3: Biochemistry of alcohol Flashcards
Which GI disease is alcohol a common cause of?
Acute and chronic pancreatitis
What are two enzymes used as indicators for pancreatitis?
Amylase
Lipase
What does GGT levels do in response to alcohol consumption?
Increases
In chronic alcoholism, MCV (mean corpuscular volume) is (increased / decreased).
increased
Why do triglyceride levels increase during excessive drinking?
Increased lipid synthesis in the liver
What tests can be used to see if a patient is a chronic drinker?
Gamma GT (GGT)
MCV
Triglycerides
What tests are done for a patient who comes to hospital in a coma?
Blood glucose tested (for hypoglycaemia)
Serum osmolality
How do you calculate serum osmolality?
Serum osmolality roughly equals 2 x [Na+]
How is serum osmolality used to prove a patient is in an alcoholic coma?
Osmolal gap = Measured osmolality - calculated osmolality
Big gap = ethanol contributing to osmolality
What tests are carried out to pinpoint the cause of a patient’s abdominal pain?
Amylase
LFTs
differential for abdominal pain
Acute pancreatitis
Alcoholic hepatitis
Peptic ulcers +/- perforation
Portal hypertension –> Ascites +/- peritonitis
If amylase is raised in a patient with abdominal pain, what is the likely diagnosis?
Pancreatitis
ALT (alanine aminotransferase)
- found in the LIVER hepatocytes
- released in response to DAMAGE
ALP (alkaline phosphatase
- found in LIVER, BONE, KIDNEYS, SMALL INTESTINE
- differentiate liver and bone by testing GGT
Gamma GT
- found in the liver, BD, GB
- too sensitive to be diagnostic but can be used to confirm liver damage when ALT is raised
Albumin
- produced by liver
- decreases in inflammatory disease
Prothrombin time
- clotting factors produced by the liver - gives an indication of liver function
- ALSO gives a measure of tendency to bleed
What tests would be carried out for someone whose main complaint is vomiting?
U&Es
LFTs
Amylase
ABGs
What is commonly seen on the U&Es of an alcohol user who is vomiting?
Low sodium
Low potassium
?High urea and creatinine, reflect reduction in glomerular function
What tests should be done in a patient who presents with haematemesis?
U&Es
LFTs
PTR
Lactate
when does urea production increase?
when protein consumption does i.e red meat
when is urea classically raised?
in haematemesis because you’re absorbing your own blood
what happens when hyponatremia occurs?
when aldosterone and adh work together because the ratio of water to sodium is greater
i.e more water reabsorbed than sodium
spironolactone - aldosterone antagonist - causes low sodium and high potassium
what is used to treat toxic alcohol poisoning
ethanol is a competitive inhibitor with methanol and polyethylene glycol (antifreeze)
