Alcohol Related Liver Disease Flashcards
What is the safe limit of alcohol?
Zero
What percentage of people with alcoholic fatty liver will progress to cirrhosis?
20%
How much alcohol per day to lead to Acute Alcoholic Hepatitis?
6 Units
What Score is used for Acute Alcoholic Hepatitis?
GAHS score
GAHS Score measures what? for what condition (5)
Age WCC Urea INR Bilirubin
Acute Alcoholic Hepatitis
What do 75% of people die of in Alcoholic Cirrhosis?
Liver Decompensation
Alcohol and Teenagers. What happens to bloods?
Deranged LFTs
Exposure to alcohol before what age is strongly associated with later alcohol abuse and dependence?
<14
Long Term survival in Alcohol use is related to?
Abstinence
What law provides regulation of sale of alcohol in Scotland?
Licensing Scotland Act 2005
What prevalence of doctors are alcoholics?
10-12%
What prevalence of doctors are drug addicts?
7%
Alcoholic Ketoacidosis tends to occur when?
Day after massive binge
Pathophysiology of Alcoholic Ketoacidosis? (8)
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
Lipolysis in Alcohol use happens why?
Increased Cortisol and Catecholamines
What to use to stabilise patients with alcohol use?
Pabrinex (Thiamine )
What cells are particularly sensitive to Thiamine Deficiency?
Cells in Cerebellum
What to do for patients with unexplained lactic acidosis?
Give Thiamine
Harmful use of alcohol is classified as?
Use >1 Month or Repeatedly over 12 Months
Hallucinations in Alcohol withdrawal state happen when?
12-24 hours after time from last drink
Delirium Tremens and Low Grade fever in alcohol withdrawal state happen when”
48-72 Hours
Mortality of Delirium tremens?
5%
When does Delirium Tremens happen?
48-72 Hours after stopping alcohol
Wernicke Encephalopathy presents with what 4 symptoms?
Confusion
Ataxia
Opthalmoplegia
Nystagmus
Causes of Korsakoff Psychosis?
Thiamine Deficiency
4 Screening Tests for Alcohol?
CAGE
AUDIT
FAST
PAT
what classification of cage to consider likely alcohol problem?
2+
Medications to manage alcohol withdrawal? (2)
Benzodiazepines
Chloradiazepoxide
Medications to manage Aversion/Deterrent Medication in Alcohol?
Disulfiram (Antabuse)
What medications for anti-craving in alcohol? (4)
Acamprosate (Campral)
Naltrexone
Nalmefane
Baclofen
What medication can be used for alcohol addiction anti-convulsant?
Carbamazepine
What medication can be used for acute alcohol withdrawal
Benzodiazepine eg Diazepam
How many units of alcohol per week for female? and per day
14 per week (2 per day)
How many units of alcohol per week for male and per day?
24 units per week or not regularly more than 4 per day
Treatment for opiate dependence?
Methadone
What medication can be used for post detox which causes unpleasant reaction if alcohol is taken?
Disulfiram post-detox