Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

#Phase 2.1: GI > Alcohol Liver Disease > Flashcards

Alcohol Liver Disease Flashcards

1
Q

What is the spectrum of ALD? (3 things)

A
  1. Alcoholic Steatosis (Fatty Liver) (Reversible)
  2. Alcoholic Hepatitis (Inflamm Fatty Liver) (Can be Reversible)
  3. Cirrhosis (Irreversible)
    (Can progress from 1-3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are all disorders in ALD secondary to?

A

Chronic alcohol abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is alcohol metabolized to?

A

Acetaldehyde

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Acetaldehyde? (3 things)

A
  1. Highly reactive toxic metabolite
  2. Carcinogen
  3. Accum contributes to oxidative liver damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the pathways that metabolize alcohol? (2 things)

A
  1. Alcohol dehydrogenase

2. Cytochrome P450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which of the 2 alcohol metabolism pathways can be upregulated when there is high alcohol consumption?

A

Cytochrome P450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes Triglycerides to accum in liver in Alcoholic Steatosis (Fatty Liver)? (3 things)

A
  1. Reduced liver fatty acid oxidation –> reduced fat export
  2. Increased peripheral lipolysis –> increased input of lipids to hepatic tissue
  3. Increased Triglyceride synthesis –> increased input of lipids to hepatic tissue
    (all dis reversible tho bc dis only first stage of ALD liver clartation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathophysiology of Alcoholic Hepatitis? (3 things)

A
  1. Steatosis
  2. Inflamm
  3. Regions of liver necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens in Cirrhosis? (2 things)

A
  1. Fibrogenesis

2. Scarring of liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes Fibrogenesis + Scarring of liver in Cirrhosis? (2 things)

A
  1. Hepatic tissue inflamm

2. Degeneration + Regeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is existing liver tissue replaced by in Cirrhosis? (2 things)

A
  1. ECM

2. Collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the liver tissue replacement in Cirrhosis cause? (2 things)

A
  1. Reduced functional capacity of liver

2. Micronodules in liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the CF of Alcoholic Steatosis? (Fatty Liver)? (3 things)

A
  1. Asymptomatic
  2. Maybe vague abd discomfort
  3. Hepatomegaly @ exam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the CF of Alcoholic Hepatitis? (8 things)

A
  1. Low grade Fever
  2. Lethargy + Confusion (bc hepatic encephalopathy)
  3. Nausea
  4. Jaundice
  5. Loss of appetite
  6. RUQ discomfort
  7. Hepatomegaly
  8. Ascites
    (Head to toe)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the CF of Cirrhosis? (14 things)

A
  1. Alopecia
  2. Fatigue
  3. Lethargy + Confusion + Coma (bc hepatic encephalopathy)
  4. Jaundice
  5. Upper GI bleeding (bc portal HTN –> oesophageal varices)
  6. Asterixis (hand flap) (bc hepatic encephalopathy)
  7. Palmar erythema (red palms)
  8. Clubbed nails
  9. Dupuytren’s Contracture (flexion deformity of fingers bc thickening + shortening of palmar fascia)
  10. Pruritis (bc salt deposition in skin)
  11. Caput medusae (periumbilical vein dilation)
  12. Spider naevi
  13. Ascites (bc portal HTN + low albumin)
  14. Weight loss
  15. Hyperoestrogenism (gynecomastia / erectile dysf / infertility)
    (Head to toe)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What investigations should you do for sus ALD? (5 things)

A
  1. Bloods
  2. US
  3. Endoscopy
  4. CT / MRI
  5. Liver biopsy
17
Q

What bloods should you do in sus ALD? (4 things)

A
  1. FBC
  2. LFTs
  3. Clotting
  4. UnEs
18
Q

What will FBC show you in ALD?

A

Raised MCV (RBC size)

19
Q

What will LFTs show you in ALD? (5 things)

A
  1. Raised ALT + AST
  2. Raised gamma-GT
  3. Raised ALP (late in disease)
  4. Low albumin (bc reduced synthetic function of liver)
  5. Raised bilirubin (cirrhosis)
20
Q

What will Clotting show you in ALD?

A

Elevated prothrombin time (bc reduced synthetic function of liver)

21
Q

What may a US of liver show in ALD? (2 things)

A
  1. Fatty changes

2. Reduced elasticity (FibroScan US) (shows degree of cirrhosis)

22
Q

When should you do an Endoscopy in ALD?

A

When sus Portal HTN

23
Q

What would an Endoscopy show in ALD?

A

Oesophageal varices (if portal HTN)

24
Q

Apart from seeing Oesophageal varices in ALD, what else is an endoscopy useful for?

A

Even treating da oesophageal varices

25
Q

What can you see in a CT / MRI of liver in ALD? (5 things)

A
  1. Fatty infiltration of liver
  2. Hepatosplenomegaly
  3. Abn blood vessel changes
  4. Ascites
  5. Hepatocellular carcinoma
26
Q

What patients does NICE recommend doing a liver biopsy for in ALD?

A

Patients where steroid treatment being considered

27
Q

What is a liver biopsy used for in ALD?

A

Confirm Alcoholic Hepatitis / Cirrhosis diagnosis

28
Q

What is the management for ALD? (5 things)

A
  1. X Alcohol 6awali
  2. High vit + prot diet
  3. Steroids (for short term improvement in Alcoholic Hepatitis)
  4. Treat cirrhosis complications (portal HTN / varcies / ascites / h. encephalopathy)
  5. Liver transplant referral (severe disease)
29
Q

What need to be treated first before Steroids can be given in ALD? (2 things)

A
  1. Infection

2. GI Bleeding

30
Q

How long must patients abstain from alcohol to be referred for liver transplants?

A

3 months

31
Q

What should be given to treat alcohol withdrawal symptoms?

A

Benzodiazepines (e.g Chlordiazepoxide)

32
Q

What are the complications of ALD? (4 things)

A
  1. Hepatic encephalopathy
  2. Portal HTN
  3. Hepato-renal syndrome
  4. Hepatocellular carcinoma
33
Q

Why does Hepatic encephalopathy occur bc of ALD?

A

Bc build up of ammonia

34
Q

What are the CF of Hepatic encephalopathy? (5 things)

A
  1. Confusion / Coma
  2. Drowsiness
  3. Fetor hepaticus (strong musty breath smell)
  4. Hyperventilation
  5. Asterixis
35
Q

How should Hepatic encephalopathy be managed?

A

Lactulose

I’d like-to-lose dis encephalopathy

36
Q

When do you get Portal HTN in ALD?

A

Once Cirrhosis established

Rarely in Alcoholic Hepatitis

#Phase 2.1: GI (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions