Hepatitis additional

Question 1

clues for different types of hepatitis

Answer 1

• acute hepatitis B infection = hepatitis B surface antigen.
• autoimmune hepatitis = serum autoantibodies.
• alcoholic cirrhosis = chronic alcohol consumption
• NAFLD - High BMI, suddent weight loss, metabolic syndrome

Question 1

which hepatitis is sudden weight loss associated with? explain.

Answer 1

Sudden weight loss is associated with acute exacerbations of non-alcoholic fatty liver disease. This is particularly relevant in the context of obese patients with metabolic syndrome undergoing bariatric surgery and sudden weight fluctuations. Weight loss triggers catabolism of peripheral adipose reserves and importation of toxic lipids to the liver which trigger steatosis, inflammation and hepatocyte cell death. This manifests with deranged serum liver enzymes and raised bilirubin.

Question 2

most likely diagnosis in an obese type 2 diabetic? which investigations?

Answer 2

non-alcoholic fatty liver disease.
- liver screen
- ultrasound
- liver biopsy

Question 3

Liver function tests for NAFLD

Answer 3

• elevated bilirubuin (mostly conjugated)
• elevated ALP
• Elevated ALT
• ellevated ast

Question 4

First line NAFLD management

Answer 4

Weight loss. Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease (NAFLD), which can lead to cirrhosis, hepatocellular carcinoma and liver failure. The mainstay of treatment for NASH is lifestyle modification, with weight loss being the most effective intervention. According to UK guidelines, reducing body weight by 7-10% can lead to significant histological improvement in NASH.

Question 5

liver ultrasound finding in NAFLD

Answer 5

increased echogenicity of the liver