General Liver dz & Alcoholic Liver disease Flashcards
progression & reversibility of fibrosis (2)
- progression varies– months to years
- fibrosis is reversible to a point
two ways people with cirrhosis can present
asymptomatic– incidental LFT findings
end-stage liver dz w/ decompensation– variceal hemorrhage, ascites, encephalopathy, jaundice
most are asymptomatic till they decompensate
platelet count below what value is suspicious for cirrhosis
under 100K
what are 4 complications of liver disease
jaundice
ascites
encephalopathy
variceal hemorrhage
gold standard for staging liver disease is..
liver biopsy
what grade of fibrosis is considered cirrhosis
grade 4
two ways to do liver biopsy? which is preferred if ascites is present?
percutaneous & transjugular
if ascites– transjugular
imaging to get rough glance; fatty liver; look at “big things” or monitor cirrhosis
US
imaging used to find small things
CT/MRI w/ contrast
5 ways patients can avoid synergistic injury
- avoid excess alcohol
- Hep A & B vaccines
- maintain normal BMI (to avoid metabolic dz)
- no more than 2g of acetaminophen daily
- evaluate for hemachromatosis if applicable
what is the first & second most common cause of cirrhosis in the US?
- Chronic Hep C
- Alcoholic liver disease– most don’t develop cirrhosis
what are 4 risk factors for progression of alcoholic liver dz
- WOC (woman of color)
- alcohol amount
- genetics
- concomitant injury (NASH,HCV, HBV)
how much alcohol is too much for men vs women?
men: 4/day or 14/wk
women: 3/day or 7/wk
these findings belong under what condition in the EtOH clinical spectrum
hepatomegaly
mild AST>ALT elevation
asymptomatic
Steatosis (fatty liver)
these findings belong under what condition in the EtOH clinical spectrum
hepatomegaly
marked high bilirubin & PT/INR
pain, jaundice, fever
alcoholic hepatitis
