Non-Alcoholic fatty liver disease Flashcards

1
Q

What does Non-alcoholic fatty liver disease encompass

A

Steatosis without liver inflammation,

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2
Q

Who does NAFLD affect

A

All age groups - including children

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3
Q

How does the prevalence of NAFLD increase

A

With an increasing body weight

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4
Q

What is NASH

A

Non-alcoholic steatohepatitis

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5
Q

Most NAFLD is primary (idiopathic) true or false

A

True

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6
Q

What drugs can cause NAFLD

A

Amiodarone
Tamoxifen
synthetic oestrogens
glucocorticoids

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7
Q

What does the first “hit” of NAFLD consist of

A

Excessive triglyceride accumulation in the liver

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8
Q

Steatotic liver is then vulnerable to second hits. What do these result in

A

Inflammation and liver damage

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9
Q

Is NASH worse than alcoholic steatophepatitis

A

No. it is better - it progresses to cirrhosis less frequently and has a better long term survival

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10
Q

What are some of the risks of progression of NASH

A
Increasing age
Obesity 
Pronounced weight loss 
Diabetes mellitus 
AST/ALT ratio >1 
ALT more than 2 times the normal raised triglycerides
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11
Q

What are the symptoms of NAFLD

A

generally mild and non-specific (RUQ pain)

hepatomegaly

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12
Q

How is the diagnosis made for NAFLD

A

Incidentally - a detailed history of alcohol consumption should be obtained
Persistently elevated LFT with no alcohol history
Weight loss

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13
Q

What can differentiate simple fatty liver from NASH

A

Nothing

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14
Q

What is the hallmark of NAFLD

A

Macrovesicular steatosis in the absence of alcohol excess

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15
Q

Why should all patients have fasting sugars and lipids taken

A

Due to the association with the metabolic syndrome

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16
Q

What are the differences in ALT and AST in alcoholic liver disease and also NAFLD

A

ALT is greater than AST in NAFLD

AST is greater than ALT in ALD

17
Q

What imaging is usually used

A

Ultrasound - hyperechoic liver

Liver biopsy: diagnosis

18
Q

What has been developed as a way of predicting fibrosis

A

NAFLD Fibrosis Score

19
Q

What is the management for NAFLD

A

Lifestyle modification: short term weight loss in combination with exercise leads to improvement in liver biochemical tests
Correction of cholesterol, triglycerides and blood sugar

20
Q

When is pharmacological therapy considered

A

When there is no change in the condition after lifestyle modification