NAFLD Flashcards
1
Q
Steatosis and Steatohepatitis
A
- Steatosis is accumulation of fat
- Steatohepatitis if associated with inflammation
- Fatty liver divided into alcohol-related and non-alcoholic
- The only difference is the alcohol consumption
- NASH when there’s inflammation
2
Q
Steatosis and Steatohepatitis Pathophysiology
A
- Accumulation of fat in hepatocytes
- Result of defective fatty acid metabolism
- Complicated process
3
Q
Steatosis and Steatohepatitis Aetiology
A
- Metabolic syndrome features
- PCOS
- Alcohol excess
- Sudden weight loss
- Medication and metabolic disorders
- HB/CV
4
Q
Steatosis and Steatohepatitis Epidemiology
A
-Develops in 46-90% of heavy alcohol drinkers and 94% of obese individuals
5
Q
Steatosis and Steatohepatitis Presentation
A
- Majority are asymptomatic, presentation is often coincidental
- Persisten fatigue, malaise, RUQ pain
- Advanced disease may present as cirrhosis (jaundice, oedema, ascites)
- Hepatomegaly very common
- Splenomegaly may occur with cirrhosis
6
Q
Steatosis and Steatohepatitis Differentials
A
- Alpha-1-antitryspin deficiency
- Autoimmune hepatitis
- Coeliac disease
- Cirrhosis
7
Q
Steatosis and Steatohepatitis Ix
A
- Definitive diagnosis from biopsy and histopathology
- LFTs, lipids, FBC, viral studies, iron studies, caeruloplasmin, autoimmune disease
- USS shows bright hyper-echogenic image
8
Q
Steatosis and Steatohepatitis Management
A
- As per diagnosis
- If alcohol related; abstinence, adequate diet (abstinence can reverse)
- Treat the cause
- Weight loss
- No drugs licensed for NASH in the UK
- Diet, exercise, bariatric surgery, referral
9
Q
Steatosis and Steatohepatitis Complications
A
-Steatohepatitis can progress to cirrhosis and liver failure
10
Q
Steatosis and Steatohepatitis Prognosis
A
- Steatosis has good prognosis with abstinence and weight loss
- Steatohepatitis progression to cirrhosis is 10%
