Alcoholism 3D module

Question 1

What is Palmar erythema?

Answer 1

Redness of the palms

Question 2

How does palmar erythema arise?

Answer 2

Usually due to underlying liver cirrhosis, increased oestrogen levels cause changes in the small anastomoses of the hand increasing vascularity

Question 3

What is Dupuytren’s contracture, and what other conditions can cause it?

Answer 3

Benign fibrosis of the flexor tendon of the fingers; also present in diabetes and caused by anti-epileptic medicine

Question 4

What is Caput medusae?

Answer 4

Prominent veins around umbilicus, occurs secondary to portal hypertension

Question 5

What is a subdural haematoma?

Answer 5

Bleeding in the subdural space

Question 6

Why do thiamine deficiency sufferers experience loss of sensation in the arms and legs?

Answer 6

Thiamine is used to maintain the peripheral nerves

Question 7

What happens if the vagus nerve is affected by thiamine deficiency?

Answer 7

Cardiac rhythm abnormalities can occur and are a rare cause of death in chronic alcoholics

Question 8

What is the most common cardiomyopathy linked to alcohol?

Answer 8

Dilated Cardiomyopathy

Question 9

What is the condition of the heart in dilated cardiomyopathy?

Answer 9

Heart is heavier and enlarged, but the thickness of the ventricular walls is normal

Question 10

What does a fatty liver look like?

Answer 10

Liver capsule is smooth and shiny, cut surface is clearly discoloured and greasy, fatty inclusions in hepatocytes

Question 11

What is the condition of the liver in Liver cirrhosis?

Answer 11

Enlarged with clearly irregular capsular surface, nodules of various sizes present throughout, hepatocytes are encircled by dense bands of fibrosis

Question 12

What is the issue with the bands of fibrosis present in liver cirrhosis?

Answer 12

They prevent proteins synthesised by the hepatocytes from being able to leave and stop toxic substances from being able to reach the hepatocytes to be metabolised

Question 13

How does portal hypertension arise?

Answer 13

Scarred liver tissue leads to increased vascular pressure throughout the liver

Question 14

How does splenomegaly, oesophageal varices and spider naevi occur?

Answer 14

In cirrhosis the large volume of blood is redirected to smaller veins elsewhere and to superficial vasculature

Question 15

How does alcohol cause hypoglycaemia?

Answer 15

It prevents gluconeogenesis

Question 16

Where does aspiration pneumonia most often occur?

Answer 16

In the superior part of the right lower lobe

Question 17

What happens in Barrett’s oesophagus?

Answer 17

Normal squamous epithelium undergoes metaplastic change to intestinal epithelium due to acid reflux

Question 18

What are Oesophageal varices?

Answer 18

Numerous large dilated blood vessels close to surface (susceptible to bleeding)

Question 19

What occurs in acute pancreatitis?

Answer 19

Haemorrhage, fat necrosis

Question 20

How do pseudo-cysts arise?

Answer 20

Result from tissue necrosis and degeneration

Question 21

Why are pseudo-cysts not true cysts?

Answer 21

They lack an epithelial lining

Question 22

What are some symptoms of acute pancreatitis?

Answer 22

Umbilical region pain, feeling/being sick, diarrhoea, indigestion, fever, jaundice, tenderness/swelling of abdomen, tachycardia

Question 23

What are symptoms of chronic pancreatitis?

Answer 23

Repeated episodes of pain on middle/left side, pain can move along back, pain may come on after a meal, nausea/vomiting, steatorrhoea, weight loss, anorexia, jaundice

Question 24

How is aspiration pneumonia caused commonly?

Answer 24

Due to sterile and acidic gastric contents reaching the lung parenchyma

Question 25

What is pneumonitis?

Answer 25

Inflammation without infection