Alcoholic Liver Disease Flashcards
True or false: Alcoholic liver disease is the most common cause of liver failure
True
What are risk factors for alcoholic liver disease?
Chronic alcohol
Smoking
Obesity
What word describes an undamaged yet fatty liver?
Steatosis
(NASH, Non-alcoholic steatohepatitis, is advanced stage of NFLD caused by build up of fat causing inflammation and damage)
Hard q: What structure may be found in alcoholic hepatitis?
Mallory bodies
(Cytoplasmic eosinophilic inclusions in hepatocytes, associated with ballooning and inflammation)
Early stages of alcoholic liver disease may show little signs.
Name 3 symptoms of later more severe stages of alcoholic liver disease
Jaundice
Hepatomegaly
Ascites
Hepatic Encephalopathy
Spider naevi (see central arteriole with capillaries radiating out)
Caput medusae (distended and engorged umbilical veins)
Palmar erythema (red palms)
Easy bruising
Name an alcohol dependency questionnaire used to determine whether someone is alcohol dependent (score of 2 or more)
CAGE
should you Cut down?
are people Annoyed by your drinking?
Feel Guilty about drinking?
Eye opening - do you drink in morning?
What is the recommended weekly limit of alochol?
14 units per week max
How do you work out how many units are in a drink?
Strength (ABV) x Volume (ml)
_______________________________
1000
1 unit = _g of alcohol
8g
1 unit = _ ml of alcohol
10ml
What would the ratio of AST:ALT be in alcoholic liver disease?
Greater than 2
(2:1)
What would LFT show in alcoholic liver disease?
Raise in AST and ALT
Raised bilirubin
Drop in albumin
Greater PT
What kind of anaemia is present in patients with alcoholic liver disease?
Macrocytic non-megaloblastic anaemia
What might happen to levels of folate in alcoholic liver disease?
May fall
Liver converts folate into active form, impaired liver so lower levels of active form.
Often poor dietary habits
Chronic alcohol use damages GI tract so less absorption
Alcohol causes increased urinary excretion of folate
What is needed to confirm extent of cirrhosis and differentiate from hepatitis?
Biopsy
What would a biopsy of alcoholic liver diseased show?
Inflammation
Necrosis
Mallory cytoplasmic inclusion bodies
What is conservative treatment for alcoholic liver disease?
Abstain from alcohol
Healthy diet
Lower BMI
What are alcohol withdrawal symptoms caused?
Delirium tremens
What are some alcohol withdrawal symptoms (delirium tremens)?
Tremors
Agitation
Ataxia
Disorientation
What can be given to help with alcohol withdrawal symptoms (delirium tremens)?
Diazepam or chlordiazepoxide
What pharmacological interventions should be considered for alcoholic liver disease?
Consider short term steroids (anti-inflammatory properties to reduce liver inflammation)
B1 supplements (prevent Wernicke encephalopathy)
Folate supplements
Maddrey’s discriminant function is used to assess s_____ of alcoholic hepatitis and predict the m______ risk.
severity
mortality
How long must a patient abstain from alcohol before being considered for a liver transplant?
3 months
HE is a complication of alcoholic liver disease. How do you treat this?
lactulose
Ascites is a complication of alcoholic liver disease. How do you treat it?
Diuretics
What kind of cancer is a complication of alcoholic liver disease?
HCC
Wernicke Korsakoff syndrome (complication of alcoholic liver disease) is combined __ deficiency and alcohol withdrawal symptom
B1 (alcohol causes this deficiency)
What are symptoms of Wernicke Korsakoff syndrome?
Ataxia
Nystagmus
Encephalopathy
Disproportional memory loss
What is treatment for Wernicke Korsakoff syndrome?
IV thiamine (or as Pabrinex)
