Alcoholic Liver Dz Flashcards
What is normal bilirubin level? Conjugated?
Normal - 0.3-1.9
Conjugated 0-0.3
What causes the majority of chronic liver dz? second most amt?
hep c then alcohol
What are general characteristics of alcoholic liver dz?
steatosis, alcoholic hepatitis and alcoholic cirrhosis
what does alcoholic cirrhosis predispose someone to?
HCC and cholangiocarcinoma
What is the amt of alcohol and the length of time to lead to alc liv dz?
greater than 40-80 gm/day and more than 5 yrs duration
What is the amt required to cause a woman to develop ald?
3 drinks/day
what is the characteristic presentation of alcoholic hepatitis?
40-60 yo greater than 80 mg/day for five years rapid onset of jaundice, fever muscle wasting, ascited heaptomegally with tenderness ast and alt rarely over 300 ast>2xalt
T or F with Alcoholic hepatitis
- leukocytosis
- decreased inr
- elevated leukocytosis
- elevated iNR
what is the functional polymorphism assocaited with increased susceptibility to ald in east asians?
adh21
in caucasian, what is the only known polymorphism associated with ald?
tnfa-238
what results in endotoxemia mechanistically?
ethanol and acetyladehyde cause intestinal injury and increased permeability
What cell is responsible for releasing cytokines and chemokines upon increased endotoxin levels?
kuppfer cells
What is the two hit theory associated with ald?
1st - fatty liver (oxidative stress, increased nadh/nad ratio obesity and dm,
2nd - inflammation and necrosis, oxid stress/hypoxia/immunological rxns
What is commonly also seen in people with advanced liver dz in alcoholics?
hep c
then hemachromatosis or alpha one antitrypsin def
Does hep c or alcohol cause more cirrhosis?
hep c