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Fifty vocabulary flashcards covering signs, laboratory findings, scoring, pharmacologic treatments, dosing, contraindications, and adverse effects related to severe alcoholic hepatitis.
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Jaundice
Yellow discoloration of skin and sclera that can appear within three months in alcoholic hepatitis patients.
Anorexia
Loss of appetite commonly reported as a symptom of alcoholic hepatitis.
Fever
Elevated body temperature that may accompany acute alcoholic hepatitis episodes.
Right upper-quadrant abdominal pain
Pain over the liver area typical of alcoholic hepatitis presentations.
Abdominal distension
Visible swelling of the abdomen, often caused by fluid accumulation in liver disease.
Ascites
Pathologic buildup of peritoneal fluid leading to abdominal distension in advanced liver disease.
Proximal muscle weakness
Loss of strength in shoulder or hip girdle muscles due to wasting in chronic liver illness.
AST (Aspartate Aminotransferase)
Liver enzyme that rises moderately in alcoholic hepatitis.
ALT (Alanine Aminotransferase)
Liver enzyme elevated alongside AST but usually to a lesser extent in alcoholic hepatitis.
AST/ALT ratio >1
Laboratory pattern highly suggestive of alcoholic liver injury.
Serum bilirubin
Blood pigment that becomes elevated in alcoholic hepatitis, contributing to jaundice.
Gamma-glutamyl transferase (GGT)
Cholestatic enzyme elevated in many patients with alcoholic hepatitis.
INR (International Normalized Ratio)
Coagulation test that prolongs when liver synthetic function is impaired.
Neutrophilic leukocytosis
Increase in white blood cells with neutrophil predominance seen on labs for alcoholic hepatitis.
Maddrey Discriminant Function (MDF)
Scoring system that predicts short-term mortality in alcoholic hepatitis.
MDF score >32
Value indicating high early mortality and the need for consideration of glucocorticoid therapy.
MDF score <32
Value signifying low early mortality; patients usually managed with supportive care alone.
Severe alcoholic hepatitis
Clinical entity defined by MDF >32 or hepatic encephalopathy requiring pharmacologic treatment.
Glucocorticoids
First-line anti-inflammatory drugs for severe alcoholic hepatitis; suppress cytotoxic pathways.
Pentoxifylline
Oral drug that inhibits TNF synthesis, used when steroids are contraindicated in alcoholic hepatitis.
Beta-blockers discontinuation
Recommendation to stop these agents because they heighten acute kidney injury risk in severe alcoholic hepatitis.
Prednisolone
Preferred oral glucocorticoid that does not require hepatic activation.
Prednisone
Glucocorticoid prodrug requiring liver conversion, therefore avoided in alcoholic hepatitis.
Methylprednisolone
Intravenous glucocorticoid alternative for patients unable to take oral medication.
Prednisolone 40 mg daily
Standard oral dose given for 28 days in patients with MDF >32 or encephalopathy.
Methylprednisolone 32 mg IV daily
Equivalent daily intravenous dose for severe alcoholic hepatitis therapy.
28-day treatment course
Recommended duration for glucocorticoid or pentoxifylline therapy in severe alcoholic hepatitis.
Prednisolone taper
Gradual dose reduction schedule to prevent adrenal crisis after a full steroid course.
HPA axis suppression
Decreased endogenous steroid production caused by prolonged glucocorticoid use.
Contraindication: infection/sepsis
Active systemic infection that precludes glucocorticoid therapy.
Contraindication: gastrointestinal bleed
Recent or ongoing GI hemorrhage that disallows steroid use.
Contraindication: renal insufficiency (<30)
Severe kidney dysfunction that makes glucocorticoid therapy unsafe.
Emotional lability
Rapid mood swings that can occur as a side effect of prednisolone.
Skin atrophy
Thinning and fragility of skin resulting from prolonged steroid exposure.
Osteoporosis
Loss of bone density enhanced by chronic glucocorticoid therapy.
Diabetes
Steroid-induced or worsened hyperglycemia associated with prednisolone use.
Insomnia
Difficulty sleeping frequently reported with systemic steroid therapy.
Weight gain
Increase in body weight due to fluid retention and appetite stimulation by steroids.
Prednisolone adverse effects
Collective term for emotional lability, infection risk, osteoporosis, diabetes, insomnia, and weight gain.
Pentoxifylline mechanism
Inhibition of tumor necrosis factor (TNF) synthesis, reducing inflammation in alcoholic hepatitis.
Pentoxifylline 400 mg TID
Standard dosing of pentoxifylline three times daily for 28 days.
No taper needed
Instruction that pentoxifylline can be discontinued abruptly after completing therapy.
ICAM-1 reduction
Glucocorticoid action that lowers leukocyte adhesion in hepatic sinusoids, dampening inflammation.
Tumor necrosis factor (TNF)
Pro-inflammatory cytokine elevated in alcoholic hepatitis and targeted by pentoxifylline.
Acute kidney injury risk
Potential renal complication intensified by beta-blocker use in severe alcoholic hepatitis.
Glucocorticoid contraindications
Conditions such as sepsis, GI bleed, or renal failure that prohibit steroid use.
Hepatic encephalopathy
Neuropsychiatric manifestation of liver failure qualifying a patient for steroid therapy.
Intravenous route
Method of administration for methylprednisolone when oral intake is not feasible.
Short-term mortality
Early death risk predicted by high MDF scores in alcoholic hepatitis.
Supportive measures
Basic care—nutrition, abstinence, monitoring—used when MDF is below 32.