Alcoholic liver disease

Question 1

Define

Answer 1

Chronic liver disease caused by excess of alcohol

Question 2

Presentation

Answer 2

Fatty liver-usually no symptoms
Possible hepatomegaly on examinations- enlarged
Alcoholic hep- rapid onset jaundice
Nausea
Anorexia
Fever
May be asymptomatic with complications of cirrhosis

Question 3

Most chronic liver disease in western world

Answer 3

Alcoholic liver disease

Question 4

Cause

Answer 4

Excessive consumption of alcohol
Exact mechanism unknown
Beyond identifying alcohol as a hepatoxin
Some genetic deposition

Question 5

Investigation

Answer 5

Liver bio Chem- AST ALT rise

Bloods - elevated MCV

Question 6

Treatement

Answer 6

Lifelong abstinence of alcohol

Corticosteroids to control inflammation if no renal failure

Question 7

Complications

Answer 7

Liver failure if untreated

Question 8

Pathology

Answer 8

Fatty liver: biopsy finding
Hepatocytes contain macrovesicular droplets of triglycerides
Fat disappears on cessation of alcohol intake
But otherwise progresses
To cirrhosis and fibrosis
As result of mitochondrial damage
Alcoholic hep: ballooned hepatocytes
Contain eosinophilia material
Call Mallory bodies
Surrounded by neutrophils
Fibrosis and foamy degeneration of hepatocytes
Usually coexists with cirrhosis
Final stage of alcholic liver disease is:
Distraction of liver architecture and fibrosis
Regenerating nodules
Bring micro nodular cirrhosis
Mallory bodies also present