Alcoholic Liver Disease

Question 1

What are the three stages of alcohol liver disease?

Answer 1

Alcoholic fatty liver disease, alcoholic hepatitis, cirrhosis

Question 2

What are the features of alcoholic hepatitis?

Answer 2

Malaise, increased temperature/pulse/respiratory rate, anorexia, diarrhoea, vomiting, tender hepatomegaly +/- jaundice, bleeding, ascites

Question 3

What is the typical AST:ALT ratio in ALD?

Answer 3

2:1 or more

Question 4

What enzyme would you expect to be very raised?

Answer 4

GGT

Question 5

What type of anaemia would you see?

Answer 5

Macrocytic

Question 6

What would be increased in blood investigations in alcoholic hepatitis?

Answer 6

WCC, INR, AST, MCV, urea

Question 7

What would be decreased in blood investigations in alcoholic hepatitis?

Answer 7

Platelets

Question 8

What is the main management?

Answer 8

Stop alcohol

Question 9

How do you calculate units of alcohol?

Answer 9

(Strength x volume) ÷ 1,000

Question 10

What are potential complications?

Answer 10

Wernicke-Korsakoff encephalopathy, acute/chronic pancreatitis, Mallory-Weiss tear

Question 11

How does Wernicke-Korsakoff encephalopathy present?

Answer 11

Ataxia, confusion, nystagmus, memory impairment

Question 12

How would you manage Wernicke-Korsakoff encephalopathy?

Answer 12

IV thiamine

Question 13

What causes Wernicke’s encephalopathy?

Answer 13

Lack of vitamin B1 (thiamine) in the brain