Alcohol: The Clinician's Perspective

Question 1

what number of units constitutes binge drinking in men?

Answer 1

8

Question 2

what number of units constitutes binge drinking in women?

Answer 2

6

Question 3

what age group and gender had the highest number of alcohol related deaths

Answer 3

men aged 55-64

Question 4

what symptoms would mild alcohol withdrawal cause?

Answer 4

fine tremor
sweating
anxiety
tachycardia
HBP
fever
anorexia
nausea
can last up to 24hrs

Question 5

how does moderate alcohol withdrawal differ from mild?

Answer 5

tremor worse
confusion
disorientation
seizures
hallucinations
can last up to 5 days

Question 6

how does severe alcohol withdrawal differ from moderate?

Answer 6

can last up to 7+ days
delirium tremens
circulatory collapse
death

Question 7

is delirium tremens (DT) an emergency?

Answer 7

DT

Question 8

what medication is usually given to ease withdrawal?

Answer 8

diazepam on reducing dose

Question 9

how to tell the difference between an alcohol withdrawal seizure and epileptic?

Answer 9

epileptic = in morning after drinking, any pattern

alcohol= after a sudden cessation/reduction of alcohol; clustered over a few hours

Question 10

what occurs in compression neuropathy?

Answer 10

temporary damage to myelin sheath

Question 11

how to treat wernickes-korsakoff syndrome?

Answer 11

immediate thiamine replacement

Question 12

when would someone with an alcohol problem typically get dilated cardiomyopathy?

Answer 12

usually need 8-9 units a day for 5+ years aka heavy drinking

Question 13

why does cardiomyopathy happen from alcohol?

Answer 13

impairs ventricular function, causes chronic inflam and fibrosis of myofibrils

Question 14

when will holiday heart syndrome usually resolve?

Answer 14

24 hours

Question 15

what is the pathogenesis of cirrhosis

Answer 15

regular heavy drinking -> accummulation in hepatocytes -> inflammation -> fibrosis -> cirrhosis

Question 16

how common is alcoholic steatosis in alcoholics

Answer 16

almost universal

Question 17

which of steatosis and hepatitis is reversible

Answer 17

steatosis

Question 18

what is the pathogenesis in steatosis

Answer 18

hepatocytes swell with triglycerides

Question 19

what is the pathogenesis in alcoholic hepatitis

Answer 19

parenchymal acute inflam and hepatocyte damage

Question 20

what are the risks associated with alcoholic hepatitis

Answer 20

renal failure, bleeding, infection

Question 21

treatment for alcoholic hepatitis

Answer 21

abstinence, nutrition –> SUPPORTIVE

Question 22

what symptoms would suggest decompensated cirrhosis?

Answer 22

impaired synthetic function
ascites
encephalopathy

Question 23

pathogenesis of hepatic encephalopathy

Answer 23

portosystemic shunting through collaterals -> failure to clear toxins/ammonia from blood -> crosses blood-brain barrier

Question 24

role of B blockers in liver disease?

Answer 24

varices

Question 25

role of lactulose and rifaximin in liver disease?

Answer 25

encephalopathy