LIVER and fwends 2 Flashcards
What are the 7 functions of the liver?
- Oestrogen regulation2. Detoxification3. Metabolism of carbohydrates4. Albumin production5. Clotting factor production6. Bilirubin regulation7. Immunity
What is alcoholic liver disease?
Liver damage caused by excess alcohol intake
Describe the epidemiology of alcoholic liver disease
- Most common cause of chronic liver disease in the western world- Usually presents in men in 40s-50s
What are 2 causes of alcoholic liver disease?
- Excessive consumption of alcohol (main)2. Some genetic predisposition
Describe the order of alcoholic liver disease
Fatty liver (steatosis) –> alcoholic hepatitis –> cirrhosis
Describe the pathophysiology of fatty liver (steatosis)
- Metabolism of alcohol produces fat in the liver- Cells become swollen with fat with large amounts of alcohol- Fat disappears on alcohol abstinence- Alcohol directly affects stellate cells (fat-storing cells) which are transformed into collagen-producing myofibroblast cells
Describe the pathophysiology of alcoholic hepatitis
- Fatty change and infiltration by polymorphonuclear leukocytes and hepatocyte necrosis- Presence of mallory bodies and giant mitochondria
What are 4 signs of alcoholic liver disease?
- Hepatomegaly2. Ascites3. Rapid onset jaundice 4. Encephalopathy
What are the symptoms of fatty liver (alcoholic liver disease)?
Usually asymptomatic
What are 4 symptoms of alcoholic hepatitis (alcoholic liver disease)?
- Nausea and vomiting2. Diarrhoea3. Anorexia4. RUQ pain
What is a symptom of alcoholic cirrhosis (alcoholic liver disease)?
May be asymptomatic- Spider naevi (clusters of RBCs visible under skin)
What are 8 investigations for patients with alcoholic liver disease?
- LFTs2. FBC3. PTT (increased)4. Abdominal ultrasound5. Fibroscan6. Endoscopy7. CT/MRI8. Liver biopsy
Describe LFT results for patients with alcoholic liver disease
- GGT = very raised- AST:ALT = raised ratio (2:1)
Describe FBC results for patients with alcoholic liver disease
- Macrocytic anaemia (elevated MCV)- Thrombocytopenia- Hypoglycaemia
What is the recommended alcohol consumption?
- No more than 14 units per week for both men and women- No more than 5 units in a day
How do you calculate the number of units of alcohol?
Strength (ABV) x volume (ml) / 1,000
What is the treatment for alcoholic liver disease?
- Lifelong abstinence from alcohol- Corticosteroids (to control inflammation)- IV thiamine - Diet high in vitamins and proteins- Liver transplant
What are 5 complications of alcoholic liver disease?
- Liver failure2. Wernicke-Korsakoff encephalopathy3. Acute/chronic pancreatitis4. Mallory-Weiss tear5. Increased risk of cancers (particularly breast/mouth/throat)
What is non-alcoholic fatty liver disease?
Range of conditions caused by a build-up of fat in the liver
Describe the epidemiology of non-alcoholic fatty liver disease
25% of population
What are 3 risk factors for non-alcoholic fatty liver disease?
- Obesity2. Diabetes3. Hyperlipidaemia
Describe the order of non-alcoholic fatty liver disease
Healthy –> steatosis –> steatohepatitis –> fibrosis –> cirrhosis
What are 2 signs of non-alcoholic fatty liver disease?
- Hepatomegaly2. Jaundice
What are 5 symptoms of non-alcoholic fatty liver disease?
Asymptomatic1. Nausea and vomiting2. Diarrhoea3. Fatigue4. Malaise5. RUQ pain