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Mental health/ psychiatry matrix > Alcohol abuse/ dependence 1A > Flashcards

Alcohol abuse/ dependence 1A Flashcards

1
Q

Define hazardous drinking?

A

This is consumption of alcohol that increases risk of harm. This is the stage before harmful drinking

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2
Q

What is harmful drinking?

A

this is drinking that adversely affects physical or mental health

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3
Q

What is dependence?

A

this is the prolonged and compulsive use of a substance leading to addiction, tolerance and the potential for withdrawal symptoms. The metrics for dependence include the following; - Tolerance, - withdrawal (physical = hand tremors, nausea, sweating, visual hallucination and seizures) (psychological symptoms= irritability, anxiety, depression, restlessness, - desire, - time, - activities

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4
Q

What are the physical presentations of alcohol abuse on the liver?

A

ascites, fatty liver disease, cirrhosis and liver failure

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5
Q

What are the GI symptoms presented in alcohol abuse?

A

diarrhoea, vomiting, varices (hematemesis / melena), oesophageal erosions, pancreatitis, Gi cancer

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6
Q

What are neurological symptoms presented in alcohol abuse?

A

memory & cognitive impairment, peripheral neuropathy, seizures, falls, wernickes encephalopathy & korasakoff

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7
Q

What are the psychological symptoms that present in alcohol abuse?

A

psychosis, morbid jealousy e.g. delusions that their partner is unfaithful, alcoholic hallucination (auditory in chronic alcoholism and visual or tactile in withdrawal states)

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8
Q

What are the cardiovascular symptoms seen in alcohol abuse?

A

arrhythmia, HTN, cardiomyopathy

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9
Q

What are the other presentations seen in alcohol abuse?

A

anaemia (macrocytic), osteoporosis, reduced fertility, breast Ca, accident and social problems

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10
Q

What is the initial identification tool used in investigating alcohol abuse?

A

CAGE tool

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11
Q

What are the further assessment tools used in alcohol abuse?

A

AUDIT, SADQ, APQ

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12
Q

What investigation can be carried out if health problems are suspected?

A

FBC (macrocytic anaemia, LFT (raised GGT, really raised AST, raised ALT)

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13
Q

What should be offered to diagnose cirrhosis in persistent heavy drinkers?

A

transient elastography (fibroscan)

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14
Q

What medications are given in the management of alcohol abuse?

A

benzodiazepine (chloradiazepoxide/diazepam), thiamine (to prevent neurological complications)

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15
Q

What medication can be given to prevent relapse after withdrawal?

A

acamprosate or naltrexone

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16
Q

What is an important social issue to consider in patients with alcohol abuse?

A

safeguarding issues e.g. child neglect or domestic abuse

17
Q

What are the signs of alcohol withdrawal?

A

seizures, hallucinations and delirium tremens

18
Q

Typically how long after last drink do patients experience signs and symptoms of alcohol withdrawal?

A

6-24hrs

19
Q

What are the physical signs of alcohol withdrawal?

A

tremor, sweats and nausea

20
Q

What are the psychological symptoms of alcohol withdrawal?

A

insomnia, altered mood, alcohol hallucinosis

21
Q

What type of seizures is associated with alcohol withdrawal and how long does after last drink does it typically occur?

A

generalised tonic -clonic seizures and 12-48hrs after last drink

22
Q

What type of visual hallucinations do people with alcohol withdrawal experience?

A

lilliputan hallucinations where things and people seem smaller

23
Q

Do people with alcohol hallucinisos due to alcohol withdrawal experience tactile hallucinations?

A

yes, e.g. formication where they feel insects crawling on and under the skin

24
Q

What is the timeline for delirium tremens?

A

3-7 days after last drink

25
Q

What is experienced in delirium tremens?

A

delirium, confusion, tremor and seizures, increased HR and low BP

26
Q

What is the management of alcohol withdrawal?

A

ABC(airway, breathing, circulation), monitor symptoms with CIWA-AR assessment scale, benzodiazepines PO for sedation and seizure and nutritional support (thiamine, folate, and electrolyte correction i.e. glucose, K+, Mg and Po

27
Q

What is the name of the neurological syndromes caused by thiamine deficiency (B1)?

A

Wernickes encephalopathy and Korsakoff

28
Q

How does alcohol misuse result in reduced thiamine intake?

A

from poor nutrition and impaired GI absorptions

29
Q

What is wernickes encephalopathy?

A

this is an acute presentation of thimine deficiency which can be sometimes mistaken for intoxication

30
Q

What is the triad of wernickes encephalopathy?

A

COG(confusion, opthalmoplegia: nystagmus and LR6 palsy and Gait: ataxia with wide gait)

31
Q

What is korsakoff syndrome?

A

this is the chronic manifestation of thiamine deficiency

32
Q

What are classic symptoms observed in korsakoff syndrome?

A

anterograde amnesia, retrograde amnesia and confabulation to fill in memory gaps

Mental health/ psychiatry matrix (1 decks)

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