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BDS3 OSCE > Alcohol advice > Flashcards

Alcohol advice Flashcards

1
Q

How is alcohol metabolised

A

in the liver

acetaldehyde –> acetate –> water

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2
Q

What is the effect of alcohol intoxication

A

Mild sedative
Mild anaesthetic
Stimulates dopamine and serotonin

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3
Q

What is the safe limit of alcohol

A

14 units

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4
Q

Over how many days should drinking be spread

A

3 +

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5
Q

What does the risk of developing health problems increase with

A

the more you drink regularly

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6
Q

What are oral problems in chronic drinkers

A 
Oral cancer (concurrent tobaco use)
Oral ulceration 
Dental neglect
Dental trauma (falls)
Lost dentures
Dental erosion
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7
Q

What does (alcoholic) liver disease result in

A

Reduced synthesis of clotting factors in damaged liver
Combined with reduced absorption of vitamin K and hence effecting vitamin K clotting factors
Thromboytopenia (splenomegaly)
Fewer platelets
Platelet aggregation reduced

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8
Q

What analgesic should be prescribed with caution with heavy drinkers

A

aspirin/NSAIDs

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9
Q

Why must we be cautious on giving NSAIDs to heavy drinkers

A

Both gastric irritant, both have effect on bleeding

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10
Q

What are the 3 types of drinking

A

hazardous drinking
harmful drinkings
dependent drinking alcohol

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11
Q

What is hazardous drinking

A

risks for problems are likely

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12
Q

What is harmful drinking

A

problems associated with alcohol are actually present

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13
Q

What types of drinking are amenable to brief intervenetion

A

hazardous + harmful drinking

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14
Q

What is dependent drinking

A

drink needed to function

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15
Q

What alcohol screening tools are there

A

FAST
AUDIT
PAT

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16
Q

What is the gold standard screening tool

A

AUDIT

17
Q

What sort of questions does AUDIT ask

A 
How often
How many units
How many units on a single occasion
Guilt for drinking?
Injured someone because of drinking?
Anyone concerned about your drinking?
And a few more but these are easiest to remember
18
Q

What is a patients readiness to change

A

What change are they considering
How important is the change
How confident are you that you can make the change

19
Q

What is the cycle of change

A 
precontemplative
contemplative
preparation
action
maintenance
relapse
20
Q

What is precontemplation

A

dont see a problem

21
Q

What is contemplation

A

Sees the problem, but says things like ‘i enjoy drinking though’

22
Q

What is preparation

A

Discussing possibility of cutting down in the future

23
Q

What is action

A

Cutting down right now

24
Q

What is maintenance

A

Keeping it going

25
Q

What is the framework for brief intervention

A 
feedback
responsibility
advice
menu of options
empathic
self efficacy
26
Q

What is feedback

A

give feedback to the px on their behaviour

27
Q

What is responsibility

A

change is placed on the patient

28
Q

What is advice

A

advise them to change

tell them about benefits of quitting

29
Q

What is meant by menu of options

A

giving the patient a menu of options to self direct change

can offer treatment if required e.g counselling / signposting

30
Q

What are simple tips for cutting down on alcohol consumption

A 
make a plan (set a limit)
set a budget (take only a specific amount out with you)
let your family and friends know 
buy smaller sizes of drinks
have lower strength drinks
alternate water and alcohol 
have several drink free days a week
31
Q

What is meant by empathic style

A

be warm, respectful and understanding

32
Q

What is meant by self efficacy

A

empower patient that you believe they can make this change

33
Q

Feedback example

A

How often do you drink? What type of drinks? How many drinks do you have? This is when to use screening tools. Sum up what patient has said and give them feedback in relation to drinking guidance. Ask patient how they feel about that?

34
Q

Responsibility example

A

Ask patient about if they would like to change? How motivated are they? How ready are they? What is going on in their life that is preventing them from changing? Are they unaware? Are they stressed? Can they get through the day without a drink (addicted?)?

35
Q

Advice example

A

Two way conversation. Advice on benefits of cutting down. What benefits would the patient reap from quitting? Less hangovers, better health, saving money

36
Q

Menu of options example

A

NHS has alcohol addiction services, if underlying factors e.g stress or financial burdens than signpost. If only slightly over, could recommend use of non-alcoholic substitutes.

37
Q

Empathy example

A

show empathy to patients circumstances, try not to be judgemental

38
Q

Self efficacy example

A

tell them you believe they can change, have they ever made changes in other aspects in their life?

BDS3 OSCE (65 decks)

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