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Psychiatry 🤓 > Alcohol Misuse > Flashcards

Alcohol Misuse Flashcards

1
Q

What are the main causes of alcohol-related mortality in the age group 16-34?

A
  • Accidents/trauma
  • Self Harm and Suicide
  • Alcohol intoxication (poisoning)

7-10% female deaths and 15-20% male deaths in this age group

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2
Q

What are the main causes of alcohol-related mortality in the age group 34-64?

A
  • Alcohol related liver disease

6-12% female deaths and 10-12% male deaths in this age group

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3
Q

What types of cancers are related to alcohol consumption in individuals aged 64 and older?

A
  • Breast
  • Oesophagus
  • Colon
  • Mouth
  • Upper aerodigestive tract

2-3% of deaths in this age group are alcohol related

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4
Q

What was the impact of the Minimum Unit Price for Alcohol in Scotland?

A
  • Decrease in alcohol consumption
  • Downward trend in Alcohol-Related Liver Disease, especially in lower income groups
  • Alcohol mortality fell by 10% in 2019

This indicates a positive effect on public health.

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5
Q

What are the low dosage effects of alcohol?

A
  • Euphoria
  • Reduced anxiety
  • Relaxation
  • Sociability
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6
Q

What are the high dosage effects of alcohol?

A
  • Intoxication
  • Impaired attention and judgement
  • Unsteadiness
  • Flushing
  • Nystagmus
  • Mood instability
  • Slurring
  • Unconsciousness
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7
Q

When does Delirium Tremens typically present after stopping alcohol?

A

48-72 hours

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8
Q

What are the symptoms of Delirium Tremens?

A
  • Profound confusion
  • Tremor
  • Seizures
  • Severe agitation
  • Hallucinations
  • Delusions
  • Sleeplessness
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9
Q

What does Thiamine (Vitamin B1) deficiency in alcoholism lead to?

A
  • Wernicke’s Encephalopathy
  • Korsakoff’s Psychosis

Wernicke’s is reversible but Korsakoff’s is irreversible

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10
Q

What are the characteristic symptoms of Wernicke’s Encephalopathy?

A
  • Confusion
  • Opthalmoplegia
  • Gait Ataxia
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11
Q

What are the symptoms of Korsakoff’s Psychosis?

A
  • Impairment of recent and remote memory
  • Confabulation
  • Impaired learning and disorientation
  • Personality changes
  • Psychosis
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12
Q

What is Acute Alcoholic Hepatitis?

A

Inflammation of the liver due to alcoholic consumption >8 units/day for a prolonged period of time

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13
Q

What is Alcoholic Ketoacidosis?

A

Build-up of ketones secondary to high numbers of free fatty acids due to increased lipolysis caused by alcohol

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14
Q

What leads to the pathophysiology of Alcoholic Ketoacidosis?

A
  • Increased lipolysis
  • Excess alcohol drives NADH+ production
  • Impaired hepatic gluconeogenesis
  • Thiamine deficiency can cause lactic acid build-up
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15
Q

What are the reasons for Thiamine deficiency in alcoholism?

A
  • Used as a cofactor in Krebs Cycle
  • Blocks duodenal uptake of thiamine
  • Interferes with thiamine storage and conversion
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16
Q

What are the stages of alcohol usage in diagnosis?

A
  • Acute Intoxication
  • Harmful Use
  • Dependence
  • Withdrawal State
  • Delirium Tremens

Each stage has specific criteria for diagnosis

17
Q

What are the symptoms of Acute Intoxication?

A
  • Intoxication
  • Impaired attention and judgement
  • Unsteadiness
  • Flushing
  • Nystagmus
  • Mood instability
  • Slurring
  • Unconsciousness
18
Q

What defines Harmful Use of alcohol?

A

Pattern of use causing damage to physical or mental health

19
Q

What criteria define Dependence on alcohol?

A
  • Cravings/compulsions
  • Difficulty controlling use
  • Primacy
  • Increased tolerance
  • Physiological withdrawal
  • Persistence despite harmful consequences
20
Q

What constitutes a Withdrawal State?

A
  • Tremor
  • Weakness
  • Nausea
  • Vomiting
  • Anxiety
  • Seizures
  • Confusion
  • Agitation
21
Q

What is the CAGE screening tool used for?

A

Identifying potential alcohol problems

2 or more ‘yes’ responses indicate likely alcohol problem

22
Q

What does the Glasgow Alcoholic Hepatitis Score (GAHS) indicate?

A

If GAHS ≥9, 30-day mortality without steroid is 48% and with is 22%

23
Q

What is the acid-base status in alcoholism?

A
  • pH is acidotic
  • Low bicarbonate (metabolic acidosis)
  • Breathing off CO2 to compensate
24
Q

What are the LFT findings in Alcoholic Hepatitis?

A
  • Raised MCV
  • AST/ALT ratio reversed (AST:ALT >2)
  • Markedly High GGT
  • Elevated bilirubin
25
Q

What is the first-line treatment for alcohol withdrawal?

A

High dose Benzodiazepines (e.g., chlordiazepoxide)

26
Q

What medication is used to prevent Wernicke-Korsakoff Syndrome?

A

IV Vitamin B1 Thiamine (Pabrinex)

27
Q

What is Disulfiram (Antabuse) used for?

A

Aversion medication for chronic alcoholism by causing hangover effects upon drinking

28
Q

What are some anti-craving medications for chronic alcoholism?

A
  • Acamprosate
  • Naltrexone
  • Nalmefene
  • Baclofen

Psychiatry 🤓 (28 decks)

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