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15 Cards in this Set
- Front
- Back
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difference betwee simple steatosis and non-alcoholic steatohepatitis
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NASH has fat + inflammation
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Simple steatosis appearance on H&E
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bubbles of fat that displace the nucleus
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2 theories for steatosis to steatohepatitis
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lipotoxicity theory v. 2-hit hypothesis
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Histo findings on steatohepatitis
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macrovesicular steatosis
cytologic ballooning Mallory bodies Scattered lobular inflammation |
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3 causes of incidence in new NAFLD
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obesity, diabetes, physical inactivity
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For dx of NAFLD, what do you consider?
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general LFT elevation
absence of HBV, HCV, hemachromatosis... |
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Eval algorithm for NAFLD
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Repeat LFTs, check for Viral Hep, iron overload, hepatic auto antibodies
if negative, check U/S. |
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Assessing severity of NAFLD
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liver bx, transient elastography
NAFLD fibrosis score |
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How can NAFLD score be used?
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risk stratification
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What supplement was beneficial for tx of NASH?
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Vitamin E, but consider individual risk-benefit
have to take for 2 years to see benefit. |
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Ratio for ETOH liver disease on LFTs
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AST:ALT 2:1-3:1 ratio
AST rarely exceeds 300-400 May see GGT, normal AP |
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Signs of acute alcoholic hepatitis
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fever (low grade), leukocytosis, hepatomegally
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Tx formula for acute alcoholic hepatitis
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4.6 * (PT-control) + bilirubin
score >32 would benefit from tx -prednisolone 40mg -pentoxifylline 400mg |
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5 notorious drugs for DILI
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MTX
tylenola statins -antibiotics -NSAIDs |
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3 patterns of DILI
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subclinical
acute liver injury (may be 10% of acute hepatitis) chronic liver injury (may mimic AI or NAFLD) |
