Alcoholic liver disease

Question 1

Epidemiology

Answer 1

more commonly in men

usually in 4th and 5th decades

Question 2

what does alcohol act as?

Answer 2

a hepatotoxin

Question 3

3 major pathological lesions + clinical illnesses associated with excessive alcohol intake

Answer 3

1. fatty change
2. alcoholic hepatits
3. alcoholic cirrhosis

Question 4

fatty liver (steatosis)

Answer 4

hepatocytes contain macro vesicular droplets of triglycerides

Question 5

what does an elevated mean corpuscular volume often indicate?

Answer 5

heavy drinking!!!

Question 6

histology of alcoholic hepatitis

Answer 6

steatosis

ballooned hepatocytes, containing **mallory bodies, surrounded by neutrophils

Question 7

clinical features of alcoholic hepatitis

Answer 7

rapid onset of jaundice

nausea, anorexia, RUQ pain, encephalopathy, fevers

Question 8

Ix alcoholic hepatitis

Answer 8

FBC: leucocytosis, elevated MCV and often thrombocytopenia

Hyponatraemia

Liver: elevated AST and ALT.
serum albumin is low and prothrombin time prolonged

Question 9

Mx alcoholic hepatitis

Answer 9

supportive Tx, NG tube?

corticosteroids

Question 10

What is alcoholic cirrhosis?

Answer 10

final stage of liver disease from alcohol abuse

destruction of liver architecture + fibrosis, regenerating nodules

Question 11

Mx alcoholic cirrohsis

Answer 11

directed at the complications of cirrhosis

patients are advised to stop drinking for life