Alcohol Use Disorders

Question 1

1 unit = how much alcohol?

Answer 1

10ml

Question 2

How many units is necessary to be high risk drinking?

Answer 2

regular consumption of over 35 units per week

Question 3

What are the UK alcohol guidelines?

Answer 3

Men and women should not regularly drink more than 14 units of alcohol a week - ideal spread evenly over 3 or more days

Question 4

What is alcohol dependence syndrome?

Answer 4

Strong desire or sense of compulsion to take drug

Difficulty in controlling use of substance in terms of onset, termination or level of use

Physiological withdrawal state

Evidence of tolerance

Progressive neglect of other pleasures /interests because of use /effects of substance

Persistence with use despite clear evidence of harmful consequences

Question 5

Laboratory testing is useful in screening alcohol related problems - T/F?

Answer 5

False

Question 6

What is represented by GGT?

Answer 6

liver injury - inducible

Question 7

What causes carbohydrate deficient transferrin?

Answer 7

men drinking 5 or more units per day for a year or more

Question 8

What common abnormality on FBC is seen in alcoholic patients?

Answer 8

raised MCV

Question 9

How long should a brief intervention last?

Answer 9

10-15 mins

Question 10

What is the FRAMES model of brief intervention?

Answer 10

feedback on problems experienced

responsibility for change

advise abstinence or reduction

menu - provide options for change

empathy

self-efficacy - encourage optimism

Question 11

What is detoxification?

Answer 11

the process by which patients become alcohol free

Question 12

What is relapse prevention?

Answer 12

a combination of interventions to maintain abstinence or problem free drinking following detox

Question 13

What consequences does alcohol withdrawal have?

Answer 13

causes excess glutamate activity and reduced GABA activity

Question 14

What effects does excess glutamate have on the nerve cells?

Answer 14

it is toxic!

Question 15

What causes CNS excitability and neurotoxicity?

Answer 15

acute alcohol withdrawal

Question 16

what are some features of alcohol withdrawal syndrome?

Answer 16

restlessness 
tremor 
sweating 
anxiety 
cause and vomiting 
loss of appetite 
insomnia

Question 17

How long do symptoms take to resolve in AWS?

Answer 17

5-7 days

Question 18

What is delirium tremens?

Answer 18

confusion, disorientation, agitatio, hypertension, fever, hallucinations, paranoia in response to alcohol withdrawal

Question 19

How is alcohol withdrawal managed?

Answer 19

general support - reassurance

Benzodiazepines - reduce gradually

vitamin supplementation - thiamine

Question 20

What is thiamine given to prevent in alcohol withdrawal?

Answer 20

Wernicke’s encephalopathy?

Question 21

What should be done with thiamine dose if Wernicke’s is suspected?

Answer 21

increase dose

Question 22

Where are most patients detoxified?

Answer 22

in the community

Question 23

What psychosocial interventions can be used in relapse prevention

Answer 23

CBT
motivational enhancement therapy
12 step facilitation therapy (AA)

Question 24

What does disulfiram do?

Answer 24

inhibits acetaldehye dehydrogenase leading to accumulation of acetaldehyde if alcohol is ingested

Question 25

What does acamprosate do?

Answer 25

reduces cravings

can cause headache, diarrhoea, nausea

Question 26

What is naltrexone?

Answer 26

opioid antagonist - reduces reward from alcohol