alcoholic liver disease

Question 1

where is ethanol metabolised

Answer 1

liver

Question 2

where is TNF-alpha released from

Answer 2

kupffer cells

Question 3

what does TNF-alpha cause

Answer 3

release of reactive oxygen species leading to tissue injury and fibrosis

Question 4

how is acetaldehyde formed

Answer 4

by oxidation of ethanol

Question 5

what released from neutrophils is a feature of alcoholic hepatitis

Answer 5

IL-8

Question 6

what can alcohol cause in liver (3)

Answer 6

• fatty change
• hepatitis
• cirrhosis

Question 7

what does metabolism of alcohol cause in the liver

Answer 7

fat in liver (in zone 3)

Question 8

what can collagen laid down around central hepatic veins cause

Answer 8

cirrhosis

Question 9

what cells does alcohol directly affect

Answer 9

stellate

transforming them into collagen producing myofibroblast

Question 10

what are Mallory bodies suggestive of

Answer 10

alcoholic damage

but also seen in:

• Wilsons
• PBC

Question 11

fatty liver symptoms

Answer 11

• asymptomatic
• nausea
• vomiting
• diarrhoea

Question 12

alcoholic hepatitis symptoms

Answer 12

• jaundice
• ascites
• abdominal pain
• fever
• hepatomegaly
• splenomegaly
• ankle oedema

Question 13

alcoholic cirrhosis diagnosed by

Answer 13

liver biopsy

Question 14

investigations for fatty liver

Answer 14

ultrasound and CT demonstrates fatty infiltration

Question 15

what can be used to estimate the degree of fibrosis

Answer 15

elastography

Question 16

general management

Answer 16

• stop drinking
• bed rest
• high protein diet

Question 17

if they have delirium as a withdrawal symptom what do you treat it with

Answer 17

diazepam

Question 18

is fatty liver reversible

Answer 18

yes

Question 19

what’s given for alcoholic hepatitis

Answer 19

steroid therapy