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Gastroenterology > Non Alcoholic Fatty Liver Disease > Flashcards

Non Alcoholic Fatty Liver Disease Flashcards

1
Q

What is NAFLD?

A

Non-alcoholic fatty liver disease (NAFLD) is characterised by excessive fat in the liver cells, specifically triglycerides. These fat deposits interfere with the functioning of the liver cells.

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2
Q

What can NAFLD progress to? (2)

A

Hepatitis
Cirrhosis

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3
Q

What are the 4 stages of progression of NAFLD?

A
  1. Non-alcoholic fatty liver disease
    1. Non-alcoholic steatohepatitis (NASH)
    2. Fibrosis
    3. Cirrhosis
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4
Q

What are the risk factors of NAFLD? (7)

A

• Middle age onwards
• Obesity
• Poor diet and low activity levels
• Type 2 diabetes
• High cholesterol
• High blood pressure
• Smoking

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5
Q

What is metabolic syndrome?

A

Combination of hypertension, obesity and diabetes

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6
Q

What does metabolic syndrome increase your risk of? (2)

A

CVD
NAFLD
Loads of other health problems

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7
Q

What LFTs indicate NAFLD?

A

Raised ALT

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8
Q

What investigation can confirm a diagnosis of hepatic steatosis?

A

Liver ultrasound
Shoes increased echogenicity

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9
Q

What is the first line investigation for assessing fibrosis in non-alcoholic fatty liver disease?

A

Enhanced liver fibrosis (ELF) blood test

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10
Q

What indicates advanced fibrosis in the ELF blood test?

A

10.51 or above

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11
Q

What 3 markers are measured in the ELF blood test?

A

HA
PIIINP
TIMP-1

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12
Q

What is the NAFLD fibrosis score?

A

A second line option for assessing liver fibrosis in NAFLD

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13
Q

What is the fibrosis 4 score?

A

A second line option for assessing liver fibrosis in NAFLD

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14
Q

The ELF blood test indicates advanced fibrosis in a patient with NAFLD. What investigation is done next?

A

Transient elastography (fibroscan)
Determines the degree of fibrosis

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15
Q

What does a AST:ALT ratio between 0.8-1.5 mean?

A

Suggests advanced fibrosis in NAFLD

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16
Q

What is the gold standard test for diagnosing NAFLD?

A

Liver biopsy

17
Q

What is the management of NAFLD? (8)

A

• Weight loss
• Healthy diet (Mediterranean diet is recommended)
• Exercise
• Avoid/limit alcohol intake
• Stop smoking
• Control of diabetes, blood pressure and cholesterol
• Refer patients where scoring tests indicate liver fibrosis to a liver specialist
• Specialist management may include vitamin E, pioglitazone, bariatric surgery andliver transplantation

Gastroenterology (31 decks)

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