Liver

LIVER

  1. Alcohol and Alcohol Abuse
  2. Basic Liver Physiology
  3. Bilirubin Metabolism and Jaundice
  4. Causes of Hepatomegaly
  5. Causes of Splenomegaly
  6. Clinical Consequences of Liver Disease
  7. Haemochromatosis
  8. Liver Function Tests
  9. Liver Transplantation
  10. Wernicke's Encephelopathy and Korsakoff's Syndrome
  11. Wilson's Disease
  12. Hepatorenal Syndrome (HRS)

 

Introduction 
The recommended weekly amounts of alcohol are:

  • 14 Units for women
  • 21 Units for men
These recommendations are based on the presumption that you should recommend half the amount that would cause problems in 50% of people. So, if a man drank 42 units a week for several years, then he has a 50% chance of negative consequences.
 
How much is a unit?
Bottle of wine
9 units
Glass of wine (large – 250ml)
3 units
Bottle of spirits
30 units
Pint of beer
2 units
Strong pint of beer
3 units
Alocpop bottle
2 units
Bottle of cheap cider
10 units
A bottle of spirits has roughly 40% alcohol by volume; which equates to 70% alcoholic proof.
10ml of pure alcohol is ‘one unit’
Susceptibility to alcoholic disease varies widely. 1/3 of serious alcoholics will get cirrhosis. Some may drink 500 units a week for years, and never have any liver problems, but some might drink 100 a week for a year and already start to show serious signs of damage.
 
The difference between an alcoholic and an alcohol abuser is dependency.
 
Who are the heavy drinkers in society?
  • City Workers
  • Barmen (drink 7x greater than average)
  • Chefs (5x)
  • Publicans (10x)
  • Seamen
  • Architect and accountants drink the least
  •  Doctors drink just very slightly above the average. Psychiatrists are significantly higher than other specialities.
 
Which nation are the heaviest drinkers?
  • Russia
  • Scandinavia
  • Eastern Europe
  • France
  • Britain (above average, but not as high as those mentioned above)
 

Consequences due to drunkenness

  • Trauma
  • Vomiting - this can lead to aspiration, which if light, is likely to cause pneumonia, but if serious could lead to death as the patient is unable to breathe.
  • Radial nerve palsy – if you fall asleep with your arm in an unusual position (e.g. over the back of a chair) then your radial nerve can get stuck in the radial groove and compressed. This can lead to nerve damage. The typical sign of this damage is a drooping wrist. Sometimes it is permanent, but in some cases it may only last a couple of weeks.
  • Risk taking behaviours – e.g. climbing trees, swimming across rivers etc.
  • Vasodilatation – this is not necessarily very dangerous, unless you combine it with being in a cold place for a long time – e.g. sleeping in the park after a drunken night out. In this case it may lead to hypothermia.
  • Hyperglycaemia
  • 50% of weekend hospital admissions in some cities (Manchester included) are due to alcohol.
 

Consequences of Withdrawal