Alcohol Related

Question 0

Define alcohol dependence. (1)

Answer 0

Physical dependance on or addiction to alcohol.

Key feature is lack of control over use, indicated by compulsive need to drink and inability to cut down.

Question 1

Which drug is the leading cause of preventable hypertension and increases risk of MI and stroke? (1)

Answer 1

Alcohol

Question 2

What are the weekly alcohol limits for men and women? (2)

Answer 2

Men: 21 units
Women: 14 units

Question 3

How are alcohol units calculated? (1)

Give 2 examples of 1 unit of alcohol. (2)

Answer 3

Volume (L) x % alcohol = Units

1 measure of spirits, 125ml of wine, half pint standard strength beer

Question 5

Name 2 blood tests that are useful for screening for high alcohol usage. (2)

Answer 5

Raised serum gamma-GT (glutamyl transpeptidase)
Raised MCV
Blood and urine alcohol levels also used sometimes.

Question 6

What are the physical consequences chronic alcohol use? (2)

Answer 6

• CV: direct alcohol toxicity causes cardiomyopathy and arrhythmias
• Neuro: acute- ataxia, falls and head injury - subdural
  chronic- polyneuropathy, myopathy, cerebellar degeneration, dementia, epilepsy, WE, Korsakoff’s
• GI: liver damage, acute and chronic pancreatitis, oesophagitis, increased risk of oesophageal carcinoma
• Haem: thrombocytopenia, raised MCV, folate deficiency anaemia
• Psych: depression, DSH, attempted suicide
• Social: homelessness, marital difficulties, unemployment, financial difficulties.

Question 7

What is Wernicke’s encephalopathy? (2)

What are the symptoms? (3)

Answer 7

Deficiency of vitamin B1 (thiamine)

Classic triad is confusion, ataxia and opthalmoplegia; other symptoms include drowsiness and coma.

Question 8

How is Wernicke’s encephalopathy diagnosed? (1)
What is the long term complication? (1)
What is the management of WE? (2)

Answer 8

Clinical diagnosis
Korsakoff’s syndrome
2 pairs of Pabrinex ampoules, TDS for 3 days then 1 pair OD for 5 days.

Question 9

What are the 2 classical symptoms of Korsakoff’s syndrome? (2)

Answer 9

Gross defect of short term memory

Confabulation

Question 10

Hector is a known alcoholic and has been admitted following an attempt at going “cold turkey”.
What symptoms might he have experienced? (4)

Answer 10

early, mild: 6-12 hours after stopping drinking. tremor, nausea, sweating.
late, major: from 2-3 days after cessation. generalised tonic-clonic seizures, delirium tremens

Question 11

What is delirium tremens? (2)

Answer 11

Potentially fatal, severe alcohol withdrawal syndrome.
Marked tremor, fever, tachycardia, agitation and visual hallucinations.
Requires urgent treatment.

Question 12

What is acamprosate? (1)

Answer 12

GABA analogue used in prevention of relapse in alcoholism.