Alcoholic Liver Disease

Question 1

What is it?

Answer 1

Response of liver to excess alcohol

Question 2

What are the stages of it?

Answer 2

Steatosis (fatty liver disease)
Steatohepatitis (same thing as alcoholic hepatitis)
Fibrosis + cirrhosis (build-up of scar tissue)

Question 3

What is the difference in histology between non-alcoholic vs alcoholic steatohepatitis?

Answer 3

The histology in NASH is similar to alcohol induced damage

Question 4

What is steatohepatitis?

Answer 4

Fatty liver with inflammation + neutrophil infiltration

Question 5

What is the presentation of someone with alcoholic liver disease?

Answer 5

Majority no physical findings until advanced liver disease
Jaundice
Muscle wasting (not a lot of nutrients + vitamins in their diet, the body needs protein from somewhere so it takes it from their muscles)

Question 6

What are some signs of chronic liver disease?

Answer 6

Spider naevi
Palmar erythema
Gynaecomastia
Loss of axillary + pubic hair
Ascites
Encephalopathy

Question 7

What are some laboratory findings?

Answer 7

AST > ALT (ratio >2)
Raised GGT
Macrocytosis
Thrombocytopenia (low platelets)

Question 8

What can be used to visualise the fatty liver

Answer 8

USS

Question 9

What history taking acronym can be used to investigate a patients alcohol usage?

Answer 9

CAGE

Question 10

What are some complications of alcohol related liver disease?

Answer 10

Cirrhosis
Hepatic encephalopathy
Spontaneous bacterial peritonitis