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Preventative Medicine > Alcohol Abuse > Flashcards

Alcohol Abuse Flashcards

1
Q

Intoxicating ingredient found in wine, bear, and distilled spirits?

A

Ethyl alcohol

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2
Q

Structure of ethyl alcohol

A

CH3CH2OH - 2 Carbon w/ a single OH

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3
Q

How is ethyl alcohol produced?

A

fermentation of carbohydrate by microorganisms (yeast)

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4
Q

solubility of ethanol?

A

fully water soluble and somewhat lipid soluble

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5
Q

How does ethanol cross membranes?

A

diffusion

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6
Q

What is the rate of alcohol absorption influenced by?

A

presence of food or water, absorbed faster on a empty stomach

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7
Q

That which is not absorbed from the stomach is absorbed where?

A

in the upper small intestine

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8
Q

How is ethanol excreted?

A

5% in urine, expired in air and lost in sweat

95% oxidized to acetaldehyde by the liver

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9
Q

T/F Ethanol oxidation by the liver is obligatory?

A

True

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10
Q

If ethanol is taken with a high fat meal what gets precedence in the liver for breakdown?

A

alcohol

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11
Q

Where is ethanol largely absorbed?

A

stomach

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12
Q

ethanol to acetaldehyde is what type of reaction?

A

rate limiting step (slow)

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13
Q

What two major pathways are involved in ethanol metabolism?

A

Alcohol dehydrogenase system (ADH)

Microsomal Ethanol Oxidizing system (MEOS)

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14
Q

What can be used to measure the amount of ingested alcohol?

A

Breathaloizer

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15
Q

Ethanol oxidation by the liver is ….???

A

obligatory

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16
Q

What is the problem with a fatty liver?

A

can’t clear out other molecules which causes them to get deposited in tissues

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17
Q

What does ethanol do to other drugs clearance?

A

speeds up their clearance rate, so have to use higher doses

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18
Q

Where does ADH occur?

A

in cytosol

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19
Q

Where does MEOS occur?

A

in microsomes

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20
Q

MOA of ADH enzyme?

A

oxidizes ethanol to acetalydehyde

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21
Q

When is ADH active?

A

at low ethanol concentrations

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22
Q

T/F MEOS is inducible?

A

True

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23
Q

When does MEOS come out to play?

A

@ blood alcohol concentration >10mg/dl

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24
Q

If you DON’T consume alot of alcohol what pathway are you likely to use?

A

Alcohol dehydrogenase system (ADH)

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25
Q

If you consume alot of alcohol what pathway are you likely to use?

A

Microsomal Ethanol Oxidizing System (MEOS)

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26
Q

Ethanol metabolized by MEOS can do what to other drugs?

A

alter the rate of drug clearance, which increases the chances for over and underdosing

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27
Q

When is MEOS active?

A

high alcohol levels

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28
Q

Tolerance can occur in what pathway?

A

MEOS

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29
Q

What is MEOS?

A

Microsomal Ethanol Oxidizing System

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30
Q

What is responsible for the metabolism of all drugs?

A

MEOS

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31
Q

How does a alcoholic build up tolerance?

A

because the MEOS is constantly be induced

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32
Q

What disruptions are seen in the liver

A

decreased rate of beta oxidation
decrease in protein synthesis
increased synthesis of fatty acids from acetyl CoA
Increased rate of synthesis of alpha glycerol phosphate and formation of triglycerides

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33
Q

What causes the initial accumulation of fatty acids?

A

decreased beta oxidation

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34
Q

What further causes a accumulation of fatty acids?

A

acetyl CoA

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35
Q

What is considered early stage of liver degeneration

A

fatty liver

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36
Q

What can fatty streaking progress too

A

alcohol hepatitis and cirrhosis

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37
Q

Moderate alcohol intake does what to appetite?

A

stimulates it (increased food intake)

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38
Q

Why isn’t alcohol a nutrient?

A

added energy 7 kal/gram, contributes to body fat stores

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39
Q

What contributes to obesity

A

moderate alcohol consumption

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40
Q

What is one thing we can eliminate from the diet?

A

alcohol

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41
Q

What is a major cause of alcohol abuse?

A

chronic ETOH abuse

42
Q

What are the 3 reasons for malnutrient due to alcohol?

A
  • excessive consumption suppresses appetite
  • alcohol interferes w/ the body’s ability to absorb and utilize nutrients
  • nutrient content of the diet is often poor
43
Q

Proportional to anorexia

A

degree of alcohol abuse

44
Q

The faster you drink alcohol

A

the higher the blood concentrations go

45
Q

since alcohol depresses appetite it can cause..

A

anorexia

46
Q

What abnormalities is seen in mucosal cells?

A
  • decreased production of mucosal enzymes

- impaired transport of nutrients (facilitated diffusion, active transport)

47
Q

What is the toxic effect and DANGEROUS problem of alcohol

A

can cause fatty liver

48
Q

What vitamins and minerals are effected by ethanol?

A 
folate
thaimin
B12
Ca
Mg
Vitamins A,D,E,K
49
Q

ETOH effect on pancreas

A

decreases protein synthesis, reduces production of pancreatic enzymes (risk for pancreatitis)

50
Q

ETOH effect on muscle

A

inhibits glucose uptake and glycogen synthesis (DM)

51
Q

What leads to hematologic problems?

A

folate deficiency

52
Q

What deficiency is common

A

folate

53
Q

What general symptoms may be linked to nutrient deficiencies seen in alcohol

A

immune suppression
cardiac myopathies
respiratory disorders

54
Q

What 4 neurological problems are seen

A
  • Wernickes encephalopahty
  • Korsakoff psychosis
  • Peripheral neuropathy
  • Pellagrous psychosis
55
Q

Severe form of thiamin deficiency

A

Wernicke encephalopathy

56
Q

Txt for Wernicke?

A

withdrawal, thiamin therapy and general nutrition

57
Q

Symptoms of Wernicke

A 
visual disorder
short term memory issue
confusion
ataxia
coma
58
Q

Chronic degenerative problem arising from Wernicke

A

Korsakoff psychosis

59
Q

Korsaoff psychosis causes what

A

very poor short term memory or recollection

60
Q

Degeneration of peripheral nerve function due to thiamin or vitamin B6 deficiency

A

peripheral neuropathy

61
Q

What causes peripheral neuropathy

A

deficiency of thiamin and vitamin B6

62
Q

Chronic niacin deficiency

A

pellagrous psychosis

63
Q

Three forms of alcoholic liver disease

A
  • fatty liver (steatosis)
  • Alcoholic hepatitis
  • Cirrhosis
64
Q

Steatosis

A

fatty liver

65
Q

Seen in 80% of all cases of chronic alcohol abuse

A

steatosis

66
Q

one night of heavy drinking can cause what?

A

fatty streaks

67
Q

5 symptoms of fatty liver:

A 
Malaise
Anorexia
Vomiting
Weakness
Enlarged and tender liver
68
Q

In severe steatosis what 3 things are seen?

A

portal hypertension
fluid retention
bleeding varices

69
Q

What is the txt for fatty liver?

A

bed rest, alcohol withdrawal and proper nutrition

70
Q

what is seen on labs in steatosis

A

increased serum globulin and transaminases

decreased albumin

71
Q

Why is binge drinking so bad?

A

one day can take days to weeks to reverse these changes

72
Q

T/F alcoholic hepatitis is less common than fatty liver

A

TRUE

73
Q

Occurs in 30% of all cases of chronic alcohol abuse

A

alcoholic hepatitis

74
Q

Occurs independent from fatty liver after a bout of heavy drinking

A

alcoholic hepatits

75
Q

Symptoms of alcoholic hepatitis

A

fatigue
weakness
fever
hepatomegaly

76
Q

What happens to hepatocytes during inflammation and hyaline degeneration

A

necrosis

77
Q

What does laboratory test show in alcoholic hepatitis

A

increased transaminases, glutamate dehydrogenase, PT

78
Q

FATAL disease

A

alcoholic hepatitis

79
Q

progress to chronic liver disease and alcoholic cirrhosis

A

alcoholic hepatitis

80
Q

end stage liver disease that results in hepatocyte destruction

A

Cirrhosis

81
Q

What are some other causes of cirrhosis besides ETOH?

A

Viral hepatitis ( Hep C)
Metabolic disease
Vascular disorders

82
Q

Destruction of hepatocytes resulting from chronic abuse of alcohol?

A

cirrhosis

83
Q

10% of alcohol abusers who consume 160 g per day for 10 years or more

A

cirrhosis

84
Q

results in fibrosis and formation of hepatocyte nodules within the liver

A

cirrhosis

85
Q

what percent of pts will develop hepatoma

A

10%

86
Q

In 1988 alcohol was declared a…

A

CARCINOGENIC

87
Q

There is a causal dose dependent relationship between alcohol and ….

A

head and neck cancers

88
Q

There is a SIGNIFICANT link between alcohol….

A

and pancreatic cancer

89
Q

T/F light drinking is associated with increased risk for head, neck, and breast cancer

A

TRUE

90
Q

What provides a synergistic and increased risk of head and neck cancers

A

smoking, drinking, bad diet (fruits and veges)

91
Q

What is the safest level of alcohol consumption?

A

NONE

92
Q

consumption of what amount might be CARDIOPROTECTIVE

A

< 1 drink per day

93
Q

T/F “If you choose to drink do so in moderation”

A

TRUE

94
Q

How many drinks should a woman consume?

A

1 a day

95
Q

How many drinks should a man consume?

A

up to 2 a day

96
Q

T/F higher the proof value the less it takes to consume

A

TRUE

97
Q

What is binge drinking

A

> 5 drinks (men) or >4 (women) on one occasion

98
Q

What is heavy drinking

A

> 15 more per wk (men) or >8 (women)

99
Q

Which age group has the greatest amount of binge drinkers?

A

25-34 yr ( 18-24)

100
Q

Where is binge drinking mostly seen on the map?

A

above the Manson Dixon line (north central region)

101
Q

What states have the highest or lowest intensity of binge drinking?

A

West Virginia- highest

D.C.- lowest

Preventative Medicine (7 decks)

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