Non-alcoholic fatty liver disease
36,033views
00:00 / 00:00
Videos
Notes
Non-alcoholic fatty liver disease
Gastrointestinal system
Peritoneum and peritoneal cavity disorders
Peritonitis
Pneumoperitoneum
Upper gastrointestinal tract disorders
Cleft lip and palate
Congenital diaphragmatic hernia
Esophageal web
Tracheoesophageal fistula
Pyloric stenosis
Sialadenitis
Parotitis
Oral candidiasis
Ludwig angina
Aphthous ulcers
Temporomandibular joint dysfunction
Dental abscess
Gingivitis and periodontitis
Dental caries disease
Oral cancer
Warthin tumor
Barrett esophagus
Achalasia
Plummer-Vinson syndrome
Mallory-Weiss syndrome
Boerhaave syndrome
Gastroesophageal reflux disease (GERD)
Zenker diverticulum
Diffuse esophageal spasm
Esophageal cancer
Eosinophilic esophagitis (NORD)
Gastritis
Gastric dumping syndrome
Peptic ulcer
Gastroparesis
Cyclic vomiting syndrome
Gastroenteritis
Gastric cancer
Lower gastrointestinal tract disorders
Gastroschisis
Imperforate anus
Omphalocele
Meckel diverticulum
Intestinal atresia
Hirschsprung disease
Intestinal malrotation
Necrotizing enterocolitis
Intussusception
Tropical sprue
Small bowel bacterial overgrowth syndrome
Celiac disease
Short bowel syndrome (NORD)
Lactose intolerance
Whipple's disease
Protein losing enteropathy
Microscopic colitis
Crohn disease
Ulcerative colitis
Bowel obstruction
Intestinal adhesions
Volvulus
Gallstone ileus
Abdominal hernias
Femoral hernia
Inguinal hernia
Small bowel ischemia and infarction
Ischemic colitis
Familial adenomatous polyposis
Peutz-Jeghers syndrome
Gardner syndrome
Juvenile polyposis syndrome
Colorectal polyps
Colorectal cancer
Carcinoid syndrome
Irritable bowel syndrome
Gastroenteritis
Diverticulosis and diverticulitis
Appendicitis
Anal fissure
Anal fistula
Hemorrhoid
Rectal prolapse
Liver, gallbladder and pancreas disorders
Crigler-Najjar syndrome
Biliary atresia
Gilbert's syndrome
Dubin-Johnson syndrome
Rotor syndrome
Jaundice
Cirrhosis
Portal hypertension
Hepatic encephalopathy
Hemochromatosis
Wilson disease
Budd-Chiari syndrome
Non-alcoholic fatty liver disease
Cholestatic liver disease
Hepatocellular adenoma
Autoimmune hepatitis
Alcohol-induced liver disease
Alpha 1-antitrypsin deficiency
Primary biliary cirrhosis
Primary sclerosing cholangitis
Hepatitis
Neonatal hepatitis
Reye syndrome
Benign liver tumors
Hepatocellular carcinoma
Gallstones
Biliary colic
Acute cholecystitis
Ascending cholangitis
Chronic cholecystitis
Gallstone ileus
Gallbladder cancer
Cholangiocarcinoma
Acute pancreatitis
Pancreatic pseudocyst
Chronic pancreatitis
Pancreatic cancer
Pancreatic neuroendocrine neoplasms
Zollinger-Ellison syndrome
Gastrointestinal system pathology review
Congenital gastrointestinal disorders: Pathology review
Esophageal disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Malabsorption syndromes: Pathology review
Diverticular disease: Pathology review
Appendicitis: Pathology review
Gastrointestinal bleeding: Pathology review
Colorectal polyps and cancer: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Pancreatitis: Pathology review
Gallbladder disorders: Pathology review
Jaundice: Pathology review
Viral hepatitis: Pathology review
Cirrhosis: Pathology review
Assessments
Non-alcoholic fatty liver disease
Flashcards
0 / 10 complete
USMLE® Step 1 questions
0 / 1 complete
High Yield Notes
27 pages
Flashcards
Non-alcoholic fatty liver disease
of complete
Questions
USMLE® Step 1 style questions USMLE
of complete
Memory Anchors and Partner Content
External Links
Transcript
Content Reviewers
Rishi Desai, MD, MPHNonalcoholic fatty liver disease is actually a spectrum of disease, going from least to most severe—steatosis, steatohepatitis, fibrosis, and finally cirrhosis.
Nonalcoholic fatty liver disease results from fat deposition in the liver, which is unrelated to alcohol or viral causes.
Typically, it affects individuals with metabolic syndrome, which includes a combination of three of the following five diagnoses: obesity, hypertension, diabetes, hypertriglyceridemia, and hyperlipidemia.
Given how common metabolic syndrome has become, it’s not surprising that the rate of nonalcoholic fatty liver disease has also increased dramatically.
It’s a massive problem growing in lock-step with expanding waistlines, affecting about three quarters of all obese individuals, including many children.
Although the exact mechanism of nonalcoholic fatty liver disease isn’t clear, insulin resistance seems to play an important role.
Over time, insulin receptors on various tissues including the liver become less responsive to insulin, and as a result the liver goes into a mode where it increases fat storage and decreases fatty acid oxidation.
That means decreased secretion of lipids into the bloodstream, in the form of lipoproteins, and increased synthesis and uptake of free fatty acids from the blood, a process called steatosis.
Steatosis causes fat droplets to form within hepatocytes, some of which become large enough to cause the hepatocytes to swell up with fat and push the nuclei to the edge of the cell.
You can see this on a histopathology slide of the liver.
All of these white circles are large deposits of fat.
Zooming out and looking at the liver, you see widespread steatosis which makes the liver appear large, soft, yellow, and greasy.
Over time, that fat in the hepatocytes is vulnerable to degradation.
Unsaturated fatty acids, or fatty acids that have at least one double bond in their carbon chain, have hydrogen atoms that are especially vulnerable to initiators such as the reactive oxygen species like the hydroxyl radical that have an unpaired electron.
Summary
Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat is deposited in the liver, leading to inflammation and scarring. NAFLD is a common liver disorder that affects people who do not drink alcohol excessively. NAFLD commonly affects people with metabolic syndrome, which includes a combination of three of the following five diagnoses: obesity, hypertension, diabetes, hypertriglyceridemia, and hyperlipidemia.
Symptoms of NAFLD may be subtle or absent in the early stages of the disease. In advanced stages, symptoms may include fatigue, abdominal pain, and jaundice. NAFLD can progress to a more serious condition called non-alcoholic steatohepatitis (NASH), which can lead to liver scarring and cirrhosis. Treatment for NAFLD may involve lifestyle changes such as weight loss, regular exercise, and a healthy diet to help reduce fat in the liver and improve insulin resistance.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw Hill Professional (2019)
- "The Role of Intestinal Bacteria Overgrowth in Obesity-Related Nonalcoholic Fatty Liver Disease" Nutrients (2014)
- "Non-alcoholic fatty liver disease" BMJ (2014)
Copyright © 2023 Elsevier, except certain content provided by third parties
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.
