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Alcohol-Related Liver Disease

Pathogenesis of Alcohol-Related Liver Disease (ArLD)

Clinical Assessment and Risk Stratification

Clinical Features

The Spectrum of Alcohol-Related Liver Disease

Screening Tools

Management in the Emergency Department

Symptoms and Signs

Risk Stratification

Biochemical Tests

Diagnosing ArLD with Blood Findings

Management in the Emergency Department

Thiamine Deficiency

Management of ArLD

Ongoing Management

Alcoholic Liver Disease – Post Test

Case 2

Alcohol-Related Liver Disease
Clinical Cases
Case 2

A 64-year-old male presents to your ED with new onset of confusion. You know very little history.

He is vomiting and tremulous. On examination:

His heart rate is 98 bpm

BP 87/54 mmHg

Temp 35.6^oC

He is ataxic

Time limit: 0

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Question 1 of 3

1. Question

Rank the following diagnoses into order of likelihood for this patient, from most appropriate (1st) to least appropriate (4th):

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2
3
4

Wernicke's

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Alcohol withdrawal

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Viral encephalitis

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Urinary sepsis

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Question 2 of 3

2. Question

What are the features of Wernicke's?

Poor visual acuity
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Nystagmus
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Hyperthermia
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Ataxia
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Vomiting
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Confusion
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Confabulation
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Urinary retention
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Question 3 of 3

3. Question

What is your course of action for this patient?

Gain wide bore IV access
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Give IV Pabrinex (high potency B vitamins)
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Apply an external re-warming device
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Immediate CT head
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1 litre 10% dextrose
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Start Chlordiazopoxide regime
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Septic screen
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