Alcoholic Liver Disease Flashcards
Learn it all!
1
Q
How is Alcoholic liver disease classified morphologically
A
- Fatty change
- Alcoholic hepatitis
- Alcoholic Cirrhosis
2
Q
What are the risk factors for ALD?
A
- Drinking pattern
- Women more susceptible
- Genetic
- Nutrition
- Coexistence of viral infections
3
Q
Presentation of ALD?
A
Non specific symptoms:
- Anorexia
- Morning nausea
- Dry retching
- Diarrhoea
- Vague upper right quadrant pain
4
Q
What investigations are needed for ALD?
A
- FBC: may reveal macrocytosis
- Raised ¥GT: alcohol abuse
- ALT: hepatocellular damage
- AST:ALT ratio>2 suggests alcoholic damage
- Elevated serum IgA
- Blood alcohol
5
Q
What is the management of ALD?
A
- Encourage reduction/ abstinence
2. Anticipate the development if withdrawal
6
Q
How is alcoholic hepatitis treated?
A
- Treat ascites and encephalopathy
- Corticisteroids used
- NICE suggest Maddrey’ discriminant function
- DF of 32: liver biopsy/ offer cortcosteroids
- If hepatorenal syn: Antibiotics/terlipressin
- K, Zn & Mg given
- Vits B complex, C & K
7
Q
What is the management of alcohol dependence?
A
- Pharmacological treatment
- Psychological and social support
- Pharmacological prevention of relapse
8
Q
What drugs are used in fixed dose or symptom triggered medication programmes?
A
- Benzodiazepine
- Chlordiazepoxide
- Diazepam
9
Q
What Pharmacological measures help to prevent relapse?
A
After successful withdrawal offer:
- Acamprosate
- Oral naltrexone
- Behavioural couples therapy
- Use disulfiram if Acamprosate/naltrexone not suitable
10
Q
How are alcohol units measured?
A
Number of units = mm of drink × ABV(%)/1000
