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GI > Fatty Liver Disease > Flashcards

Fatty Liver Disease Flashcards

1
Q

How does alcohol lead to fatty liver?

A
  • Increase in NADH leads to inc in FA synthesis and a dec in fatty acid oxidation
  • This leads to FA accumulation in hepatic cytoplasm
  • Then esterification
  • Stored as TGs
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2
Q

How does alcohol cause liver damage?

A
  • ETOH metabolism creates ROS that attack lipids (lipid peroxidation)
  • Kupffer cells are activated leading to cytokine/oxidant production
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3
Q

How does alcohol cause fibrosis

A

Compounds produced from ETOH metabolism activate stellate cells to lay down collagen in the liver

(necroinflammatory and fibrotic changes which can lead to alcoholic hepatitis or cirrhosis)

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4
Q

What compounds can activate stellate cells?

A
  • acetaldehyde
  • ROS
  • products of lipid peroxidation
  • TGF-beta (kupffer cells)
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5
Q

Symptoms of fatty liver

A
  • Non/mild (fatigue, anorexia, abd discomfort etc)

- Tender hepatomegaly on exam

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6
Q

Fatty liver labs

A

Inc liver enzymes

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7
Q

Best treatment for fatty liver?

A

Decrease alcohol or wt dep on cause

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8
Q

What is alcoholic hepatitis

A

After years of heavy drinking get constitutional symptoms. If severe get ascites, HE and vacices

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9
Q

How long does it take for fatty liver to happen?

A

days-wks of drinking chronically

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10
Q

What liver lab is more elevated with alcohol abuse?

A

AST (mitochondria due to ROS)

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11
Q

What is a mallory body?

A

Seen in alcoholic hepatitis, intermediate keratin filament proteins

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12
Q

What cures cirrhosis

A

transplant only

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13
Q

List 3 alcoholic liver diseases

A
  1. Fatty Liver 2. Alcoholic Hepatitis 3. Alcoholic Cirrhosis
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14
Q

What is NAFLD?

A

Non alcoholic fatty liver disease

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15
Q

What are the 3 entities of NAFLD?

A
  1. NASH
  2. Steatosis
  3. Cirrhosis
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16
Q

What are the risk factors for NAFLD?

A
  • obesity
  • hyperglycemia
  • T2D
  • HyperTG
  • associated with metabolic syndrome and insulin resistance
17
Q

What 2 things contribute to pathogenesis of NAFLD?

A

Insulin resistance and oxidative stress on hepatocytes leads to NAFLD

18
Q

How does insulin resistance lead to accumulation of fat in hepatocytes?

A
  1. Increased lipolysis (FA floating around)–>ROS–>lipid peroxidation
  2. Hyperinsulinemia (inc glycolysis and synthesis of FFAs, dec hepatic production of Apo B which allows export of TGs in VLDL)
19
Q

Ratio of AST/ALT in NASH

A

AST 3x ALT

metabolic damage

20
Q

Who gets NASH more? M or F

A

F

21
Q

Potential drug to treat NASH

A

Pioglitazone (TZD)

22
Q

NAFLD is associated with…

A

insulin resistance and metabolic syndrome

23
Q

What is the number 1 cause of crytogenic cirrhosis?

A

NASH

GI (12 decks)

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