Alcoholic Liver Disease

Question 1

What are the RF for ALD

Answer 1

Chronic alcohol
Obesity
Smoking

Question 2

How do you calculate units of Alcohol

Answer 2

(ABV x ml) / 1000

Question 3

What is the max recommendation for units of alcohol per week

Answer 3

14/week

Question 4

What is the pathology of ALD

Answer 4

Steatosis (Undamaged fatty liver) = Alcoholic hepatitis (Mallory bodies) = Alcoholic Cirrhosis (Micronodular)

Question 5

At which state of ALD would you find mallor bodies

Answer 5

Alcoholic hepatitis

Question 6

What are the symptoms of ALD

Answer 6

Early = ASx
Late = Chronic liver fail Sx w/ Alcohol dependency

Question 7

What are some signs found in ALD relating to chronic liver fail

Answer 7

Jaundice
Hepatomegaly
HE
Ascites
Spider Naevi
Caput Medusae

Question 8

What two questionnaires are given to test alcohol dependency

Answer 8

1st = AUDIT
2nd = CAGE

Question 9

What are the charecteristics of the CAGE questionnaire for alcohol dependency

Answer 9

Should you CUT
Are people ANNOYED
Do you feel GUILTY
EYE OPENING
>1 = Dependant

Question 10

How can ALD be diagnosed

Answer 10

LFT (RAISED GGT)
Bloods = macrocytic non megaloblastic anaemia
Biopsy = Mallory Cytoplasmic Inclusion Bodies

Question 11

What do LFTs show for ALD

Answer 11

Raised LFT EXCEPT LOW ALBUMIN
RAISED GGT
AST:ALT = 2

Question 12

What can be seen in a biopsy of ALD

Answer 12

Malloy Cytoplasmic inclusion bodies
Inflammation
Necrosis

Question 13

What is the treatment plan for ALD

Answer 13

1. Stop Alcohol and give Diazepam
2. Healthy Diet and Decrease BMI
3. Short term steroids w/ B1/Folate
4. Liver transplant for decompensation

Question 14

Why is an ALD patient treated with Diazepam when alcohol is withdrawn

Answer 14

For Delerium Tremens

• Tremors
• Agitation
• Ataxia
• Disorientation

Question 15

In order to asses ALD severity and treatment plan, what must be attained

Answer 15

Maddreys value 32+

Question 16

In order to be considered for lung transplant, What must a patient do

Answer 16

Abstain from Alcohol for 3 months

Question 17

What are some complications of ALD

Answer 17

WERNICKE KORSOKOFF
Pancreatitis
HE
Ascites
Mallory Weis tear

Question 18

What is the major complication of ALD

Answer 18

Wernicke Korsakoff
-B1 Deficiency Sx w/ Alcohol Withdrawal Sx
(B1 low w/ Delerium tremens)
Sx = Ataxia, nystagmus, Encephalopathy, Memory loss

Question 19

What are the symptoms of Wernicke Korsakoff

Answer 19

Ataxia
Nystagmus
Encephalopathy
Memory loss

Question 20

How is Wernicke Korsakoff treated

Answer 20

IV Thiamine