ALCOHOLIC LIVER DISEASE Flashcards
1
Q
Definition
A
- All should stop alcohol, be given IV thiamine to prevent Wernicke Korsakoff encephalopathy, advised with bed rest, and increase protein and vitamin intake
2
Q
Fatty Liver- Pathology (4)
A
- Metabolism of alcohol - fat deposition (mainly zone 3)
- Dose related
- No liver cell damage
- Perivenular fibrosis - cirrhosis
3
Q
Fatty Liver- Clinical features (3)
A
- Often asymptomatic
- Vague abdominal pain, N/V
- Hepatomegaly
4
Q
Fatty Liver- Investigations (6)
A
- High MCV —> heavy drinker
- Mild increase of both aminotransferases
- GGT —> high with alcohol consumption
- Biopsy, US, CT —> fatty infiltration
- Elastography
- Severe fatty infiltration - all liver biochemical parameters are largely increased
5
Q
Fatty Liver- Management
A
Stop alcohol
6
Q
Alcoholic Hepatitis - Pathology (3)
A
- Infiltration by PMN and centrilobular hepatocyte necrosis (zone3)
- Mallory bodies in hepatocytes and giant mitochondria
- Progress to cirrhosis
7
Q
Alcoholic Hepatitis - Clinical features (2)
A
- Range from being well with few symptoms, to mild/deep jaundice and chronic liver disease signs: ascites, HSM, ankle edema
- Abdominal pain and high fever
8
Q
Alcoholic Hepatitis - Investigations (4)
A
- Leukocytosis
- High AST, ALT, bilirubin, PT, ALP
- AST:ALT ratio > 2
- Low albumin
9
Q
Alcoholic Hepatitis - Managment
A
Admission with enteral nutrition and vitamin intake
10
Q
Alcoholic Cirrhosis - Pathology
A
Micronodular (small regenerative nodules) type/mixed with fatty changes
11
Q
Alcoholic Cirrhosis - Clinical features
A
Range from well with few symptoms to presenting with cirrhosis complications
12
Q
Alcoholic Cirrhosis - Management (5)
A
- Treat complications
- Salt restriction (<=2g/day)
- 6 monthly US for HCC
- Hepatitis A and B vaccinations
- Avoid NSAIDs/Aspirin (as they can cause GI bleeding and renal impairment)
