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Gastrointestinal Week 7 2016/17 > 2: Medical consequences of alcohol excess > Flashcards

2: Medical consequences of alcohol excess Flashcards

1
Q

What is the weekly recommended limit of alcohol intake for men and women?

A

14 units

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2
Q

Alcohol intake should be spread evenly over ___ days or more.

A

three

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3
Q

Should pregnant women drink alcohol?

A

No

obviously

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4
Q

Patients often (overestimate / underestimate) how much they drink.

A

underestimate

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5
Q

Which lifestyle factor is mostly responsible for the increase in chronic liver disease mortality in Scotland?

A

Alcohol

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6
Q

Young people tend to suffer the ___ consequences of alcohol excess.

Older people tend to suffer the ___ consequences of alcohol excess.

(chronic / acute)

A

acute

chronic

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7
Q

Alcohol intake is also related to ___ disease.

A

cardiovascular

e.g MI

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8
Q

As of 2003, what percentage of deaths in Scotland were caused by alcohol?

A

5%

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9
Q

What is a liver disease associated with sustained excessive alcohol intake?

A

Alcoholic fatty liver disease

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10
Q

What are some long-term complications of alcoholic fatty liver disease?

A

Cirrhosis

Hepatocellular carcinoma

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11
Q

Excessive alcohol consumption causes ___ and ___ effects.

A

acute , chronic

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12
Q

What are some acute CNS effects of alcohol excess?

A

Poor decision making:

Accidents

Violence

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13
Q

What are some acute GI effects of alcohol excess?

A

Oesophagitis

Gastritis +/- gastric ulcers

Acute pancreatitis

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14
Q

What are some acute respiratory effects of alcohol excess?

A

Aspiration

Respiratory depression

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15
Q

What are some chronic cardiovascular outcomes of alcohol excess?

A

Hypertension

Cardiomyopathy

MI

Stroke

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16
Q

What are some chronic GI outcomes of alcohol excess?

A

Liver disease (ALCOHOLIC FATTY LIVER DISEASE!!!)

Stomach disease

Pancreatic disease

17
Q

What is the presentation of Wernicke-Korsakoff’s syndrome?

Why does it occur?

A

Encephalopathy, lots of nervous/neuro problems

Vitamin B1 (thiamine) deficiency as a result of chronic alcoholism

18
Q

Excessive alcohol use chronically causes (hypertrophy / atrophy) of the brain.

A

atrophy

19
Q

Underage drinking has effects on the development of the brain - how do these manifest?

A

Poor memory

Increased activity re: reward, desire, gratification

20
Q

What is foetal alcohol syndrome?

A

Pregnant women who drink cause damage to their foetus

21
Q

What is the presentation of foetal alcohol syndrome?

A

Impaired growth

Mental retardation

Learning disabilities

Behavioural problems

22
Q

Which enzymes play a role in alcohol metabolism?

A

Alcohol dehydrogenase

Aldehyde dehydrogenase

23
Q

Ketone bodies from alcohol are ___ and 80% of them are broken down to carbon dioxide and water by enzymes.

A

toxic

24
Q

Alcohol excess causes inflammation and fibrosis in the liver. What are the proper names for these two states?

A

Hepatitis

Cirrhosis

25
Q

What is the technical name for the process in which a liver is infiltrated by fat?

What is the technical name for an inflamed fatty liver?

A

Steatosis

Steatohepatitis

26
Q

Are steatosis and steatohepatitis reversible?

A

Yes

if the patient stops drinking

27
Q

Is cirrhosis reversible?

A

No

Fibrosis is established and does not resolve. Prevention of deterioration achieved by stopping drinking but the damage is done

28
Q

Any patient with cirrhosis has an increased risk of developing which cancer?

A

Hepatocellular carcinoma

29
Q

What are the diseases found on the spectrum of alcoholic liver disease?

A

Alcoholic fatty liver disease (steatosis)

Alcoholic hepatitis (steatohepatitis)

Cirrhosis

30
Q

What are some symptoms of alcoholic liver disease?

A

Malaise

Nausea

Fever

Jaundice

31
Q

What are some signs of alcoholic liver disease?

A

Hepatomegaly

Jaundice

Sepsis

Abdominal distension

Encephalopathy

Renal dysfunction

Long INR

32
Q

What are some signs of ALD that you would see on examination?

A

Spider naevi

Encephalopathy

Signs of portal hypertension - varices, caput medusae

Splenomegaly

33
Q

What is thrombocytopenia?

A

Reduced number of thrombocytes (platelets) in the blood

Contributes to increased clotting time seen in liver disease

34
Q

Which grading system can be used to decide on a cirrhosis patient’s prognosis?

A

Childs system

35
Q

In alcoholic liver disease, which liver enzyme is raised?

A

AST

36
Q

In alcoholic liver disease, ___ is higher than ___.

(ALT, AST, ALP, GGT)

A

AST > ALT

remember that when you drink alcohol you get wASTed

37
Q

How are alcoholic hepatitis patients treated?

A

Supportive treatment (fluids, blood transfusion)

38
Q

Which drug improves alcoholic hepatitis mortality in the short term?

A

Steroids e.g prednisolone

Gastrointestinal Week 7 2016/17 (9 decks)

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