FN: Alcoholic Hepatitis

Question 1

Presentation

Answer 1

􏰀 Anorexia
􏰀 D/V
􏰀 Tender hepatomegaly
􏰀 Ascites
􏰀 Severe: Jaundice, bleeding, encephalopathy

Question 2

Ix

Answer 2

􏰀 Bloods: ↑MCV, ↑GGT, AST:ALT>2
􏰀 Ascitic tap
􏰀 Abdo US + PV duplex

Question 3

Rx

Answer 3

􏰀 Stop EtOH
􏰀 Rx withdrawal
􏰀 High dose B vitamins: Pabrinex
􏰀 Optimise nutrition
􏰀 Daily wt., LFT, U+E, INR
􏰀 Mx complications of failure

Question 4

Prognosis

Answer 4

􏰀
Maddrey score predicts mortality
􏰁 Mild: 0-5% 30d mortality
􏰁 Severe: 50% 30d mortality
􏰁 1yr after admission: 40% mortality