Alcohol

Question 1

Effects of alcohol on men:

Answer 1

Impotence
Retarded ejaculation
Premature ejaculation

Question 2

Effects of alcohol on women:

Answer 2

Vaginal dryness

Inability to orgasm

Question 3

Definition of alcohol dependence:

Answer 3

Noticeable mental, marital, bodily, interpersonal, social or economic functioning disturbance as a result of dependence
Or people who show prodromal signs of such a development

Question 4

What type of anaemia is brought about by alcoholism?

Answer 4

Chronic microcytic anaemia

Question 5

Gastric symptoms of alcoholism?

Answer 5

Haematemesis
Pancreatitis
Gastritis and peptic ulcer
Oesophagitis and oesophageal varices
Melaena

Question 6

Neurological symptoms of alcoholism?

Answer 6

Peripheral neuritis
Head injuries
Epileptic seizures
Delirium tremens

Question 7

Cardiovascular symptoms of alcoholism?

Answer 7

Hypertension due to atherosclerosis

Question 8

Psychological symptoms of alcoholism?

Answer 8

Anxiety
Depressive illness and suicide
Korsakoff's psychosis
Alcohol dementia
Paranoia
Othello's syndrome
Alcoholic hallucinations

Question 9

Reversible effects of chronic alcoholism on the liver:

Answer 9

Fat accumulation

Alcoholic hepatitis

Question 10

Irreversible effect of chronic alcoholism on the liver:

Answer 10

Cirrhosis

Question 11

Alcoholic presentation with N+V, abnormal digestion and severe pain?

Answer 11

Pancreatitis

Question 12

Neoplasia and alcoholics:

Answer 12

10x risk

Throat, larynx, pharynx, oesophagus, upper stomach, liver and pancreas

Question 13

Foetal features of foetal alcohol syndrome:

Answer 13

Small heads
Abnormal facies
Heart defects
Mentally impaired

Question 14

Alcohol related neurodevelopment disorders:

Answer 14

Learning and behavioural problems

More likely to have substance abuse problems as adults

Question 15

Clinical presentation of Wernicke’s encephalopathy (thiamine deficiency):

Answer 15

Confusion
Ataxia
Dysarthria (speech difficulty)
Occulomotor abnormalities
Tachycardia
Orthostatic hypotension
Hypothermia

Question 16

Korsakoff’s psychosis:

Answer 16

Emerges as Wernicke’s delirium subsides
Loss of memory of recent events
Disorientation/confusion
Confabulation

Question 17

What causes hepatic encephalopathy?

Answer 17

Accumulation of nitrogenous waste products

May be precipitated by many factors e.g. sepsis

Question 18

Stages of hepatic encephalopathy:

Answer 18

I = General apathy
II = Lethargy, drowsiness, variable orientation, asterixis
III = Stupor with hyperreflexia, extensor plantar reflexes
IV = Coma

Question 19

Symptoms of hepatic encephalopathy:

Answer 19

Anorexia
Weight loss
GI upset
Fever

Question 20

Signs of hepatic encephalopathy:

Answer 20

Hepatosplenomegaly
Leukocytosis (raised WCC)
AST elevated (<300), ALT elevated (<150)

Question 21

Alcohol is an…

Answer 21

Immunosuppressant

Question 22

What causes alcoholic ketoacidosis?

Answer 22

Acute cessation of 2nd degree intake (/starvation and dehydration)
Ketone formation
Tremor/dizziness, altered mental status and SOB

Question 23

Alcohol excess causes…

Answer 23

Reduced electrolytes

Question 24

Hypoglycaemia can cause…

Answer 24

Seizures

Question 25

Hypomagnesaemia can cause…

Answer 25

Confusion, seizures, psychoses, tremor

Question 26

Hypocalcaemia can cause…

Answer 26

Seizures

Question 27

Hypokalaemia can cause…

Answer 27

Weakness

Question 28

ER management of alcoholic?

Answer 28

IV fluids
Pabrinex 1+2 over next 20 minutes
Diazepam/chlorodazepoxide if withdrawing (Benzo if vomiting)
If GCS still <14/not improving at 2 hours then CT scan

Question 29

Discharge of alcoholic presentation to ER?

Answer 29

Home on thiamine, folic acid, ascorbic acid, Via-B complex forte

Question 30

Alcohol dependency drugs:

Answer 30

Acamprostae calcium - reduces withdrawal and craving
Disulfiram - unpleasant reaction to alcohol ingestion
Nalmefen - reduces urge to drink but not intoxication