Alcoholic Liver Disease

Question 1

Where is alcohol primarily metabolised?

Answer 1

In the liver by alcohol dehydrogenase

Question 2

What does the microsomal ethanol-oxidizing system composed of?

Answer 2

Smooth ER, mixed-function oxidase -> minor metabolic pathway for alcohol

Question 3

What are the three major morphologic and clincal entities of alcoholic liver disease?

Answer 3

Fatty liver, acute alcoholic hepatitis, cirrhosis

Question 4

Accumulation of fat in hepatocytes?

Answer 4

Steatosis

Question 5

How does alcohol result in fatty liver?

Answer 5

1. Increase fatty acid synthesis
2. Decrease mitochondrial oxidation of fatty acids
3. Increase production of TGs
4. Impair release of lipoproteins

Question 6

Characteristics of alcoholic hepatitis?

Answer 6

1. Necrosis of hepatocytes, predominantly in the central zone
2. Cytoplasmic hyaline inclusions w/i hepatocytes (Mallory bodies)
3. A neutrophilic inflammatory infiltrate in the lobule
4. Perivenular fibrosis

Question 7

Alcoholic hyaline found in alcoholic hepatitis?

Answer 7

Mallory bodies

Question 8

Morphological changes that always occur in alcoholic hepatitis?

Answer 8

Collagen deposition, especially around the central veins

Question 9

AST:ALT ratio in alcoholic hepatitis?

Answer 9

2:1