Alcohol Flashcards
Effects of alcohol on men:
Impotence
Retarded ejaculation
Premature ejaculation
Effects of alcohol on women:
Vaginal dryness
Inability to orgasm
Definition of alcohol dependence:
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
What type of anaemia is brought about by alcoholism?
Chronic microcytic anaemia
Gastric symptoms of alcoholism?
Haematemesis Pancreatitis Gastritis and peptic ulcer Oesophagitis and oesophageal varices Melaena
Neurological symptoms of alcoholism?
Peripheral neuritis
Head injuries
Epileptic seizures
Delirium tremens
Cardiovascular symptoms of alcoholism?
Hypertension due to atherosclerosis
Psychological symptoms of alcoholism?
Anxiety Depressive illness and suicide Korsakoff's psychosis Alcohol dementia Paranoia Othello's syndrome Alcoholic hallucinations
Reversible effects of chronic alcoholism on the liver:
Fat accumulation
Alcoholic hepatitis
Irreversible effect of chronic alcoholism on the liver:
Cirrhosis
Alcoholic presentation with N+V, abnormal digestion and severe pain?
Pancreatitis
Neoplasia and alcoholics:
10x risk
Throat, larynx, pharynx, oesophagus, upper stomach, liver and pancreas
Foetal features of foetal alcohol syndrome:
Small heads
Abnormal facies
Heart defects
Mentally impaired
Alcohol related neurodevelopment disorders:
Learning and behavioural problems
More likely to have substance abuse problems as adults
Clinical presentation of Wernicke’s encephalopathy (thiamine deficiency):
Confusion Ataxia Dysarthria (speech difficulty) Occulomotor abnormalities Tachycardia Orthostatic hypotension Hypothermia
Korsakoff’s psychosis:
Emerges as Wernicke’s delirium subsides
Loss of memory of recent events
Disorientation/confusion
Confabulation
What causes hepatic encephalopathy?
Accumulation of nitrogenous waste products
May be precipitated by many factors e.g. sepsis
Stages of hepatic encephalopathy:
I = General apathy II = Lethargy, drowsiness, variable orientation, asterixis III = Stupor with hyperreflexia, extensor plantar reflexes IV = Coma
Symptoms of hepatic encephalopathy:
Anorexia
Weight loss
GI upset
Fever
Signs of hepatic encephalopathy:
Hepatosplenomegaly Leukocytosis (raised WCC) AST elevated (<300), ALT elevated (<150)
Alcohol is an…
Immunosuppressant
What causes alcoholic ketoacidosis?
Acute cessation of 2nd degree intake (/starvation and dehydration)
Ketone formation
Tremor/dizziness, altered mental status and SOB
Alcohol excess causes…
Reduced electrolytes
Hypoglycaemia can cause…
Seizures
Hypomagnesaemia can cause…
Confusion, seizures, psychoses, tremor
Hypocalcaemia can cause…
Seizures
Hypokalaemia can cause…
Weakness
ER management of alcoholic?
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
Discharge of alcoholic presentation to ER?
Home on thiamine, folic acid, ascorbic acid, Via-B complex forte
Alcohol dependency drugs:
Acamprostae calcium - reduces withdrawal and craving
Disulfiram - unpleasant reaction to alcohol ingestion
Nalmefen - reduces urge to drink but not intoxication
