Alcoholic Liver Disease

Question 1

How long does it take to reverse alcohol-related fatty liver?

Answer 1

2 weeks

Question 2

What will LFTs show in alcohol liver disease?

Answer 2

Elevated ALT and AST (particularly gamma-GT)
ALP elevated later in disease
Low albumin
Elevated bilirubin in cirrhosis

Question 3

What drugs can be used in alcohol liver disease?

Answer 3

Steroids - improve short term outcomes over 1 month in severe alcoholic hepatitis

Question 4

What is a state of severe alcohol withdrawal called?

Answer 4

Delirium tremens

Question 5

What receptors does alcohol stimulate in the brain?

Answer 5

GABA receptors
Glutamate (NMDA) receptors

Question 6

What system becomes down-regulated in chronic alcohol use?

Answer 6

GABA system
Glutamate system

Question 7

What drug can be used to manage the effects of alcohol withdrawal?

Answer 7

Chlordiazepoxide (Librium) = benzodiazepine

Question 8

What vitamin should be given in alcohol dependency?

Answer 8

Intravenous high-dose B vitamins followed by oral thiamine to prevent Wernike’s encephalopathy.

Question 9

What does Wenicke’s encephalopathy progress to?

Answer 9

Korsakoff’s syndrome

Question 10

Features of Wernike’s encephalopathy?

Answer 10

Confusion
Oculomotor disturbances
Ataxia

Question 11

Features of Korsakoff’s syndrome

Answer 11

Memory impairment
Behavioural changes