Alcoholic and non alcoholic liver disease Flashcards
he prognosis of severe alcoholic liver disease is dismal; the mortality of patients with alcoholic hepatitis concurrent with cirrhosis is
nearly 60% at 4 years.
Although alcohol is considered a direct hepatotoxin, only between_____of alcoholics will develop alcoholic hepatitis.
10 and 20%
Gene that has been associated with alcoholic cirrhosis.
Patatin-like phospholipase domain-containing protein 3 (PNPLA3)
one beer, four ounces of wine, or one ounce of 80% spirits all contain ∼12 g of alcohol
∼12 g of alcohol
Obesity, a high-fat diet, and the protective effect of ___ have been postulated to play a part in the development of the pathogenic process.
coffee
In men, ____g/d of ethanol produces fatty liver; ____ g/d for ____ years causes hepatitis or cirrhosis. Only ____ of alcoholics develop alcoholic liver disease.
In men, 40–80 g/d of ethanol produces fatty liver; 160 g/d for 10–20 years causes hepatitis or cirrhosis. Only 15% of alcoholics develop alcoholic liver disease.
Women exhibit increased susceptibility to alcoholic liver disease at amounts ____
> 20 g/d
Chronic infection with hepatitis C virus (HCV).
Even moderate alcohol intake of _____ increases the risk of cirrhosis and hepatocellular cancer in HCV-infected individuals.
20–50 g/d
Increased liver iron stores and, rarely, ________ can occur as a consequence of the overlapping injurious processes secondary to alcohol abuse and HCV infection.
porphyria cutanea tarda
In addition, alcohol intake of >50 g/d by HCVinfected patients decreases the efficacy of interferon-based antiviral therapy.
FACT
Hepatocyte injury and impaired regeneration following chronic alcohol ingestion are ultimately associated with_______ and _______, which are key events in fibrogenesis.
Hepatocyte injury and impaired regeneration following chronic alcohol ingestion are ultimately associated with stellate cell activation and collagen production, which are key events in fibrogenesis.
The hallmark of alcoholic hepatitis is hepatocyte injury characterized by ballooning degeneration, spotty necrosis, polymorphonuclear infiltrate, and fibrosis in the _________
perivenular and perisinusoidal space of Disse.
______bodies are often present in florid cases of alcoholic hepatitis but are neither specific nor necessary to establish the diagnosis.
Mallory-Denk
In alcoholic hepatitis and in contrast to other causes of fatty liver, AST and ALT are usually elevated two- to sevenfold. They are rarely _____, and the AST/ALT ratio is___
> 400
>1
Severe alcoholic hepatitis is heralded by coagulopathy (prothrombin time increased _____), anemia, serum albumin concentrations ______ , serum bilirubin levels ________, renal failure, and ascites.
Severe alcoholic hepatitis is heralded by coagulopathy (prothrombin time increased >5 s), anemia, serum albumin concentrations <25 g/L (2.5 mg/dL), serum bilirubin levels >137 μmol/L (8 mg/dL), renal failure, and ascites.
