alcoholic liver disease Flashcards
define alcoholic liver disease
most common cause of liver failure
- chronic liver disease caused by excess alcohol
what are the risk factors for alcoholic liver disease?
- chronic alcohol
- obesity
-smoking
how do you calculate units of alcohol consumed?
[strength (ABV) x vol/ml]/
1000
what is the recommended units of alcohol a week?
14 a week
describe the progression of alcoholic liver disease
- steatosis
- ( undamaged fatty liver) - alcoholic hepatitis
-( with mallory bodies) - alcoholic cirrhosis
- (micronodular)
what are the symptoms at an early stage of alcohol liver disease?
no symptoms
what are the symptoms at a late stage of alcohol liver disease?
chronic liver + alcohol dependency failure symptoms
what are the signs of alcoholic liver disease?
hepatomegaly
what questionnaire is used to ask about alcohol dependency?
CAGE
what does CAGE stand for?
C- cut down
A- annoying people
G- guilt
E- eye opening ( morning drink)
what score in the cage questionnaire would mean dependent on alcohol?
> 12 ( or equal to)
how is alcohol liver disease diagnosed?
- bloods- FBC,LFT,Clotting profile
- biopsy
FBC: what would an ALD patient look like
macrocytic
non megaloblastic anaemia
low folate
LFT: what would an ALD patient look like
High bilirubin
low albumin
high GGT
AST: ALT > 2
CLOTTING PROFILE: what would an ALD patient look like
High PT
what would a biopsy tell you?
confirm the extent
shows the inflammation, necrosis, mallory cytoplasmic inclusion bodies
what are the three types of treatment for ALD?
- conservative
- pharmacological
- surgical
what does conservative treatment for ALD include?
stop alcohol
healthy diet
- give diazepam
what does pharmacological treatment for ALD include?
short term steroids
- maddreys discriminant value 32+
- B1 + Folate supplements
why do you give diazepam for?
Delirium tremens - withdrawal symptoms
what is the surgical treatment for ALD?
Liver transplant
what are the 7 complications associated with alcoholic liver disease?
- pancreatitis
- mallory weiss tear
- heapatocellular carcinoma
- delirium tremens
- HE
- ascites
- Wernicke-Korsakoff syndrome ( a combined b1 deficiency and alcohol withdrawal)
what is the treatment for Wernicke-Korsakoff syndrome?
iv thiamine
what are the symptoms of wernicke Korsakoff?
ataxia, nystagmus, encelopathy, low memory, confusion
