Non-Alcoholic Fatty Liver Disease

Question 1

stages of NAFLD

Answer 1

steatosis
steatohepatitis
fibrosis
cirrhosis

Question 2

what can cause NAFLD

Answer 2

often due to metabolic syndromes:
obesity
HTN
diabetes
hyperlipidaemia

Question 3

what is the brief pathophysiology of NAFLD

Answer 3

insulin resistance plays a key role: liver will increase fat storage and decrease fatty acid oxidation
decreased lipoprotein secretion and increased uptake from blood

fat can become degraded by free radicals and lead to inflammation

over time this inflammation leads to fibrosis

Question 4

what might the LFTs show in NAFLD

Answer 4

ALT has the most significant rise
AST may rise but less so than in ARFLD

Question 5

presentation of NAFLD

Answer 5

may be asymptomatic / vague fatigue until fibrosis occurs
leads to:
- hepatomegaly
- jaundice
- RUQ pain
- Ascites

Question 6

diagnosis of NAFLD

Answer 6

USS, CT, MRI to look for fatty infiltrates
biopsy to confirm

Question 7

management of NAFLD

Answer 7

early disease is reversible by correcting the underlying cause
reversible fators: diet, activity, BM controlling medications