Alcohol Flashcards
What are the guidelines regarding weekly alcohol consumption?
- exceed no more than 14 units a week on a regular basis and spread your drinking over 3 or more days
- the more you drink, the more you are at risk of health problems
What are symptoms and signs of alcohol intoxication?
- nausea and vomiting
- impaired attention and judgement
- unsteadiness
- flushing
- nystagmus
- mood instability
- disinhibition
- slurring
- stupor
- unconsciousness
When would ‘harmful use of alcohol’ be diagnosed as opposed to acute intoxication?
- pattern of causing damage to physical or mental health
- alcohol use >1month or repeatedly over 12 months
When would alcohol dependence be diagnosed?
3 or more of the following for >1month or repeatedly over 12 months:
- cravings/compulsions to take
- difficulty controlling use
- primacy
- increased tolerance
- physiological withdrawal on reduction/cessation
- persistence despite harmful consequences
What are symptoms and signs of alcohol withdrawal?
- tremor
- weakness
- nausea
- vomiting
- anxiety
- seizures
- confusion
- agitation
- death
- delirium tremens
What characterises delirium tremens?
- profound confusion
- tremor
- agitation
- hallucinations
- delusions
- sleeplessness
- autonomic overactivity
What would be the cause of death in delirium tremens?
- cardiovascular collapse
- infection
- hyperthermia
- seizures
- self injury
When will delirium tremens set in?
usually 48-72 hours after alcohol stopped
What is wernicke’s encephalopathy?
- prolonged abuse of alcohol can lead to vitamin B deficiency
- this condition is a s a result of B deficiency
What characterises Wernicke’s encephalopathy?
- confusion
- ataxia
- opthalmoplegia
- nystagmus
How can Wernicke’s encephalopathy be treated?
symptoms completely reversible if treated with parenteral thiamine
What is Korsakoff’s psychosis?
- chronic Wernicke’s encephalopathy leading to irreversible brain damage
- long term thiamine deficiency
What are characteristics of Korsakoff’s syndrome?
problems learning new information, inability to remember recent events and long-term memory gaps. Memory problems may be strikingly severe while other thinking and social skills are relatively unaffected. For example, individuals may seem able to carry on a coherent conversation, but moments later be unable to recall that the conversation took place or to whom they spoke.
Those with Korsakoff syndrome may “confabulate,” or make up, information they can’t remember. They are not “lying” but may actually believe their invented explanations. Scientists don’t yet understand why Korsakoff syndrome may cause confabulation.
What screening tools can be used to assess alcohol related health problems?
- CAGE
- AUDIT
- FAST
- PAT
Describe CAGE.
(2 or more = likely alcohol problem)
Have you tried to Cut down?
Have you felt Annoyed by people criticising your drinking?
Have you felt Guilty about drinking?
Have you felt the need to have an Eye-opener
What is a common medication used to manage alcohol withdrawal?
benzodiazepines e.g. chlordiazepoxide
What medication can be used as a deterrent to taking alcohol?
medication that will make you feel uncomfortable when you take alcohol to try and put you off it e.g. disulfiram
What are examples of medications that can be used for anti-craving?
-acamprosate
-naltrexone
-nalmefene
idea is that reduces endogenous opiate effect of taking alcohol which will make it less pleasurable to drink
What can chronic alcohol excess do to the liver?
alcoholic fatty liver(reversible)–alcoholic hepatitis(reversible)—alcoholic cirrhosis(irreversible)
What is the prognosis of alcoholic fatty liver?
- good if become abstinent (disappears within 6 weeks of abstinence)
- can go on to alcoholic hepatitis and alcoholic cirrhosis if keep drinking
At what level of daily alcohol intake is alcoholic hepatitis a risk? What other signs indicate diagnosis of alcoholic hepatitis?
- alcohol intake>6 units per day
- drinking until previous 3 weeks
- jaundice with bilirubin>80
- no evidence of other liver disease or biliary obstruction
What tool can be used to assess severity of alcoholic hepatitis?
Glasgow hepatitis score
looks at coagulation, age, urea etc
What glasgow hepatitis score indicates poor prognosis in alcoholic hepatitis?
> 9
What are possible causes of liver cirrhosis?
- alcoholic liver disease
- hepatitis B and C
- non alcoholic fatty liver disease
- haemochromatosis
What is the main cause of high mortality liver cirrhosis?
alcohol
What is meant by ‘decompensated liver disease’?
- liver not doing what it should
- gastrointestinal bleeding
- encephalopathy
- ascites are all signs
What is the treatment of hepatocellular cancer?
- surgical resection
- liver transplant
- radiofrequency/microwave ablation
- transarterial embolisation
- chemotherapy
What is he most common reason for liver transplantation in scotland?
alcohol related liver disease
What are resistant complications of cirrhosis?
- jaundice
- ascites
- coagulopathy
- encephalopathy
