Lecture 1.5 - Alcoholic Liver Disease

Question 1

Where does risk for Liver damage from alcohol increase a lot?

Answer 1

Women/Men ~ 1-2 drinks/day, dramatically increases with higher consumption

Question 2

Pathogenesis of Liver disease?

Answer 2

Alcohol increase intestinal permeability to toxins

causes direct oxidative stress when consume more than you can process

bunch of factors lead to Fibrosis, Necro-inflammation & apoptosis of Hepatocytes

Question 3

3 stages of liver injury

Answer 3

1. Steatosis (can reverse to normal liver)
2. Hepatitis (can reverse to normal liver)
3. Cirrhosis

Question 4

Steatosis

Answer 4

Fatty Change
Perivenular fibrosis

90-100%

Question 5

Hepatitis

Answer 5

Liver cell necrosis
inflammation
Mallory bodies
Fatty change

10-35%

Question 6

Cirrhosis

Answer 6

non-reversible

Fibrosis, Hyperplastic nodules, 8-20%

Question 7

Liver Complications

Answer 7

Ascites
Changes in drug metabolism
Coag disorders
Esophageal Varices
Hepatic encephalopathy
Hepatorenal syndorme
Spontaneous bacterial peritonitis

Question 8

Clinical presentation of alcohol liver disease?

Answer 8

don’t really have signs or symptoms

Question 9

AST/ALT ratio for Alcohol Liver Disease?

Answer 9

usually > 2

Question 10

Tests that reflect functional/synthetic capacity of the liver?

Answer 10

Albumin decreased
Factors V & VIII decreased
Prolonged PT & Inc INR

Question 11

Considering severity of Liver disease we want to consider…

Answer 11

Presence of Ascites
Elevations of Bilirubin
Dec in albumin
Inc in INR
Presence of Encephalopathy

Question 12

MELD score used to…

Answer 12

predict 90 day survival, adding ppl to transplant list

Question 13

MELD score components

Answer 13

Bilirubin
INR
Creatinine

Question 14

Treatment plan for Alcoholic Liver Disease

Answer 14

1. Reverse/Elim cause ie Alcoholism + nutrition replacement
2. Alcoholic hepatitis = give steroids
3. Prevent complications through treatment of portal hypertension
4. Managing complications when they occur