Non Alcoholic Fatty Liver Disease

Question 1

What is NAFLD

Answer 1

Chronic liver disease not caused by Alcohol

Question 2

What are the RF for NAFLD

Answer 2

Obesity
HTN
Hyperlipidemia 
T2DM
NSAIDs and Amiadarone

Question 3

What does the typical patient of NAFLD present with

Answer 3

Obese/T2DM w/ deranged LFT

Asymptomatic

Question 4

What is the pathology of NAFLD

Answer 4

Hepatosteatosis = Non Alcoholic Steatohepatitis = Fibrosis = Cirrhosis
(NAFLD -> NASH -> Fibrosis = Cirrhosis)

Question 5

How is NAFLD investigated

Answer 5

Bloods = Deranged LFT
= FBC (Thrombocytopenia and hyperglycaemia)
Imaging = Abdo USS
Exclude other causes (Hep, Wilson, A1ATD)

Question 6

What is the gold standard investigation for NAFLD

Answer 6

Abdo USS

-High sensitivity for steatosis

Question 7

What do the LFT look like for NAFLD

Answer 7

Raised = PT/INR and Bilirubin
Low = Albumin

Question 8

How is Risk of fibrosis in NAFLD assessed

Answer 8

FIB-4
(Non invasive)
>2.67 = referral

Question 9

How is NAFLD treated

Answer 9

Lose weight
RF Control
Vitamin E (Improve steatitic/ fibrotic liver)

Question 10

What are the complications of NAFLD

Answer 10

Ascites -> Portal HTN -> Oes.Varices
HE
HCC