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3: MED2 Y3 - Gastrointestinal [7] > [40] Alcoholism and Alcoholic Hepatitis > Flashcards

[40] Alcoholism and Alcoholic Hepatitis Flashcards

1
Q

What are the categories of complications of alcohol abuse?

A 
Hepatic
GIT
CNS
Heart
Blood
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2
Q

What are the hepatic complications of alcohol abuse?

A

Fatty liver, leading to hepatitis and cirrhosis

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3
Q

What signs on LFTs indicate alcoholism?

A

AST:ALT >2

Increased GGT

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4
Q

What are the gastrointestinal complications of alcohol abuse?

A 
Gastritis and erosions
Peptic ulcer disease
Varices 
Pancreatitis 
Carcinoma
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5
Q

What are the CNS complications of alcohol abuse?

A 
Poor memory/cognition
Peripheral polyneuropathy 
Wernicke's encephalopathy 
Korsakoff's 
Fits and falls
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6
Q

What are the symptoms of Wernicke’s encephalopathy?

A

Confusion
Opthalmoplegia
Ataxia

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7
Q

How does opthalmoplegia manifest in Wernicke’s encephalopathy?

A

Nystagmus

LR palsy

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8
Q

What does Korsakoff’s cause?

A

Amnesia leading to confabulation

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9
Q

What are the cardiovascular complications of alcohol abuse?

A

Arrhythmias
Dilated cariomyopathy
Hypertension

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10
Q

What effect can chronic alcoholism have on the blood?

A

Increased MCV

Folate deficiency leading to anaemia

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11
Q

When does alcohol withdrawal kick in?

A

10-72 hrs after last drink

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12
Q

When should alcohol withdrawal be considered in a patient?

A

In a new ward patient with acute confusion

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13
Q

What are the signs of alcohol withdrawal?

A 
Increased HR
Decreased BP
Confusion
Fits
Hallucination
Tremor
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14
Q

What kind of hallucinations are common in alcohol withdrawal?

A

Formication (sensation of insects crawling over skin)

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15
Q

How is alcohol withdrawal managed acutely?

A

Tapering regime of chlordiazepoxide PO/lorazepam IM

Thiamine

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16
Q

How is alcoholism managed?

A

Group therapy or self-help
Baclofen
Acamprosate
Disulfriram

17
Q

What does baclofen and acamprosate do?

A

Reduce cravings

18
Q

What does disulfiram do?

A

Aversion therapy

19
Q

How does alcoholic hepatitis present?

A

Anorexia
Diarrhoea and vomiting
Tender hepatomegaly
Ascites

20
Q

What are the signs fo severe alcoholic hepatitis?

A

Jaundice
Bleeding
Encephalopathy

21
Q

What investigations are done in alcoholic hepatitis?

A

Bloods
Ascitic tap
Abdo US and PV duplex

22
Q

What might be found on bloods in alcoholic hepatitis?

A

Increased MCV
Increased GGT
AST:ALT >2

23
Q

How is alcoholic hepatitis managed?

A 
Stop alcohol (duh)
Management of withdrawal
Pabrinex
Optimise nutrition
Monitoring
Management of complications
24
Q

What is pabrinex?

A

High dose B vitamins

25
Q

What monitoring is done in alcohol hepatitis?

A

Daily weighy
LFT
U&E
INR

3: MED2 Y3 - Gastrointestinal [7] (44 decks)

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