute alcoholic hepatitis
Alcohol intake over 8 units a day
Jaundice with bilirubin over 80mg/dl
Very high mortality and no specific treatment yet
How is acute alcoholic hepatitis scored?
GAHS score 1-3
Age, WCC, urea, PT ratio or INR, and bilirubin measured
What is the prognosis of GAHS score of over 9?
30 day mortality without steroids 48% and with is 22%
84 day mortality without steroids is 62% and with is 41%
Describe alcohol and malnutrition
60% of chronic abusers have malnutrition
Most calories from alcohol
Total energy intake is reduced - N/V, abdo pain and diarrhoea
What is the mortality of alcoholic cirrhosis?
75% die of liver decompensation 20-25% hepatocellular cancer sequelae
What is the most common indication of ARLD liver transplantation?
Resistant complications of cirrhosis, jaundice, ascites, encephalopathy, hepatocellular cancer and coagulopathy
What are some examples of presentations from the effects of alcohol?
Acute intoxication, alcohol withdrawal/ delirium tremens, alcohol withdrawal seizures, falls, and road traffic collisions
Describe alcohol withdrawal seizures
Extremely dangerous
Grand-mal or tonic-clonic epileptic seizure
Typically convulsions, uncontrollable muscle contractions, unconsciousness and incontinence
Start 24 hours after last drink
What is the cause of Wernicke’s encephalopathy?
Lack of thiamine (vitamin B1) - essential nutrient
Eyes - double vision and dropping eyelids
Balance changes, movement issues and delirious and confusion
What is given for the treatment of Wernicke’s encephalopathy?
Oral thiamine
What is chlordiazepoxide?
Benzodiazepine
