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Forensic Medicine > Alcohol > Flashcards

Alcohol Flashcards

1
Q

C-OH?

A

Methanol

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2
Q

What percentgge of people are teetotal?

A

10%

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3
Q

What is recommendedalcohol intake for women a week?

A

14-21 units

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4
Q

Whast is recommended alcohol intake for men a week?

A

21-28 units

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5
Q

What is defined as a heavy drinker?

A

Men drinking over 7 units a day

Women drinking over 5 units a day

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6
Q

What is defined as ganerous consumption of alcohol per week?

A

Males over 50 units

Females over 35 units

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7
Q

When thinking abotu the alcohol cost equation is debit or credit worse?

A

Debit is only 2 billion and credit is 7 billion!

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8
Q

What social harm does alacohol play the largest part in?

A
  1. Fire deaths
  2. Suicides
  3. Head injuries
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9
Q

What are safe levels to drink a day?

A

2-3 units if female

3-4 units if male

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10
Q

What blood tests are abnormal in alcohol dependence?

A

GGT
CDT
MCV

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11
Q

wHAT IS alcohol content expressed as?

A

Percentage alcohol by volume (%abv)

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12
Q

What does 1ml of alcohol weigh?

A

0.79 grams

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13
Q

What is volume of 1 pint?

A

568mls

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14
Q

What is the equation for the amount of alcohol in grams?

A

Volume consumed (ml) x %abv x 0.79 (g/ml)

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15
Q

What is the UK unit of alcohol?

A

10ml of alcohol

8g pure alcohol

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16
Q

What is half a pint of weak beer 3.5%?

A

1 unit

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17
Q

What is one small <100ml glass of wine 12%?

A

1 unit

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18
Q

What is 28ml of spiri?

A

1 unit

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19
Q

What accelerates the absoprtion of alcohol?

A

Gastric emptying: tolerance and gastrectomy

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20
Q

What slows absorption of alcohol?

A

Food in stomach, drugs

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21
Q

How much alcohol is absorbed from the stomach and small intestine?

A

20% from stomach

80% from small intestine

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22
Q

What does rate of alcohol absorption depend on?

A

Rate of gastric emptying

Type of drink (strenght, effect of congeners)

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23
Q

What is optimum strength of alcohol for absorption?

A

10-20%

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24
Q

Name a drink which is absorbed quickly?

A

Champagne necause high conc and bubbles

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25
Q

Why is beer absorbed slowly?

A

Low conc, congeners

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26
Q

When is absorption complete by?

A

1 to 3 hours

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27
Q

What is the rate of elimination?

A

10-20 mg of alcohol/100mls of blood an hour

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28
Q

How do you work out the concentration at T hours?

A

Concentration at time 0 - (elimination rate x time)

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29
Q

Assuming 100% absorption and instant distribution, what is equation for Co?

A

weight alcohol consumed x 100.

Divided by body weight kg x W.F.

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30
Q

When can you detect breath alcohol?

A

1-2 hours after drinking

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31
Q

What is blood alcohol to breath alcohol ration?

A

2300:1

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32
Q

When does BAC more than VHAC occur?

A

During absorption

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33
Q

At equilibrium what is ratioj of vitreous humour to blood alcohol?

A

Blood alcohol is less than VHAC ratio of 0.8

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34
Q

Can you reliably predict BAC from VHAC?

A

No

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35
Q

What does VHAC corroborate?

A

PM BAC

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36
Q

When is UAC less than blood?

A

during absorption pahse

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37
Q

What does alcohol dissolve in?

A

Water

Distributed via bloostream- taken up from blood by tissues in proportion to their water content

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38
Q

What has higher water contnet, muscle or fat?

A

Muscle

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39
Q

What does lean body mass =?

A

Weight x W.F.

40
Q

What gives rough estimate of BAC after alcohol

(assuming instantaneous 100% absorption)?

A

The Widmark equation

41
Q

What is the widmark equation?

A

Co=(weight alcogol (g) x 100) / (body weight kg x W.F.)

42
Q

What are mean values for W.F. in males and females?

A 
Males = 0.68
Females = 0.55
43
Q

IS volume of distribution greater in basketball player or obese man?

A

Basket ball player

44
Q

What are conversion factors for body lfuids, urinary, breath and vitreous?

A 
BAC = BrAC x 2.3
BAC = UAC x 0.75
BAC = VHAC x 0.8
45
Q

What is legal breath limit for driving?

A

22 micrograms alcohol/100mls of breath

46
Q

What is legal blood unit for driving?

A

50mg alcohol for 100ml of breath

47
Q

What is urinary legal limit for driving?

A

67mg of alcohol/100mls of urine

48
Q

Where is 90% of alcohol broken down?

A

In the liver

49
Q

Where are small amounts of alcohol lost in ? 2-5%

A

Breaht
Sweat
Urine

50
Q

What is average rate of elimination?

A

15mg/100mls/hr which is 1 unit an hour

51
Q

What is alcoholic rate of elimination?

A

40mg/100mls/hr

52
Q

What is elimination from breathy?

A

Equivalent to blood=

15/2.3 = 6.52 ug

53
Q

What are the four stages of hepatic metabolism of alcohol?

A
  1. Ethanol
  2. Acetaldehyde
  3. Acetate: CO2 and water
  4. Uric acid, ketones, triglycerides
54
Q

What level of alcohol gives you excitment: depression of higher inhibitory cortical function?

A

Less than 100mg

55
Q

What level of alcohol gives confusion: depression of limbic system (memeory oreientation) and depression of cerebellum (coordinatin and speech)?

A

BAC 100-200

56
Q

Whats level of alcoghol gives you stupor: depression of upper BS (RAS) and lower BS (breathing and vasomotor centres)?

A

Greater than 200

57
Q

What does increasing BAC do to cerebral cortex?

A

Excitement and disinhibition

58
Q

What does increasing BAC do to limbic system?

A

Memory, confusion and disoreintation

59
Q

What does increasing BAC do to cerebellum?

A

In coordination and slurring

60
Q

What does increasing BAC do to hypothalamus and pituitary?

A

Hypothermia

61
Q

What does increasing BAC do to upper brain stem?

A

coma - RAS

62
Q

What does increasing BAC do to medulla (ulower bs)?

A

Resp and vasomotor depression, death

63
Q

What are some dangers of severe intoxication?

A 
Hypotension (low bp)
Hypothermia
Inhalation of vomit
Haematemesis
Trauma
64
Q

What might acute intoxication mimic?

A 
Head injury
Neurological disease
Diabetic hypoglycaemia
Epilepsy &amp; related states
Drug intoxication (often coexist)
65
Q

What causes a hangover?

A

Toxic effects of alcohol metabolites and congeners on brain and GIT

66
Q

what plaus a big part in hangover?

A

Hypoglycaemia

67
Q

person who drives or attempts to drive or is in charge of a motor vehicle on a road or other public place after consuming so much alcohol that the proportion of it in the breath, blood or urine exceeds the prescribed limit, …shall be guilty of an offence

A

Road traffic act section 5 (1)

68
Q

Driving, or being in charge, when under influence of drink or drugs
(1) A person who, when driving or attempting to drive a motor vehicle on a road or other public place, is unfit to drive through drink or drugs is guilty of an offence.

A

RTA section 4

69
Q

At police station what are drivers who have been drinking requires to provide?

A

Either 2 evidential breath samples on CAMIC
or
Specimin of blood for analysis

70
Q

When giving evidential breath samples what values are used?

A

Lower of two values

71
Q

Who is an evidential blood specimin taken by?

A

Forensic physician with drivers consent

72
Q

How is blood specimin analyised?

A

Gas chromatography

73
Q

How much is deducted when analyising evidential blood specimens for lab error?

A

6mg %

74
Q

When must evidential urine sample be taken?

A

Within 1 hour of incident

75
Q

What must first be done when giving evidential urine sample?

A

Empty bladder, then collect next smallest volume which can be naturally voided

76
Q

How is evidential urine sample analyed?

A

Gas chromatographt

77
Q

What happnse if drivers fail to provide roadside screening breath sample, 2 evidential breath samples, blood or urine qhen required?

A

Constitutes an offence tantamount to D AND D

78
Q

wHAT DRUGS affect driving?

A

Opiates
Cannabis
Diazepam
Stimulatnts

79
Q

When is onset of alcohol withdrawal?

A

6-12 hours

80
Q

When does alcohol withdrawal peak?

A

48 hours

81
Q

How does alcohol affect GIT?

A
  1. oesophagitis, MW tears,
  2. Gastritis, duodenitis, peptic ulcers
  3. Malabsorption
  4. Diarrhoea
  5. Pancreatitis
82
Q

How does alcohol affect the liver?

A
  1. Fatty change
  2. Alcohol hepatitis
  3. Cirrhosis
  4. Liver failure: jaundice and clotting
  5. Portal hypertension and oesophageal varices
  6. Liver cancer
83
Q

How does alcohol affect the CVS ?

A

Arrythmias
Cardiomyopathy
Wet beri beri
Hypertension

84
Q

How does alcohol affect CNS?

A
  1. Wernickes encephalopathy (disorientation and eye problems)
  2. Korsakoffs syndrome (ST memory loss and confabulation)
  3. cerebellar degeneration
  4. cerebral atrophy (dementia)
  5. Alcoholic hallucinosis
  6. Peripheral neuropathy
85
Q

What vitamin deficincies does alcohol cause?

A

Thia,ine vit B group and folate

86
Q

Metabolic disturbances with alcohol?

A
  1. Hypoglycaemia
  2. Hyperlipidaemia
  3. Hyperuricaemia
  4. Potassium, magnesium, phosphate
  5. Lactic acidosis
87
Q

`Fatal alcohol level in non tolerant person/?

A

greater than 250mg

88
Q

fatal level in alcoholics?

A

450MG

89
Q

wHEN Might urinary alcohol concentration be greater than blood?

A

If death follows prolonged coma

90
Q

Why is artefactual elevation of alcohol a problem?

A

PM alcohol redistribution

PM microbial alcohol production

91
Q

What is difference between central vessels and peripheral femoral vein?

A

Less than 400% difference

92
Q

What favours PM microbial alcohol production?

A

Warmth, hyperglycaemia, septicaemia, abdo trauma

93
Q

Give rthree features seen in hypothermia?

A

Pink discolouration
Stomach wischnewski ulcers
Urinary catecholamines

94
Q

Can alcohol intoxicationw cause pneumonia?

A

Yes

95
Q

What kind of arrythmia might alcohol cause death by?

A

Prolonged QT

96
Q

wHAT ELECTROLYTET deficiency may cause death in alcoholics?

A

Magneisum

Forensic Medicine (13 decks)

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