Alcohol disease and withdrawal

Question 1

At what time frame does withdrawal from mild dependence occur?

Answer 1

12 to 36 hours

Question 2

What are the symptoms of withdrawal from mild dependance?

Answer 2

Fine tremors, sweating, anxiety, hyperactivity, tachycardia, hypertension, nausea and retching

Question 3

What is the time frame of withdrawal from moderate alcohol dependence?

Answer 3

12 hours to 5 days

Question 4

What are the symptoms of withdrawal from moderate dependence?

Answer 4

Coarse tremors, shaking, agitation, confusion, disorientation, paranoia, seizures and hallucinations

Question 5

When are seizures from alcohol withdrawal worse?

Answer 5

24-48 hours since the last alcoholic drink

Question 6

What is the time frame of withdrawal from severe alcohol dependence?

Answer 6

12 hours to 7 days

Question 7

What are the symptoms of withdrawal from severe dependence?

Answer 7

Severe agitation, anxiety, confusion, delusions, tactile visual hallucinations

Question 8

When is the risk of DTs?

Answer 8

Usually around 48 hours post last drink

Question 9

What is the normal pattern of a seizure by alcohol withdrawal?

Answer 9

Tonic clonic

Question 10

What dangerous condition can tonic clonic seizures from alcohol withdrawal develop into?

Answer 10

Status epilepticus

Question 11

Glove and stocking refers to what conditon

Answer 11

Sensorimotor axonal polyneuropathy

Question 12

What is saturday night palsy?

Answer 12

Compression neuropathy is the temporary damage to the myelin sheath

Question 13

Where is the common site for compression neuropathy?

Answer 13

Radial nerve at the humeral head

Question 14

What is the ck in acute myopathy (after a binge)?

Answer 14

Raised

Question 15

What happen in blood results for chronic myopathy due to alcohol?

Answer 15

Normal ck
Low K
Low PO4

Question 16

What causes Wernickes encephalopathy?

Answer 16

Thiamine deficiency

Cytotoxic oedema in mamillary bodies

Question 17

What 3 symptoms are most associated with Wernickes encephalopathy?

Answer 17

Lateral nystagmus progressing to complete opthalmoparesis
Ataxic gait
Acute confusion

Question 18

What is the treatment of Wernickes encephalopathy?

Answer 18

Thiamine replacement

Banana bag/rally pack

Question 19

What cause korsakoff syndrome?

Answer 19

Cerebral atrophy resulting from Wernickes encephalopathy

Question 20

What 3 symptoms are most associated with korsakoff syndrome?

Answer 20

Anterograde amnesia
Retrograde amnesia
Confabulation

Question 21

What is the suspected amount of alcohol over what time frame to cause dilated cardiomyopathy?

Answer 21

8-9 units daily for 5+ years

Question 22

How does alcohol cause dilated cardiomyopathy?

Answer 22

Alcohol impairs the ventricular function which leads to chronic inflammation and fibrosis of myofibrils

Question 23

What type of arrhythmia is holiday heart?

Answer 23

SVT

Question 24

What ECG change can be seem most commonly in chronic alcoholics?

Answer 24

Long QT

Question 25

What does dilated cardiomyopathy predispose to?

Answer 25

Atrial and ventricular arrhythmias

Question 26

After how many units does the chance of cirrhosis massively increase?

Answer 26

30 units weekly

Question 27

How does regular drinking lead to cirrhosis?

Answer 27

Alcohol causes fat accumulation in hepatocytes
Increased fat leads to inflammation
Inflammation leads to fibrosis
Progressive fibrosis leads to cirrhosis

Question 28

Which 3 things are cirrhotic patients at a high risk for?

Answer 28

Renal failure
Bleeding
Infection

Question 29

What is the cause of portal hypertension?

Answer 29

The architectural changes in the liver cause the blood to back up applying pressure

Question 30

1.5u/d increases the risk of
Breast cancer by?
Pharyngeal cancer by?
Oesophageal cancer by?

Answer 30

5% breast cancer
17% pharyngeal cancer
30% oesophageal cancer