Alcoholic Cirrhosis

Question 1

What is the Pathophysiology behind alcoholic hepatitis

Answer 1

Alcohol is normally metabolized in the liver. Intake of alcohol increases accumulations of triglycerides and fatty acids. Oxidative stress leads to profibrogenic cytokines producing excess collagen and extracellular matrix. Nodules form and hepatocytes die. The liver shrinks

Question 2

Diagnostics for alcoholic cirrhosis

Answer 2

Rule out other forms of chronic liver disease
Liver biopsy (careful not to due while actively drinking)

Question 3

Symptoms of liver cirrhosis

Answer 3

Vague RUQ abd pain
Fever, N/V, diarrhea, anorexia, malaise, ascites, edema, GIB, jaundice, encephalopathy

Question 4

Physical exam findings of liver cirrhosis

Answer 4

Enlarged liver and spleen
Jaundice encephalopathies
Scleral icterus, palmer erythema
Muscle wasting, digital clubbing, edema, ascites

Question 5

Lab findings that suggest liver cirrhosis

Answer 5

Anemia
Elevated bilirubin
Prolonged PT
Possible hyponatremia
Elevated AST, ALT

Question 6

Treatment of alcoholic cirrhosis

Answer 6

Abstinences
Nutrition
Thiamine, folate
Glucocorticoids in severe cases w/out infection
No Acetominophen
Liver transplant
Phentoxifylline: a vasodilator used in HRS, decreases complications, does not affect mortality