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Flashcards in Alcoholic liver disease Deck (19):
1

What is alcoholic liver disease?

An umbrella term for disorders of the liver that are caused by drinking too much alcohol

2

What diseases come under the term 'alcoholic liver disease'?

Fatty liver disease
Alcoholic hepatitis
Chronic hepatitis
Cirrhosis

3

What are the risk factors for developing alcoholic liver disease?

Drinking a lot of alcohol

Drinking alcohol outside meal times

Being female: women are twice as susceptible

Hepatitis C: accelerates progress of liver injury

Genetic factors: some people are more susceptible than others

Diet: malnutrition, lack of vitamin A + E can mean hepatocytes are less able to regenerate

4

How long does it take for fatty liver disease to start developing?

Fatty liver can begin to develop even after a few weeks of heavy drinking

5

Is the damage caused by fatty liver reversible?

Yes, if you stopped drinking

Otherwise it will progress to fibrosis and cirrhosis

6

What is steatosis?

Another name for fatty liver disease

The accumulation of fatty acids in the liver cells

7

What is fatty liver disease?

When fatty acids accumulate in the liver cells

8

What is the histological appearance of fatty liver disease?

Globules of triglycerides in the hepatocyte cytoplasms

9

Pathogenesis of fatty liver disease?

Ethanol --> acetaldehyde

Aldehyde is then involved in a chain reaction resulting in the increased production of fatty acids

They bind to glycerol forming trigylcerides

They accumulate in the cells

10

What is alcoholic hepatitis?

Inflammation of the hepatocytes caused by alcohol

11

What is the histological appearance of alcoholic hepatitis

Steatosis

Swollen, foamy hepatocytes
Mallory bodies
Neutrophils
Fibrosis

12

What are Mallory bodies?

Amorphous eosinophilic material

13

Which cytokines are involved in alcoholic hepatitis?

Pro-inflammatory
TNF-a
IL6
IL8

14

What clinical features are seen in alcoholic hepatitis?

Rapid onset jaundice
Nausea
Right upper quadrant pain
Fever
Ascites
Encephalopathy

15

Management of alcoholic hepatitis?

Supportive treatment

Nutritional management

Stop drinking alcohol

Corticosteroids reduce inflammation

Prevention of worsening

16

What is the final stage of liver disease from alcohol abuse?

Cirrhosis

17

What happens to the liver in cirrhosis?

Destruction of liver architecture
Scarring
Nodules of regenerating hepatocytes

18

Management of cirrhosis?

Abstinence from alcohol and other toxins
Don't give liver toxic drugs, like methotrexate
Transplant

19

What two structures make triglycerides?

Fatty acids + glycerol