non-Alcoholic Fatty Liver Disease Flashcards
what is the NAFLD spectrum?
Steatosis
Steatohepatitis
Fibrosis
Cirrhosis
define Steatosis?
fat in liver
define Steatohepatitis?
fat in liver with inflammation
what is the equivalent to NAFLD if alcohol is the cause?
alcoholic fatty liver disease
what is the equivalent to steatohepatitis if alcohol is the cause?
alcoholic hepatitis
NAFLD is basically a consequence of what?
metabolic syndrome
NAFLD is most common cause of liver disease.
true or false?
true
what type of diagnosis is NAFLD
Diagnosis of exclusion
Morphological changes between alcoholic fatty liver disease and NAFLD are identical.
true or false.
true
causes of liver cirrhosis?
-5
alcohol NAFLD Hep B & C autoimmune hepatitis Primary Biliary Cholangitis
what are the 5 components of metabolic syndrome
Obese T2DM Hyperlipidaemia HTN low HDL
Risk factors for NAFLD?
-7
Obese T2DM Hyperlipidaemia HTN low HDL Jejunoileal bypass Sudden weight loss/starvation
why does liver cirrhosis cause hypersplenism.
what will an FBC look like for hypersplenism?
- 2
portal HTN
anaemia + thrombocytopaenia
how does liver cirrhosis change Na+ levels?
and through what mechanism?
↓Na+
↑ADH
detail the pathophysiology on how metabolic syndrome causes fat in the liver?
- 2
o Metabolic syndrome –> insulin insensitivity –> glucose does not go into cells, body thinks it is starving –> ↑fatty acid production –> fat in liver
o Insulin insensitivity –> fatty acids not oxidised*
which Ix tells you how stiff the liver is?
and a stiff liver is a sign of what?
Transient elastography
More stiffness = more fibrosis
which metabolic process breaks down fatty acids?
beta oxidation
main sign of NAFLD on examination?
hepatomegaly
NAFLD is usually asymptomatic.
true or false?
true
ALP will be higher than AST.
true or false
false
name of the blood test to check liver fibrosis?
ELF (enhanced liver fibrosis)
results of a lipid panel?
-4
↓HDL
↑elevated total cholesterol
↑LDL
↑triglyceride
results of a LFT?
-3
↑↑AST
↑ALT
↑ALP
in NAFLD LFTs are always abnormal.
true or false?
false
1st line Mx?
Lifestyle changes – weight loss, diet etc
pt with NAFLD has advanced fibrosis?
how do you manage as a GP?
refer to specialist
pt with NAFLD has T2DM.
what drug do you give to control diabetes?
metformin
surgery for Portal HTN?
intrahepatic portosystemic shunt
thrombocytopaenia etymbology?
thrombo - clot
cyto - cell
paenia - poverty
