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Medicine > Alcoholic Liver Disease > Flashcards

Alcoholic Liver Disease Flashcards

1
Q

What percentage of the global burden of diseases is attributed to alcohol according to the WHO?

A

4%

This statistic highlights the significant impact of alcohol on public health.

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2
Q

What is the leading cause of liver cirrhosis in developed countries?

A

Alcoholic Liver Disease (ALD)

ALD is recognized as the primary cause of cirrhosis in the Western world.

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3
Q

What are the components of the clinical spectrum of Alcoholic Liver Disease?

A
  • Fatty liver
  • Alcoholic hepatitis
  • Alcoholic cirrhosis

These conditions represent the progression of liver damage due to alcohol.

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4
Q

How does alcohol consumption in developed countries compare to developing countries?

A

Declining in developed countries; increasing in developing countries

This shift has implications for liver disease prevalence globally.

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5
Q

What synergistic effect does alcohol have on liver disease?

A

It worsens the progression of liver disease when combined with viral hepatitis B and/or C

This interaction can lead to more severe liver conditions.

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6
Q

What percentage of liver-related deaths in the US are attributed to alcohol?

A

> 50%

This statistic indicates the serious role of alcohol in liver disease mortality.

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7
Q

What is the estimated annual cost of Alcoholic Liver Disease in the US?

A

$3 billion

This figure reflects the economic burden of ALD on the healthcare system.

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8
Q

What is the minimum quantity and duration of alcohol consumption that is significant for morbidity?

A

≥ 50g/day for ≥10 years

This threshold is critical for understanding risk levels for developing ALD.

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9
Q

True or False: Daily drinking is less dangerous than intermittent drinking.

A

False

Daily drinking poses a greater risk for liver injury.

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10
Q

What factors determine susceptibility to Alcoholic Liver Disease?

A
  • Age
  • Sex
  • Genetics
  • Malnutrition
  • Viral hepatitis
  • Drugs
  • Obesity
  • Iron overload

These determinants influence individual risk for developing ALD.

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11
Q

What is the primary site of alcohol metabolism in the body?

A

Liver

The liver’s role is crucial for processing alcohol and its byproducts.

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12
Q

What are the mechanisms of injury in alcoholism?

A
  • Formation of acetaldehyde adducts
  • Mitochondrial injury
  • Increased liver fat
  • Immunological liver injury
  • Fibrosis

These mechanisms contribute to the pathology of ALD.

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13
Q

What is the hallmark of alcoholic hepatitis?

A

Ballooning degeneration, spotty necrosis, polymorphonuclear infiltration, and fibrosis

These pathological features are critical for diagnosing alcoholic hepatitis.

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14
Q

What are the clinical presentations of Alcoholic Liver Disease?

A
  • Fatty liver: 60-100%
  • Alcoholic hepatitis: 20-30%
  • Cirrhosis: 10-20%

The prevalence of these conditions varies among patients with ALD.

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15
Q

What is the significance of the AST/ALT ratio in diagnosing Alcoholic Liver Disease?

A

Usually > 2

This ratio is a key surrogate marker in the diagnosis of ALD.

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16
Q

What is the prognosis for clinically compensated cirrhosis with abstinence?

A

5-year survival = 90%

Abstinence significantly improves survival rates in patients with cirrhosis.

17
Q

List the main treatment options for Alcoholic Liver Disease.

A
  • Abstinence
  • Nutritional support
  • Corticosteroids
  • Pentoxifylline
  • Anti-TNF therapy
  • Liver transplantation

These treatments aim to manage ALD and improve patient outcomes.

18
Q

What role do corticosteroids play in the treatment of Alcoholic Liver Disease?

A

Ameliorate the inflammatory response

They reduce cytokine production and suppress collagen formation.

19
Q

Fill in the blank: The final common pathway in the pathogenesis of Alcoholic Liver Disease is the positive stimulation of ________ to produce myofibroblasts.

A

stellate cells

This process is crucial for the development of fibrosis in the liver.

20
Q

What is the impact of nutritional support on mortality due to alcoholic hepatitis?

A

Closely correlated with severity of protein calorie malnutrition

Addressing nutritional deficiencies can improve outcomes in ALD patients.

21
Q

The quantity of alcohol that can cause ALD in males and females are ……. respectively

A

40-80 g/day fatty liver
80-120g/day hepatitis and cirrhosis
Both in males
>20g/day will cause ALD in females

22
Q

The two systems for alcohol metabolism are

A

MEOS Microsomal ethanol oxidizing system

ADH system Alcohol dehydrogenase system

23
Q

The pathogenesis of alcoholic liver include

A

Stimulation of Collagen by acetaldehyde adducts results in fibrosis

Stimulate release of cytokines which results in inflammation
Inhibits the synthesis of s adenosyl methionine

Endotoxaemia
Common pathway stimulate stellate to release myofibroblast

Medicine (17 decks)

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