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HEPATOLOGY > Alcoholic Liver Disease > Flashcards

Alcoholic Liver Disease Flashcards

1
Q

⚡⚡ MOST COMMON CAUSE of LIVER CIRRHOSIS IN INDIA

⚡⚡ MOST COMMON CAUSE of LIVER CIRRHOSIS IN WESTERN COUNTRIES

A

⚡⚡ MOST COMMON CAUSE of LIVER CIRRHOSIS IN INDIA
🎯 ALCOHOLIC LIVER DISEASE

⚡⚡ MOST COMMON CAUSE of LIVER CIRRHOSIS IN WESTERN COUNTRIES
🎯 HCV > ALD

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2
Q

1 Standard.Drinks

A

14 gm Alcohol
18ml of 100% alcohol

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3
Q

Recommended Safe Limit

A

♂️: ≤ 2 Standard Drink
✨ 20-40 gm/day

♀️: ≤ 1 Standard Drink
✨ 16-30 gm/day

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4
Q

⭐ How much ml of BEER is Standard Drink? (5%)

⭐ How much ml of WINE is Standard Drink? ( 12%)

⭐ How much ml of VODKA, GIN, RUM, WHISKEY is Standard Drink? (40%)

A

⭐ How much ml of BEER is Standard Drink? (5%)
🎯 350 ml

⭐ How much ml of WINE is Standard Drink? ( 12%)
🎯 150 ml

⭐ How much ml of VODKA, GIN, RUM, WHISKEY is Standard Drink? (40%)
🎯 44 ml

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5
Q

When does a person develops ALCOHOLIC liver DISEASE?

A

Male:
✨ > 21 standard drinks/wk for ≥ 2 year
✨ > 210 gm/week for ≥ 2 year

Female:
✨ > 14 standard drinks/wk for ≥ 2 year
✨ > 140 gm/week for ≥ 2 year

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6
Q

Pathogenesis of ALCOHOLIC LIVER DISEASE

A
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7
Q

Effects of ⬆️ NADH DUE TO: Alcohol

A

Indicates ENERGY FULL STATE in Liver
⬇️
Energy Synthesis
⬇️
Fat synthesis⬆️
⬇️
Steatosis & Steatohepatitis⬆️

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8
Q

ALCOHOLIC Liver DISEASE Spectrum

A
  1. Fatty Liver (Steatosis)
  2. Alcoholic Hepatitis (Steatohepatitis)
  3. Cirrhosis
  4. HCC
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9
Q

⚡⚡ MOST COMMON HEPATOTOXIN causing ACUTE LIVER FAILURE

⚡⚡ MOST COMMON HEPATOTOXIN causing CHRONIC LIVER FAILURE

A

⚡⚡ MOST COMMON HEPATOTOXIN causing ACUTE LIVER FAILURE
🎯 ACETAMINOPHEN

⚡⚡ MOST COMMON HEPATOTOXIN causing CHRONIC LIVER FAILURE
🎯 Alcohol

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10
Q

⭐ DIRECT HEPATOTOXIN

⭐ INDIRECT HEPATOTOXIN

A

⭐ DIRECT HEPATOTOXIN
🎯 Alcohol

⭐ INDIRECT HEPATOTOXIN

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11
Q

Laennac CIRRHOSIS seen in

A

⭐ Alcoholic CITRHOSIS
SHOWS HOBNAIL PATTERN

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12
Q

HOBNAIL in MEDICINE

A

⭐ HOBNAIL PATTERN: ALCOHOLIC CIRRHOSIS (Laennac)

⭐ HOBNAIL CELLS: Collecting Duct (OR) Bellini Duct RCC

⭐ HOBNAIL CELLS: Clear Cell Ovarian Tumour

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13
Q

Identify

A

Mallory Hyaline Bodies
(OR)
Mallory Denk Bodies
✨ Eosinophilic Inclusion in Hepatocytes

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14
Q

Composition of Mallory Hyaline Bodies

A

Intermediate Filaments like CK8 & CK18

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15
Q

Mallory Hyaline Bodies found in
🧠⚡ New Indian WATCH⚡

A
  1. NASH
  2. Indian Childhood Cirrhosis
  3. Wilson’s disease
  4. Alpha 1 antitrypsin Disease
  5. Alcoholic Liver Disease
  6. Tumours: HCC
  7. 1° biliary Cirrhosis
  8. hyperplasia: Focal Nodular
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16
Q

Decreased Attenuation in CT Liver

A

Fatty Liver

17
Q

USG feature of Alcoholic Fatty Liver

A

⬆️ LIVER ECHOGENICITY

18
Q

How to differentiate AFLD & NAFLD

A
  1. H/O Alcoholic Liver Disease
  2. LFT is deranged (AST > ALT)
19
Q

⚡⚡ MOST COMMON Presentation of ALCOHOLIC fatty liver

A

Hepatomegaly ± Pain

20
Q

Liver Profile of ALCOHOLIC FATTY LIVER

A
  1. AST/ALT > 1
  2. Moderate ⬆️ in ALT & AST
  3. GGT ⬆️ ⬆️
21
Q

🧑🏻‍⚕️ Clinical Features of ALCOHOLIC HEPATITIS

A

Constitutional symptoms (Fever, Fatigue, Anorexia & Tachycardia)
➕
1. Tender Hepatomegaly
2. Jaundice
3. Splenomegaly
4. ASCITES (Portal HTN)
5. Evidence of Liver Failure

22
Q

LFT in ALCOHOLIC HEPATITIS

A
  1. AST & ALT ⬆️ (2-7 x Normal)
  2. AST/ALT ≥ 2:1
  3. PT/INR ⬆️
  4. Bilirubin ⬆️
23
Q

Alcoholic Hepatitis can be seen on TOP of Liver CIRRHOSIS

24
Q

Indication of treatment in ALCOHOLIC HEPATITIS

A

Discrimination Factor ≥ 32

25
Maddrey Discrimination Score used in
Alcoholic HEPATITIS ✨ For indication of initiation of STEROIDS
26
Maddrey Discrimination Score
= 4.6*(Prothrombin time - Control Prothrombin Time) ➕ Total Serum Bilirubin
27
🚫 CONTRAINDICATION of STEROIDS even if MADDREY DISCRIMINATION SCORE ≥ 32
1. Active UGI Bleed 2. Active Infection 3. HBV / HCV
28
💊💉 MANAGEMENT of ALCOHOLIC HEPATITIS
1. Prednisolone: 40mg/day * 18/days ➕ Taper in 16 days ⬇️ Assess after 1 week with Lille's Score ⬇️ No improvement: Stop Steroids 2. Pentoxyfylline (PDE ⛔)
29
Lille's score
Used to assess Response to STEROIDS in ALCOHOLIC HEPATITIS
30
MELD Score > 11 indicates
Mortality in 30 days
31
ABIC Score
Modification of MELD Score ✨ AGE ✨ Bilirubin ✨ INR ✨ Creatinine
32
ALCOHOLIC CIRRHOSIS Characteristic Features
✨ Parotid Enlargement ✨ Dupuytren's contracture
33
Microvesicular Steatosis Causes 🧠⚡READ ⚡
1. Reye's Syndrome 2. Early ALCOHOLIC liver disease 3. Acute Fatty Liver of Pregnancy 4. Drugs & Toxins
34
Macrovesicular Steatosis 🧠⚡NOC PLz ⚡
1. NASH 2. Obesity 3. C HEPATITIS CHRONIC infection 4. Protein Energy Malnutrition 5. Late ALCOHOLIC Liver Disease
35
Periportal Predominant Macrovesicular Steatosis 🧠⚡ Total SPACE⚡
1. Total Parenteral Nutrition 2. Starvation 3. Phosphorus poisoning 4. AIDS 5. Chronic Hepatitis C 6. Exogenous Steroids

HEPATOLOGY (16 decks)

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