Alcoholic hepatitis

Question 1

What is the presentation of alcoholic hepatitis?

Answer 1

Anorexia 
D/V
Tender hepatomegaly 
Ascites 
Severe: jaundice, bleeding, encephalopathy

Question 2

Investigations for alcoholic hepatitis?

Answer 2

Bloods:
Asitic tap
Abdo US + PV

Question 3

Management of alcoholic hepatitis?

Answer 3

Stop alcohol 
Treat withdrawal 
High dose vitamin B: Pabrinex 
Optimise nutrition 
Daily weight,  LFTs, U&Es, INR 
Manage complications of failure

Question 4

Prognosis of alcoholic hepatitis

Answer 4

Use Maddrey score to predict mortality
Score <32 = mild alcoholic hepatitis 5-10% 30d mortality
Score >32 = moderate-severe alcoholic hepatitis 50% 30d mortality