Nonalcoholic Liver DZ Flashcards
What is the greatest risk factor for nash?
obesity
what is the epidemiology of nonalc liv dz?
obesity, type ii diabetes, hyperlipedmia, metabolic syndrome
what race has the highest rate of nafld
mex amerians, with aas being lowets
T or F: congenital hep is the leading cause of ped liv dz
false, nafld is
What are causes of nafld besides obesity
starvation, refeeding
abetalipoproteinemia, hypobetalipoproteinemia
surgery - rapid, xs weight loss
what is the normal path of triglycerides?
trigl incorporated into chylomicrons, travel via lymphatics to peripheral fat, hydrolyzed to free FAs, stored in liver, oxidized by mitochondria
How does insulin resistnace lead to nafld?
insulin promotes uptake of glucose, stored as glycogen
inhibits lipolysis, leads to increased lipogenesis, increased FAs.
How does increased ffas lead to nafld?
increased free fatty acids lead to fatty liver and increased oxidative tress (increased free radicals and direct liver injury)
What is the two hit hypothesis associated with nafld?
hepatic fat accumulation
oxidative stress via lipid peroxidation and free radicals
What are the clinical fts of nafld?
no symptoms or signs of chronic liver dz usually, maybe fatigue
On phys exam, what will you see in nafld?
obesity, hepatomegaly, spider angiomata, palmer erythema
will ast be 2x alt in nafld?
nope
what will you see on histo with nafld?
macrovesicular fat, inflammation, degeneration, balooning, mallory bodies pericellular fibrosis then bridging
what does perisinusoidal fibrosis appear as
chicken-wire appear
What are the txs for nalfd?
weight reduction, control diabetes, cholesterol. coffee
