Alcohol Diagnosis and Treatment Flashcards

1
Q

What are the low dose effects of alcohol?

A

Euphoria, decreased anxiety, relaxation, sociability

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2
Q

What are the high dose effects of alcohol?

A

Intoxication, impaired attention and judgement, unsteadiness, flushing, nystagmus, mood instability,
disinhibition, slurring, stupor, unconsciousness

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3
Q

What are the main aspects of diagnosis?

A

Acute intoxication
Harmful use
Dependence
Withdrawal

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4
Q

What constitutes harmful use of alcohol?

A
  • Pattern of use causing damage to physical/mental health

- Use >1 month or repeatedly over 12 months

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5
Q

What constitutes dependence on alcohol?

A
  • Difficulty controlling use
  • Increased tolerance
  • Primacy (drinking in the morning)
  • Cravings/compulsions
  • Physiological withdrawal on reduction/cessation
  • Persistence despite harmful consequences
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6
Q

How many and how long must you have these symptoms to be considered dependent?

A

3 or more of the following for >1 month or repeatedly over 12 months

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7
Q

What are withdrawal symptoms?

A
Tremor
Anxiety, Agitation 
Nausea, Vomiting 
Weakness 
Confusion 
Seizures
Death
Delirium tremens
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8
Q

What is delirium tremens?

A
  • Profound confusion
  • Autonomic overactivity (e.g. sweating, palpitations, etc)
  • CV collapse
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9
Q

What are the mental health complications of alcohol abuse?

A

Anxiety, depression, sleep disruption, morbid jealousy, alcoholic hallucinosis, deliberate self injury, suicidal thoughts/acts

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10
Q

What are the physical health complications of alcohol abuse?

A

Brain damage, poor control of DM, loss of muscle, ventricular hypertrophy, GI problems, liver problems, pancreatitis, impotence/infertility, RTI, paraesthesia.

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11
Q

What is the triad for Wernicke’s encephalopathy?

A
  • Confusion
  • Ataxia
  • Opthalmoplegia/Nystagmus
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12
Q

What is Korsakoff’s psychosis?

A
  • Significant impairment of recent and remote memory in an otherwise alert person
  • Can’t remember past information, can’t make new memories
  • Impaired learning and disorientation
  • May exhibit nystagmus and ataxia
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13
Q

What is Wernicke-Korsakoff syndrome?

A

not for exam, just to understand:

Wernicke’s encephalopathy and Korsakoff’s psychosis are both caused by thiamine deficiency, whcih you get in alcohol dependence cos they don’t eat anything. So you get both at the same time.

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14
Q

Why do you get thiamine deficiency in alcohol dependence?

A

Poor intake and absorption

Poor hepatic function Increased requirement for alcohol metabolism

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15
Q

Impact of alcohol dependence on relationships?

A

Aggression
Marital difficulties
Poor parenting/neglect +/- loss of parenting rights
Loss of friendships and social support

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16
Q

What are the screening questions for alcohol dependence?

A
CAGE 
AUDIT 
FAST 
PAT
TWEAK
17
Q

What does CAGE stand for?

A

Cut down?
Annoyed by people criticising?
Guilty about drinking?
Eye-opener?

18
Q

What does AUDIT stand for?

A

Alcohol use disorders identification test

19
Q

Which screening test can you use for pregnant women?

A

TWEAK

20
Q

What is the treatment for alcohol dependence?

A
  • Lifestyle: Practical advice, education, harm reduction
  • Social support: Holistic/biopsychosocial approach
  • Medication
21
Q

What can be done in the holistic/biopsychosocial approach?

A
  • Patient and family
  • Psych help
  • Social work input
  • Skills training
  • Community support eg AA
  • Inpatient or residential treatment
22
Q

What medications can be given for alcohol dependence?

A

Thiamine
BZDs (withdrawal)
Disulfiram (aversion, nausea on ingesting alcohol)
Anti-craving medication

23
Q

What are anti-craving medications for alcohol?

A

Acamprostrate
Naltrexone
Nalmefene
Baclofen

24
Q

What types of liver disease can be reversed by abstinence?

A

Hepatic steatosis

Alcoholic hepatitis