3D alcoholism

Question 1

what is palmar erythema and what causes it

Answer 1

red hands
related to liver cirrhosis
increased oestrogen levels = changes in small anastomoses in the hand - increasing vascularity

Question 2

what is caput medusae

Answer 2

prominent veins around the umbilicus

secondary to portal hypertension

Question 3

subdural haematoma

Answer 3

consequence of falls
results from rupture of bridging veins that cross the skull into the brain
older people - brain shrinks and is looser in the skull

Question 4

most common manifestation of thiamine deficiency

Answer 4

wernicke-korsakoff syndrome

Question 5

what is wernicke korsakoff syndrome

Answer 5

abnormal shaky gait (ataxia)
nystagmus + opthalmoplegia
confusion + disorientation (confabulation)

Question 6

lung features of alcoholics

Answer 6

aspiration pneumonia

pneumonitis

Question 7

which bronchus is more likely to have a thing go down

Answer 7

right as it is more vertical

Question 8

what is the histology of aspiration pneumonia with H+E staining?

Answer 8

honeycomb shape surrounded by inflammatory cells

Question 9

what effect does alcohol have on the heart?

Answer 9

dilated cardiomyopathy
a direct negative inotropic effect meaning that the cardiac muscle does not contract as strong as normal so the heart rate must increase

Question 10

what are the 4 steps of alcoholic fatty liver disease?

Answer 10

1. increased peripheral free fatty acid production delivered to liver
2. NAD is converted by alcohol to NADH which stimulates lipid synthesis
3. mitochondrial oxidation of fatty acids is reduced by alcohol
4. there is decreased transport of fat out of hepatocytes due to intracellular tubulin impairment

Question 11

what is liver cirrhosis?

Answer 11

symptoms - portal hypertension
caused by fibrosis deposited by interstitial cells of Ito
eventually these areas of scarring encircle hepatic lobules
the entrapped hepatocytes have a reduced capacity to receive substances and secrete substances = toxic material build up

Question 12

what is barrets oesophagus

Answer 12

when there is repeated insult to the oesophagus (eg being sick), and the normal squamous epithelium changes to columnar lined epithelium

Question 13

definition of a cyst

Answer 13

lined by epithelium

Question 14

how does alcohol cause hypoglycaemia?

Answer 14

inhibits hepatic gluconeogenesis and reduces blood sugar levels