Alcohol Related Disease Flashcards
(50 cards)
Effects of alcohol on the liver
Encephalopathy
Spontaneous bacterial peritonitis
Alcoholic hepatitis
Which gender metabolises alcohol slower?
Women
If you have cirrhosis or liver disease, what does this mean when you consume alcohol?
You dont cope with acute alcohol
What is the toxic carcinogen of alcohol?
Acetaldehyde
Pathology of alcohol on the liver
Steatosis
Steatohepatitis
Definition of steatosis
Fatty Liver
Pathology of steatosis
Interruption to lipid metabolism and so fat deposited in the liver
Definition of steatohepatitis
Fatty liver with inflammation
Pathology of steatohepatitis
Neutrophil infiltration
Neutrophils cause cell damage and death
Fibrosis and cirrhosis
What questionnaires can be done in respect to alcohol?
CAGE
FAST/AUDIT
What are the 4 dependency questions of CAGE?
Have you ever felt the need to cut down?
Have you ever been annoyed by the critism of your drinking?
Have you ever felt guilty about your drinking?
Do you need an eye opener?
What does FAST/AUDIT identify?
Those at risk of dependent drinking
What are the questions of FAST?
How often have you had 6 female or 8 male or more unit in a single occasion in the last year?
How often in the last year have you failed to do what was normally expected from you because of your drinking?
How often during the last year have you been unable to remember what happened the night before because you had been drinking?
Has a relative or friend, doctor or other health worked been concerned about your drinking or suggested that you cut down?
Scoring of FAST
0, 1 or 2 on first question continue to the next questions
3 or 4 on 1st question - stop here
Overall score of 3 = FAST POSITIVE
Complete remaining audit questions
What are the AUDIT questions?
How often do you have a drink containing alcohol?
How many units of alcohol do you drink on a typical day when you are drinking?
How often during the last year have you found out you were not able to stop drinking once you had started?
How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session?
How often during the last year have you had a feeling of guilt or remorse after drinking?
Have you or somebody been injured as a result of your drinking?
Scores of AUDIT
0 - 7 = lower risk
8 - 15 = increasing risk
16 - 19 = higher risk
20 + possible dependence
Physical findings of alcoholic liver disease
Majority no findings until advanced liver disease Signs of chronic liver disease - spider naevi - palmar erythema - gynaecomastia - loss of axillary and pubic hair - ascites - encephalopathy Jaundice Muscle wasting
What lab results can be indicative of alcohol use?
AAT > ALT
Raised GGT
Macrocytosis
Thrombocytopenia
Once you are cirrhotic, are you are at risk of what?
Liver failure
If ammonia cannot be processed properly due to a damaged liver, what is the concern as it can cross what?
The blood brain barrier
Grading of hepatic encephalopathy
1 - 4
Grade 1 = mild confusion
Grade 4 = coma
Causes of hepatic encephalopathy
Infection Drugs Constipation GI bleed Electrolyte disturbance
How can constipation cause hepatic encephalopathy?
Urea usually passed out but if constipated then you can reabsorb the ammonia which the liver cannot deal with
What needs to be excluded when have suspected hepatic encephalopathy?
Infection
Hypoglycaemia
Intra-cranial bleeding e.g. due to falling over
