Alcohol symposium - Liver Flashcards

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1
Q

List some functions of the liver?

A

Carb, protein & fat metabolism
Alcohol & drug metabolism
Storage of glucose, vit, iron & copper
Synthesis of fibrinogen, thrombopoietin & bile

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2
Q

How is alcohol metabolised in the liver?

A

Alcohol

  • > Acetylaldehyde by Alcohol Dehydrogenase (ADH)
  • > Acetate by Acetylaldehyde Dehydrogenase (ALDH)
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3
Q

Other than alcohol intake what other factors affect alcoholic liver disease?

A
  • Poor nutrition
  • Simultaneous other drugs
  • Genetics
  • Female
  • Viruses
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4
Q

How does alcohol liver disease progress?

A

Normal

  • > Steatosis (fatty liver)
  • > Steatohepatitis
  • > Fibrosis
  • > Cirrhosis
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5
Q

Is liver damage reversible?

A

Steatosis is reversible i.e. the fatty change but fibrosis is not

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6
Q

The history of alcohol use is essential but what tests can we do that give us an indicator of chronic alcohol use?

A
  • Elevated Gamma GT
  • Elevated Ferritin
  • Macrocytosis (Elevated MCV)
  • Decreased Platelets
  • Enlarged smooth edged liver on US
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7
Q

Acute alcohol use can cause Alcoholic Hepatitis, how does this present?

A
  • Jaundice
  • Hepatomegaly
  • Abdo pain
  • Fever
  • Hepatic Decompensation
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8
Q

How do we assess Alcoholic Hepatitis?

A

Glasgow Alcoholic Hepatitis Score

A measure of 28day surviva;

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9
Q

How do we treat Alcoholic Hepatitis?

A

Steroids
Treat any infection
Nutrition

ABSTINENCE

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10
Q

How does fibrosis occur?

A

Chronic inflammation activates stellate cells which then lay down collagen

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11
Q

When does fibrosis become cirrhosis?

A

When the collagen is laid down bridging lobules leading to loss of normal lobular structure

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12
Q

What are the complications of cirrhosis?

A

Variceal Haemorrhage
Encephalopathy
Ascites

Hepatocellular Carcinoma

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13
Q

If you’re already cirrhotic is it really worth abstaining?

A

YES! even at that stage it doubles 6 month survival

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