Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Fatty liver: Hepatocellular steatosis results from impaired lipid metabolism owing to increased intracellular levels of NADH. (Show me the steatosis.)
• Induction of P450 enzymes: Leads to augmented transformation of medications and other drugs to toxic metabolites.
• Free radical generation: Oxidative injury to membranes and proteins.
• Microtubule and mitochondrial function: Direct action of ethanol impairs function.
• Acetaldehyde generation: The major intermediate of metabolism induces lipid peroxidation and acetaldehyde-protein formation.
• Immunologic attack on liver cells: Mechanism is thought to be through acetaldehyde and/or ethanol altered proteins.