Alcohol Use Disorder

Question 1

How much ml wise is 1 unit of alcohol?

Answer 1

10mls

Question 2

How many grams are in 1 unit of alcohol?

Answer 2

8

Question 3

How many units are recommended by WHO per week?

Answer 3

14

Question 4

What is considered binge drinking?

Answer 4

8 units in one sitting

Question 5

How many of patients admitted to hospital are at risk of alcohol withdrawal?

Answer 5

8%

Question 6

How many people drink at hazardous or harmful levels?

Answer 6

1 in 4

Question 7

What is hazardous drinking?

Answer 7

A pattern of alcohol consumption that increases the risk of harmful consequences for the user
Drinking more than 14 units a week but less than 35 (women) or 50 (men)

Question 8

What is harmful drinking behaviour?

Answer 8

A pattern of alcohol consumption that is causing mental or physical damage
More than 35 units for women
More than 50 units for men

Question 9

What is alcohol dependence?

Answer 9

A cluster of behavioural, cognitive and physiological factors that typically include a strong desire to drink alcohol and difficulties in controlling its use

Question 10

What is the DSM 5 criteria for alcohol use disorder?

Answer 10

A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 or more of the following occuring at any time in the same 12 month period:
Alcohol taken in larger amounts over a longer period than intended
Persistent desire or unsuccessful efforts to cut down
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol or recover from its effects
Craving or strong desire to use alcohol
Results in failure to fulfill major obligations

Question 11

What is the definition of tolerance?

Answer 11

Need for markedly increased amounts of alcohol to achieve intoxication or desired effect
Markedly diminished effect with continued use of the same amount of alcohol

Question 12

What is the definition of withdrawal?

Answer 12

Characteristic withdrawal syndrome for alcohol

Alcohol (or closely related substance such as BZD) is taken to relieve or avoid withdrawal

Question 13

What is mild alcohol use disorder?

Answer 13

Presence of 2-3 symptoms

Question 14

What is moderate alcohol use disorder?

Answer 14

Presence of 4-5 symptoms

Question 15

What is severe alcohol use disorder?

Answer 15

Presence of 6 or more symptoms

Question 16

What is AUDIT?

Answer 16

Alcohol Use Disorders Identification Test

Comprehensive 10 question alcohol harm screening tool

Question 17

What are the 5 elements of alcohol dependence?

Answer 17

Physical withdrawal
Affective withdrawal
Withdrawal relief drinking
Alcohol consumption 
Rapidity of reinstatement

Question 18

What is the CIWA-AR?

Answer 18

Clinical Institute Withdrawal Assessment for Alcohol

Ten item scale used in the assessment and management of alcohol withdrawal

Question 19

What is included in the FRAMES model for brief intervention?

Answer 19

Feedback; review problems experienced because of alcohol
Responsibility; patient is responsible for change
Advice; adviese reduction or abstinence
Menu; provide options for changing behaviour
Empathy; use empathic approach
Self-efficacy; encourage optimism about changing behaviour

Question 20

What are the stages of change?

Answer 20

Precontemplation 
contemplation
Planning
Action 
Maintenance
Relapse
Then back to precontemplation

Question 21

What are the 4 central principles of motivational interviewing?

Answer 21

Express empathy by using reflective listening to convey understanding
Develop discrepancy between most deeply held values and current behaviour
Sidestep resistance by responding with empathy and understanding rather than confrontation
Support self efficacy by building confidence that change is possible

Question 22

Psychosocial interventions to prevent relapse?

Answer 22

CBT
Motivational enhancement therapy
AA
Family and couple therapy

Question 23

What drug is used for medically assisted detoxification?

Answer 23

Chlordiazepoxide

Question 24

Symptoms of alcohol withdrawal syndrome?

Answer 24

Tremor, sweating, nausea, retching
Increased HR, BP, T
Anxiety, agitation 
Insomnia, nightmares
Auditory, visual and tactile hallucinations
Withdrawal seizures
Delirium tremens

Question 25

What is the time scale for withdrawal seizures?

Answer 25

0-48 hours

Question 26

What is the time scale for delirium tremens?

Answer 26

48-72 hours

Question 27

Symptoms of DTs?

Answer 27

Coarse tremor
Confusion
Delusions
Hallucinations

Question 28

What nTs drive alcohol withdrawal syndrome?

Answer 28

Low GABA

High glutamate

Question 29

What constitutes a complicated withdrawal?

Answer 29

Seizures
Hallucinosis
DTs
Wernicke-Korsakoff syndrome

Question 30

What are the licensed drugs in the UK to prevent relapse?

Answer 30

Acamprosate
Naltrexone
Disulfiram

Question 31

Mode of action of acamprosate?

Answer 31

Action on GABA and glutamate transmission, correct the nT imbalance post withdrawal and reduces craving

Question 32

Mode of action of naltrexone?

Answer 32

Blocks opioid receptors

Reduce rewarding effect mediated by endorphin system

Question 33

Mode of action of disulfiram?

Answer 33

Anticraving via increased dopamine transmission
Psychological deterrent
Inhibits aldehyde dehydrogenase