58. Alcoholic liver disease Flashcards Preview

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Flashcards in 58. Alcoholic liver disease Deck (14):
1

Alcohol related liver diseases ?

1. hepatic steatosis
2. alcoholic hepatitis
3. alcoholic cirrhosis

2

hepatic steatosis ?

macrovesicular fatty change, heavy greasy liver, that may be reversible with alcohol cessation

3

alcoholic hepatitis is due to

sustained, long - term consumption

4

alcoholic hepatitis - histology

1. Swollen and necrotic hepatocytes with neutrophilic infiltration
2. Mallory bodies

5

Mallory bodiesosis - appearance

intracytoplasmic eosinophilic inclusions of damaged keratin filaments

Mallory bodies are highly eosinophilic and thus appear pink on H&E stain. The bodies themselves are made up of intermediate keratin filament proteins that have been UBIQUINATED, or bound by other proteins such as heat shock proteins, or p62.

6

final alcohol related liver disease and irreversible

alcoholic cirrhosis

7

alcoholic cirrhosis - appearance

- Micronodular irregularly shrunken liver with " hobnail : appearance
sclerosis around central vein ( zone III)

8

alcoholic cirrhosis - manifestation

manifestations of chronic liver disease ( hypoalbuninemia , jsundice etc)

9

alcoholic cirrhosis occurs in...% of alcoholics

10-20%

10

• What potentially reversible liver pathology can be seen with moderate alcohol intake?

Macrovesicular fatty changes of the liver (hepatic steatosis)

11

• A patient with chronic alcoholism develops hepatitis. What microscopic changes do you expect to see on liver biopsy?

Swollen and necrotic hepatocytes with neutrophilic infiltration and Mallory bodies (he likely has alcoholic hepatitis)

12

• You test the AST and ALT levels of a long-term alcoholic with sustained alcohol consumption. What do you expect them to be?

AST > ALT (the ratio is usually >1.5) (make a toast with alcohol)

13

• A 48-y/o woman with chronic alcoholism crashes her car and lacerates her liver. She goes to the OR. How do you expect her liver to appear?

She will likely have a micronodular, irregularly shrunken liver (also called hobnail appearance) (this is alcoholic cirrhosis)

14

• An alcoholic patient has jaundice, a "hobnail" liver, and hypoalbuminemia. If the patient quits drinking, will these symptoms go away?

No, as this describes a micronodular, shrunken liver appearance indicating alcoholic cirrhosis, which is irreversible

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