ALCOHOLIC HEPATITIS

Question 1

What is alcoholic hepatitis?

Answer 1

A spectrum of alcohol-induced dysfunction ranging from mild, reversible fatty liver to irreversible fibrosis and cirrhosis

Question 2

What are the different types alcoholic hepatitis?

Answer 2

Non-alcoholic Fatty Liver Disease

Fatty Liver Disease (Hepatic Steatosis)

Question 3

What is non-alcoholic fatty liver disease?

Answer 3

Hepatic stratopause in those who do not consume alcohol

It is linked to diabetes, high cholesterol, use of corticosteroids and pregnancy

Question 4

What is Hepatic Steatosis?

Answer 4

Build up of fat in the liver causing inflammation

Caused by excess alcohol, obesity and hyperglycaemia

Question 5

What signs indicate the progression of fatty liver to cirrhosis?

Answer 5

Jaundice, Ascites, Encephalopathy and Variceal Bleeding

Question 6

What are the symptoms of alcoholic hepatitis?

Answer 6

Fatigue
Anorexia
Malnutrition 
Weight gain or loss
Melaena

Question 7

What are the signs of Alcoholic Hepatitis?

Answer 7

RUQ pain
Jaundice
Hepatomegaly
Splenomegaly 
Finger clubbing
Gynaecomastia 
Ascites
Palmar erythema 
Asterixis

Question 8

What are the risk factors of alcoholic hepatitis?

Answer 8

Prolonged heavy alcohol consumption

Presence of Hep. C

Female Sex

Question 9

What blood test are performed to investigate Alcoholic Hepatitis?

Answer 9

LFT: high AST, ALT, Bilirubin

FBC: high WCC and MCV; Low platelets

U&E: high urea

INR: high

Question 10

Which scans would you do for investigating Alcoholic Hepatitis?

Answer 10

Hepatic Ultrasound or Abdominal CT

Results show hepatomegaly, splenomegaly, ascites, portal being engorgement

Question 11

How is alcoholic hepatitis managed?

Answer 11

Cut down drinking, stop smoking, avoid opiates, nutritional supplementation

IV vitamin B (Thiamine) and Vitamin K

Benzodiazepines for Withdrawal symptoms

Daily monitoring