Alcohol Related Liver Disease

Question 1

What is the safe limit of alcohol?

Answer 1

Zero

Question 2

What percentage of people with alcoholic fatty liver will progress to cirrhosis?

Answer 2

20%

Question 3

How much alcohol per day to lead to Acute Alcoholic Hepatitis?

Answer 3

6 Units

Question 4

What Score is used for Acute Alcoholic Hepatitis?

Answer 4

GAHS score

Question 5

GAHS Score measures what? for what condition (5)

Answer 5

Age
WCC
Urea
INR
Bilirubin

Acute Alcoholic Hepatitis

Question 6

What do 75% of people die of in Alcoholic Cirrhosis?

Answer 6

Liver Decompensation

Question 7

Alcohol and Teenagers. What happens to bloods?

Answer 7

Deranged LFTs

Question 8

Exposure to alcohol before what age is strongly associated with later alcohol abuse and dependence?

Answer 8

<14

Question 9

Long Term survival in Alcohol use is related to?

Answer 9

Abstinence

Question 10

What law provides regulation of sale of alcohol in Scotland?

Answer 10

Licensing Scotland Act 2005

Question 11

What prevalence of doctors are alcoholics?

Answer 11

10-12%

Question 12

What prevalence of doctors are drug addicts?

Answer 12

7%

Question 13

Alcoholic Ketoacidosis tends to occur when?

Answer 13

Day after massive binge

Question 14

Pathophysiology of Alcoholic Ketoacidosis? (8)

Answer 14

Excess Alcohol = Increases NADH+ Production = Production of Ketone Beta Hydroxybutyrate

Metabolism of Ethanol = Increases NADH/NAD = Impairs Hepatic Gluconeogenesis and Lactate Metabolism

Inability to make Glucose/Metabolise Lactate = Hypoglycemia and Acidosis

Question 15

Lipolysis in Alcohol use happens why?

Answer 15

Increased Cortisol and Catecholamines

Question 16

What to use to stabilise patients with alcohol use?

Answer 16

Pabrinex (Thiamine )

Question 17

What cells are particularly sensitive to Thiamine Deficiency?

Answer 17

Cells in Cerebellum

Question 18

What to do for patients with unexplained lactic acidosis?

Answer 18

Give Thiamine

Question 19

Harmful use of alcohol is classified as?

Answer 19

Use >1 Month or Repeatedly over 12 Months

Question 20

Hallucinations in Alcohol withdrawal state happen when?

Answer 20

12-24 hours after time from last drink

Question 21

Delirium Tremens and Low Grade fever in alcohol withdrawal state happen when”

Answer 21

48-72 Hours

Question 22

Mortality of Delirium tremens?

Answer 22

5%

Question 23

When does Delirium Tremens happen?

Answer 23

48-72 Hours after stopping alcohol

Question 24

Wernicke Encephalopathy presents with what 4 symptoms?

Answer 24

Confusion
Ataxia
Opthalmoplegia
Nystagmus

Question 25

Causes of Korsakoff Psychosis?

Answer 25

Thiamine Deficiency

Question 26

4 Screening Tests for Alcohol?

Answer 26

CAGE
AUDIT
FAST
PAT

Question 27

what classification of cage to consider likely alcohol problem?

Answer 27

2+

Question 28

Medications to manage alcohol withdrawal? (2)

Answer 28

Benzodiazepines

Chloradiazepoxide

Question 29

Medications to manage Aversion/Deterrent Medication in Alcohol?

Answer 29

Disulfiram (Antabuse)

Question 30

What medications for anti-craving in alcohol? (4)

Answer 30

Acamprosate (Campral)
Naltrexone
Nalmefane
Baclofen

Question 31

What medication can be used for alcohol addiction anti-convulsant?

Answer 31

Carbamazepine

Question 32

What medication can be used for acute alcohol withdrawal

Answer 32

Benzodiazepine eg Diazepam

Question 33

How many units of alcohol per week for female? and per day

Answer 33

14 per week (2 per day)

Question 34

How many units of alcohol per week for male and per day?

Answer 34

24 units per week or not regularly more than 4 per day

Question 35

Treatment for opiate dependence?

Answer 35

Methadone

Question 36

What medication can be used for post detox which causes unpleasant reaction if alcohol is taken?

Answer 36

Disulfiram post-detox