Alcoholic liver disease Flashcards
3 steps in pathology
1 alcohol related fatty liver (if drinking stops, this process reverses in ~2 weeks)
- alcoholic hepatitis (drinking alc over long period or binge drinking causes inflammation in the liver sites). mild hepatitis is reversible with permanent abstinence
- cirrhosis. irreversible but stoppign drinking can prevent further damage
5 complications of alcohol
alcoholic liver disease alcohol dependnce and withdrawal wernicke korsakoff syndrome pancreatitis alcoholic cardiomyopathy
sx alc liver disease (or any liver disease)
jaundice hepatomegaly spider naevi palmar erythema gynaecomastia bruising (due to abnormal clotting) ascites caput medusae flapping tremor
what would FBC show
raised MCV
what do LFTs show
elevated ALT and AST
ALT > AST is seen in chronic liver disease
AST > ALT is seen in cirrhosis and acute alcoholic hepatitis
v high gamma GT
what may happen to clotting tests
elevated PT time
why may U+Es be deranged
hepatorenal syndrome = impaired kidney function in pt with advanced liver disease. no identifiable cause of kidney dysfunction and kidneys themselves are not structurally damaged
what is seem on US
increased echogenicity (fatty changes) can also show cirrhosis
what is a fibroscan
type of USS. can be used to check elasticity of the liver and help assess degree of cirrhosis
why may endoscopy done
assess for and treat oesophageal varices if portal hypertension suspected
why may CT be done
HCC
heaptosplenomegaly
abnormal blood vfessel changes
ascites
treatment of alc liver disease
STOP DRINKING (may need detox. will need vitamins, especially thiamine)
treat complications
refer for liver transplant if severe but must abstain from alc for 3 months prior to referral
