Liver and Alcohol

Question 1

Types of liver disease from alcohol

Answer 1

• Fatty liver
• Alcoholic hepatitis
• Cirrhosis

Question 2

Actions of ingested toxins

Answer 2

• Act directly
• metabolised to toxic metabolic by-products
• free radicals

Question 3

Effects of prolonged use of alcohol

Answer 3

• changes in mitochondrial/microsomal functions

- up-regulates expression of metabolising enzymes

Question 4

Overall metabolism of alcohol

Answer 4

• Absorbed directly via GIT
• metabolised (gastric mucosa/liver)
• excreted unchanged (5-10%) (urine, sweat)

Question 5

Acute effects of alcohol (on CNS)

Answer 5

• Powerful depressant
• Inhibitory control centres depressed- release excitatory pathways
• -cortecx first, then limbic system (emotions/ memory),, cerellum (motor control),, lower brain stem last (breathing, BP)

Question 6

Acute effects of alcohol on the liver

Answer 6

• Fatty liver (changes to the metabolism)
• Small (microvesiculat) lipid droplets in hepatocytes
• reversible

Question 7

Acute effects of alcohol on he stomach

Answer 7

-Acute gastritis- acute transient mucosal inflammatory process, + haemorrhage and/or sloughing of mucosa

Question 8

Risk factors for alcoholism

Answer 8

• Polymorphism in ethanol dehydrogenase gene
• obesity
• exposure to other hepatotoxins (eg analgesics, antibiotics)
• infection with hepatitis c

Question 9

Functions of the liver

Answer 9

• Digestion
• Excretion
• Nutrient storage and conversion
• Detoxification of destructive chemicals
• The creation of new molecules

Question 10

Histological features of fatty liver

Answer 10

Changes in cell-fat accumulation

• Increased FA synthesis
• decreased mitochondrial oxidatin og FA
• increased production of triglycerides
• impaired release of lipoproteins

Question 11

Pathogenesis and histopathology of alcoholic hepatitis

Answer 11

Symptoms include fever, liver tenderness, jaundice- significant mortality

• Inflammatory disease cytokines from Kupffer cells
• characterised by necrosis of hepatocytes
• Mallory bodies (non functional filamentous proteins) can be seen

Question 12

Chronic alcohol liver disease- cirrhosis

Answer 12

• necrosis + inflammation + fibrosis + regeneration
• irreversible scarring, portal hypertension
• liver failure

Question 13

Pathogenesis of liver cirrhosis

Answer 13

• fatty liver/hepatitis usual precursor but not always
• induction of P450-toxic products + O2 radicals
• microtubular and mitochondrial function affected
• acetaldehyde + protein complexes - disrupt membranes and cytoskeleton
• new epitopes- activate immune response- repeated cycles of inflammation-regeneration-inflammation

Question 14

Consequences of foetal alcohol syndrome

Answer 14

Primary
-brain damage
-lowered cognitive function
-;earning difficulties
-facial dysmorphology
-growth deficiency
Secondary
-social interaction
-alcohol/drug problems