Alcoholic Liver Disease Flashcards
What percentage of the global burden of diseases is attributed to alcohol according to the WHO?
4%
This statistic highlights the significant impact of alcohol on public health.
What is the leading cause of liver cirrhosis in developed countries?
Alcoholic Liver Disease (ALD)
ALD is recognized as the primary cause of cirrhosis in the Western world.
What are the components of the clinical spectrum of Alcoholic Liver Disease?
- Fatty liver
- Alcoholic hepatitis
- Alcoholic cirrhosis
These conditions represent the progression of liver damage due to alcohol.
How does alcohol consumption in developed countries compare to developing countries?
Declining in developed countries; increasing in developing countries
This shift has implications for liver disease prevalence globally.
What synergistic effect does alcohol have on liver disease?
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.
What percentage of liver-related deaths in the US are attributed to alcohol?
> 50%
This statistic indicates the serious role of alcohol in liver disease mortality.
What is the estimated annual cost of Alcoholic Liver Disease in the US?
$3 billion
This figure reflects the economic burden of ALD on the healthcare system.
What is the minimum quantity and duration of alcohol consumption that is significant for morbidity?
≥ 50g/day for ≥10 years
This threshold is critical for understanding risk levels for developing ALD.
True or False: Daily drinking is less dangerous than intermittent drinking.
False
Daily drinking poses a greater risk for liver injury.
What factors determine susceptibility to Alcoholic Liver Disease?
- Age
- Sex
- Genetics
- Malnutrition
- Viral hepatitis
- Drugs
- Obesity
- Iron overload
These determinants influence individual risk for developing ALD.
What is the primary site of alcohol metabolism in the body?
Liver
The liver’s role is crucial for processing alcohol and its byproducts.
What are the mechanisms of injury in alcoholism?
- Formation of acetaldehyde adducts
- Mitochondrial injury
- Increased liver fat
- Immunological liver injury
- Fibrosis
These mechanisms contribute to the pathology of ALD.
What is the hallmark of alcoholic hepatitis?
Ballooning degeneration, spotty necrosis, polymorphonuclear infiltration, and fibrosis
These pathological features are critical for diagnosing alcoholic hepatitis.
What are the clinical presentations of Alcoholic Liver Disease?
- Fatty liver: 60-100%
- Alcoholic hepatitis: 20-30%
- Cirrhosis: 10-20%
The prevalence of these conditions varies among patients with ALD.
What is the significance of the AST/ALT ratio in diagnosing Alcoholic Liver Disease?
Usually > 2
This ratio is a key surrogate marker in the diagnosis of ALD.
What is the prognosis for clinically compensated cirrhosis with abstinence?
5-year survival = 90%
Abstinence significantly improves survival rates in patients with cirrhosis.
List the main treatment options for Alcoholic Liver Disease.
- Abstinence
- Nutritional support
- Corticosteroids
- Pentoxifylline
- Anti-TNF therapy
- Liver transplantation
These treatments aim to manage ALD and improve patient outcomes.
What role do corticosteroids play in the treatment of Alcoholic Liver Disease?
Ameliorate the inflammatory response
They reduce cytokine production and suppress collagen formation.
Fill in the blank: The final common pathway in the pathogenesis of Alcoholic Liver Disease is the positive stimulation of ________ to produce myofibroblasts.
stellate cells
This process is crucial for the development of fibrosis in the liver.
What is the impact of nutritional support on mortality due to alcoholic hepatitis?
Closely correlated with severity of protein calorie malnutrition
Addressing nutritional deficiencies can improve outcomes in ALD patients.
The quantity of alcohol that can cause ALD in males and females are ……. respectively
40-80 g/day fatty liver
80-120g/day hepatitis and cirrhosis
Both in males
>20g/day will cause ALD in females
The two systems for alcohol metabolism are
MEOS Microsomal ethanol oxidizing system
ADH system Alcohol dehydrogenase system
The pathogenesis of alcoholic liver include
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
