Alcoholic hepatitis Flashcards
1
Q
define alcoholic hepatitis?
A
- inflammatory liver injury caused by chronic heavy intake of alcohol
2
Q
what are the three main forms of alcoholic liver disease?
A
- alcoholic fatty liver
- alcoholic hepatitis
- chronic cirrhosis
3
Q
what is the maximum number of units men and women should drink?
A
- they shouldnt drink more than 14 units a week
4
Q
which questionnaire can screen for harmful alcohol use?
A
- audit
5
Q
what are some histo features of alcoholic hepatitis?
A
- build up of fat
- centrilobular ballooning
- necrosis of hepatocytes
- Neutrophilic inflammation
- Mallory-hyaline inclusions
6
Q
epidemiology of alcoholic hepatitis?
A
10-35% of heavy drinkers
7
Q
presenting symptoms of mild alcoholic hepatitis?
A
- can be a mild illness with the following:
- nausea
- malaise
- epigastric pain
- right hypochondrial pain
- fever
8
Q
presenting symptoms of moderate alcoholic hepatitis?
A
- jaundice
- abdo swelling
- swollen ankles
9
Q
what are the signs of alcohol excess?
A
- palmer erythema
- Dupuytren’s contracture
- telangiectasia
- Spider naevi
- gynaecomastia
- hepatomegaly
- tachycardia
- jaundice
- bruising
- ascites
- hepatomegaly
- splenomegaly
10
Q
what might the LFTs show?
A
- high AST and ALT
- specifically AST: ALT >2:1
- high GGT
- high ALP later on
- low albumin
11
Q
what might FBC show?
A
- low Hb
- high MCV
- high WCC
- low platelets
12
Q
when might Us and Es be deranged?
A
hepatorenal syndrome
13
Q
other investigations into alcoholic liver disease?
A
- USS: early fatty changes
- Upper GI endoscopy: investigate varices
- Liver biopsy
- EEG
14
Q
management plan for alcoholic hepatitis?
A
- thiamine
- vitamin replacement
- correct electrolytes
- treat encephalopathy
- manage ascites
- nutrition
- lots of protein
15
Q
acute management?
A
- steroid treatment can improve short term prognosis
16
Q
complications of alcoholic hepatitis?
A
- Acute liver decompensation
- hepatorenal syndrome
- cirrhosis
17
Q
prognosis of alcoholic hepatitis?
A
- if alcohol intake continues will progress to cirrhosis in 1-3 years
