Alcoholic hepatitis Flashcards
What is alcoholic hepatitis
A reversible stage of alcoholic liver disease
inflammation and necrosis
What are the presentation of someone with alcoholic hepatitis
RUQ pain
hepatomegaly
malnutrition and wasting
low grade fever
jaundice– if severe
What are risk factors of alcoholic hepatitis
prolonged alcohol consumption
hepatitis C
female
smoking obesity
What are the first line of investigations
FBC- anaemia
LFT
Ultrasound
What do certain values of LFTs mean
AST and ALT elevated to >30 units /L for men and >19 units/L for women
AST/ALT ratio >2
>3 suggests acute episode
elevated ALP may indicate cholestasis
elevated bilirubin
elevated gamma- GT
What other investigations should be considered
viral hepatitis serology
serum iron, ferritin and transferrin to rule out haemochromatosis
24 hour urine copper to rule out Wilsons disease
What is the management
alcohol abstinence
weight reduction and smoking cessation
nutritional support
immunisation
What score is used whether to decide if prednisolone should be given
Maddreys discriminant score
What score is associated with a poor prognosis and prednisolone treatment
score of >32
calculate using PT time and bilirubin concentration
What can be some complications of alcoholic hepatitis
Varices
Ascites
Confusion- hepatic encephalopathy
Kidney failure
Cirrhosis
What does obesity with abnormal LFTs indicate
non-alcoholic fatty liver disease
If AST:ALT ratio is less than 1 this suggests non alcoholic liver disease
