Alcoholic Hepatitis
Please answer if the following statements are true or false:
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Key Learning Points
• No set amount of alcohol consumption reliably predicts the development of ALD. • Female sex is an independent risk factor for alcoholic hepatitis. • Greater alcohol consumption confers a greater risk of developing alcoholic hepatitis. • Severity of alcoholic hepatitis can be determined by Maddrey’s discriminant function, Glasgow alcoholic hepatitis score and MELD score. • Alcoholic hepatitis is associated with a high mortality. • Supportive care remains the mainstays of care. Corticosteroids may be of benefit to some patients with severe alcoholic hepatitis.
F. Gohar Queen Elizabeth Hospital Liver Unit, Birmingham, UK Department of gastroenterology and Hepatology, The Royal Liverpool Hospital, Prescot Street, Liverpool L7 8XP, UK P. Richardson () Department of gastroenterology and Hepatology, The Royal Liverpool Hospital, Prescot Street, Liverpool L7 8XP, UK e-mail: [email protected] T. Cross (ed.), Liver Disease in Clinical Practice, In Clinical Practice, DOI 10.1007/978-3-319-43126-0_6, © Springer International Publishing Switzerland 2017
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• Patients should be linked in with the local alcohol team, and abstinence should be maintained through regular contact (brief intervention), psychosocial therapy and possibly pharmacotherapy (acamprosate, baclofen, naltrexone, nalmaphene, disulfiram).
Questions on Alcoholic Hepatitis Please answer if the following statements are true or false: A. The United Kingdom has one of the lowest levels of alcohol-related deaths in Europe? B. Alcohol is harder to buy and consume than it was in the 1970s? C. The amount of alcohol consumed at home has increased over the last 30 years? D. Minimum unit pricing on alcohol is being considered as a way to reduce alcohol consumption by increasing cost? E. Recent guidelines have suggested that the safe level of alcohol consumption for men and women should be 14 units per week? A 44-year-old lady with a known history of heavy alcohol consumption is admitted to the emergency department. She has had three admissions in the last 12 months because of alcohol, but has not been this unwell before. She is deeply jaundiced and has ascites but is otherwise well. She says she has not taken alcohol for 3 weeks. Which of the following statements are true? A. She should be commenced on a benzodiazepine to prevent alcohol withdrawal? B. A liver biopsy should be performed immediately? C. A diagnostic ascitic tap should be performed to exclude spontaneous bacterial peritonitis? D. A liver ultrasound will be helpful? E. Alcoholic hepatitis is a diagnosis to consider?
Chapter 6.
Alcoholic Hepatitis
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She has a Maddrey’s discriminant function of >32 and a Glasgow alcoholic hepatitis score of >9. There is no evidence of infection. Which of the following statements are true? A. B. C. D. E.
She is in a good prognostic group? Pentoxifylline should be the first-line treatment? Corticosteroids might be beneficial? She should be referred for a liver transplant? She should be referred early i
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