Non Alcoholic Fatty Liver Disease

Question 1

Roughly up to how many percent of adults have NAFLD?

Answer 1

• 30%

Question 2

What are the stages of NAFLD?

Answer 2

1. NAFLD
2. NASH
3. Fibrosis
4. Cirrhosis

Question 3

What is NAFLD associated with?

Answer 3

• Metabolic syndrome
  
  • obesity
  • dyslipidaemia
  • diabetes
  • HTN

Question 4

What are the RF for NAFLD?

Answer 4

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

Question 5

What Ix would you oder for NAFLD?

Answer 5

1. Enhanced Liver FIbrosis (ELF) test - first line
2. NAFLD fibrosis score - second line
3. Fibroscan - third line

Question 6

What is the Mx for NAFLD?

Answer 6

• Weight loss
• Exercise
• Stop smoking
• Control of diabetes, blood pressure and cholesterol
• Avoid alcohol

Question 7

How would you follow up for NAFLD?

Answer 7

• Monitor cx (NASH, cirhosis, DM)
• If cirrhotic, screen for HCC
• USS +/- AFP twice yearly

Question 8

When will you perform a non invasive liver screen?

Answer 8

• Where someone presents with abnormal liver function tests without a clear cause

Question 9

What does the non invasive liver screen include?

Answer 9

• USS Liver
• Hepatitis B and C serology
• Autoantibodies (autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis)
• Immunoglobulins (autoimmune hepatitis and primary biliary cirrhosis)
• Caeruloplasmin (Wilsons disease)
• Alpha 1 Anti-trypsin levels (alpha 1 anti-trypsin deficiency)
• Ferritin and Transferrin Saturation (hereditary haemochromatosis)