Robbins 9th ed - Chapter 18 - Alcoholic liver disease (1)

Question 1

What are the three (overlapping) forms of alcoholic liver disease? Which ones are reversible, and which ones irreversible?

Answer 1

Hepatic steatosis (fatty liver)
Alcoholic hepatitis
Alcoholic cirrhosis - the only one that is irreversible. The others are reversible with abstinence and adequate nutrition.

Question 2

What proportion of alcoholics develop cirrhosis?

Answer 2

10-15%

Question 3

What is a Mallory body?

Answer 3

Intracellular eosiniophilic aggregates of intermediate filaments. Mallory bodies are found in Alcoholic hepatitis.

Question 4

What are some features of alcoholic hepatitis?

Answer 4

Hepatocyte necrosis
Ballooning degeneration
Mallory bodies
Neutrophilic reaction
Mononuclear inflammation
Fibrosis.

Question 5

Name some epidemiological factors that predispose to developing more severe alcoholic liver disease.

Answer 5

Female
African-American
Genetic factors (e.g. aldehyde dehydrogenase deficiency)
Co-morbid disease (e.g. iron overload, viral hepatitis)

Question 6

What are some ultimate causes of death in patients with alcoholic liver disease?

Answer 6

Hepatic coma
Massive GIT haemorrhage
Intercurrent infection
Hepatorenal syndrome
Hepatocellular carcinoma