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Gastrointestinal > Alcohol > Flashcards

Alcohol Flashcards

1
Q

Limit of units a week

A

14

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2
Q

What is considered a binge drink?

A

6 or more units in one sitting

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3
Q

Maximum units a week whilst breast feeding

A

<1-2 a week

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4
Q

Effect of alcohol on the CNS

A
  • Negative inotropic effects = decrease contractility of heart > heart beats faster > sensation of heavy heart beat
  • CNS depressant: increases GABA (inhib of neurotransmitters) = disinhibition, memory loss, confusion, loss of muscular coordination, slurred speech, depressed resp control
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5
Q

Alcohol hepatitis

A
  • acute life threatening manifestation
  • parenchymal inflammation and hepatocycte damage
  • high risk of renal failure, bleeding, infections
  • abdominal pain after drinking alcohol
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6
Q

Acute gastritis

A

Patient presenting with vomiting after alcohol consumption

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7
Q

Alcoholic Ketoacidosis

A
  • high glucagon
  • low insulin
  • low sugar levels
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8
Q

Acute pancreatitis

A

Epigastric abdominal pain after drinking alcohol
- not only associated with chronic drinkers

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9
Q

Chronic pancreatitis

A

Assoc. with chronic alcohol misuse - scaring and sclerosis (stiffening) and pseudocyst formation

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10
Q

Wernicke’s syndrome

A
  • Typically patient - known alcoholic
  • result of thiamine deficiency
  • bit shaky, jerky eye movements
  • follows conversation no problem
  • treatment: thiamine replacement
  • can lead to Korsakoff syndrome
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11
Q

Korsakoff syndrome

A
  • develops from the Wernicke-Korsakoff syndrome
  • involves cerebral atrophy
  • inability to retain new information and replacement of memorises with whatever information is available at the time
  • low chance of recovery
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12
Q

Wernicke-Korsakoff syndrome

A
  • thiamine defining
  • results in cytotoxic oedema leading to ocular dysfunction, ataxic gait, acute confusion
  • treatment: thiamine replacement over 5 days (should resolve in a few hours)
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13
Q

Dilated cardiomyopathy

A

The cardiomyopathy most associated with alcoholism

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14
Q

Holiday heart syndrome

A
  • binge drinking on otherwise healthy heart
  • most commonly causes a SVT
  • spontaneous resolution
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15
Q

Steatohepatitis

A

Excess NADH production

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16
Q

Thiamine deficiency

A
  • clinical signs include beriberi syndrome
  • wet beriberi - affects CVS
  • dry beriberi - affects CNS
17
Q

Aspiration pneumonia

A

Most likely in right lower lobe

18
Q

Methanol poisining

A
  • low bicarbonate
  • treatment - ethanol
19
Q

Metabolic acidosis

A
  • heavy drinking with the absence of vomit
  • activates alternate pathways (MEOS, Krebs cycle)
20
Q

Ascites

A

Abdominal pain after drinking alcohol due to abnormal fluid build up in abdomen

21
Q

Peptic ulceration

A

Presents with abdominal pain after drinking alcohol

22
Q

Alcohol related steatosis

A
  • hepatocyctes swelling with triglycerides
    -reversible with cessation of drinking
23
Q

What to Look out for the following in a sporadic drink who has presented after an evening of binge drinking

A
  • Mallory Weiss tear
  • aspiration pneumonia
  • trauma
24
Q

What to look out for in chronic drinkers

A
  • ascites
  • oesophageal varices
25
Q

Signs ands symptoms to look out for in an intoxicated patient

A
  • grey turners and Cullens sign (pancreatitis)
  • arrhythmias
  • gastric rupture
  • Hypovolaemic shock
26
Q

How to treat ascites in liver cirrhosis

A

Aim is to reduce sodium levels

27
Q

When is Antabuse (aka disulfiram) prescribed

A

To recovering alcoholics to abstain from drinking - patients will suffer severe hangover effects very shortly after drinking alcohol
Mechanism: inhibits aldehyde dehydrogenase

28
Q

How to treat methanol poisoning

A
  • ethanol
  • ethanol is preferentially metabolised
  • methanol produces a high acidic load which uses up all the bicarbonates - consider methanol poisoning if bicarbonate is low
29
Q

What is used to help assist alcohol withdrawal

A

Chlordiazepoxide

30
Q

What LFTs are markers of liver damage

A

ALT - liver specific
AST - liver, heart, muscle, kidneys, brain
ALP - liver, bone
GGT - liver, biliary cells

31
Q

What LFTs are markers of liver function

A
  • bilirubin
  • prothrombin time
  • Serum albumin (half-life is 3 weeks so not a good marker of current liver function)
32
Q

Why is drinking on a full stomach better than en empty stomach?

A

Full stomach slows gastric emptying – alcohol will be in stomach longer, the longer alcohol is in the stomach for, the more it is metabolised before being absorbed from the small intestine

33
Q

What cancers does drinking alcohol increase the risk of?

A

Bowel
Breast
Mouth/throat/oesophageal
Stomach
Liver

34
Q

What deficiencies can alcohol cause?

A

Folate and vitamin B12
Niacin
Thiamine
Vitamin A

Gastrointestinal (15 decks)

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