Based on this information and patient history you have concerns of alcohol use disorder and recommend a liver biopsy. At this time Ella is also referred to cardiology for an EKG and cardiac evaluation. A liver biopsy is performed and the following pathology is illustrated below. Pathology report: Alcohol-related steatosis consistent with small- and large-droplet fat. Fat accumulation is most prominent near the central vein (asterisk) and extends outward toward the portal tract with increasing severity. In this case, the fat extends into acinus zone 2 or the midzone of the hepatic lobule. This diagnosis is discussed with Ella and she wants to schedule a follow up to discuss her alcohol use, life-style modifications and counseling. Describe how alcohol consumption contributes to the pathology presented in the image above. Be sure to address the key terms listed below as part of your discussion; you may address additional etiologies as well. Acetoacetate ß-hydroxybutyrate Ethanol metabolism Gluconeogenesis NADH/NAD+ Fatty acid synthesis Lipolysis VLDL Ketogenesis
Based on this information and patient history you have concerns of alcohol use disorder and recommend a liver biopsy. At this time Ella is also referred to cardiology for an EKG and cardiac evaluation.
A liver biopsy is performed and the following pathology is illustrated below.
Pathology report:
Alcohol-related steatosis consistent with small- and large-droplet fat. Fat accumulation is most prominent near the central vein (asterisk) and extends outward toward the portal tract with increasing severity. In this case, the fat extends into acinus zone 2 or the midzone of the hepatic lobule.
This diagnosis is discussed with Ella and she wants to schedule a follow up to discuss her alcohol use, life-style modifications and counseling.
Describe how alcohol consumption contributes to the pathology presented in the image above. Be sure to address the key terms listed below as part of your discussion; you may address additional etiologies as well.
- Acetoacetate
- ß-hydroxybutyrate
- Ethanol
metabolism - Gluconeogenesis
- NADH/NAD+
- Fatty acid synthesis
- Lipolysis
- VLDL
- Ketogenesis
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