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M&M Test 1 > B6-041 CBCL Fractured Ribs Secondary to Alcohol > Flashcards

B6-041 CBCL Fractured Ribs Secondary to Alcohol Flashcards

1
Q

what is considered at risk drinking for a male

A

> 4 drinks per occasion, >14/week

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2
Q

what is considered at risk drinking for a female

A

> 2 drinks per occasion, >7 per week

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3
Q

[…] grams of ethanol per standard drink

A

14

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4
Q

alcohol is primarily absorbed in the

A

duodenum

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5
Q

characteristic response to alcohol consumption

A

euphoria, impaired thoughts

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6
Q

alcohol increases […] in the mesocorticolimbic system

A

dopamine

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7
Q

alcohol activates the […] peptide system

A

opioid

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8
Q

alcohol facilitates […] transmission and blocks […] receptors

A

GABA
NMDA

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9
Q

increased dopamine and opioids cause

A

euphoria/pleasure

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10
Q

increased GABA signaling causes

A

anxiolysis, ataxia

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11
Q

increased GABA + decreased NMDA signaling causes

A

sedation, amnesia

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12
Q

decreased GABA and increased NMDA signaling causes

A

withdrawal

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13
Q

decreased opioid signaling causes

A

craving

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14
Q

withdrawal symptoms of tremor, anxiety, and insomnia can persist up to […]

A

two weeks

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15
Q

withdrawal symptom of hallucinations can occur for […]

A

one week

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16
Q

seizures occur [….] in the withdrawal period

A

early

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17
Q

alcohol use disorder is more prevalent in [males/females]

A

males

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18
Q

describe the CAGE questionnaire

A

have you ever felt you should Cut down?
have people Annoyed you by criticizing your drinking?
have you ever felt Guilty about your drinking?
Eye-opener (drink first thing in the morning)

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19
Q

[…] yes responses to the CAGE questionnaire indicate risk of AUD

A

two

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20
Q

ALT/AST will be elevated in […] withdrawal/early AUD and […] in chronic AUD

A

acute
lowered

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21
Q

what liver enzymes would you expect to see elevated with AUD (in general)

A

GGTP
AST
ALT

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22
Q

2:1 AST/ALT ratio indicates

A

individual in “at risk” drinking category

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23
Q

why is MCV elevated in AUD?

A

nutritional deficiency

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24
Q

what medication class is used for acute alcohol withdrawal syndrome?

A

benzodiazepines (taper)

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25
what medication classes are used for cardiac management of alcohol withdrawal syndrome? [2]
beta blockers alpha agonists
26
what medication classes are used for promotion of sobriety? [3]
disulfiram naltrexone acamprosate
27
5 As
Ask Advise Assess Assist Arrange
28
OARS of motivation interviewing
Open Ended Affirming Reflective Summarizing
29
promotes noxious effects of etoh breakdown
disulfiram
30
blocks craving and rewards
opioid antagonists
31
reduces drinking; modulates GABA and NMDA activity [2]
acamprosate anticonvulsants
32
Wernicke-Korsakoff is caused by lack of vitamin
B1
33
confusion, ataxia, abnormal eye movement seen in the context of AWS
Wernicke encephalopathy (acute)
34
confabulation, memory loss, inability to form new memories, hallucinations
Korsakoff syndrome (chronic)
35
caused by changes to the thalmus and hypothalmus
Wernicke-Korsakoff
36
2nd line option for AUD
disulfiram
37
1st line options for AUD [2]
naltrexone acamprosate
38
inhibits ALDH preventing the conversion for acetaldehyde to acetate
disulfiram
39
patients must abstain for alcohol for at lead [...] prior to dosing with disulfiram
12 hours
40
disulfiram is absolutely contraindicated in patients with
myocardial disease (causes cardio toxicity)
41
[...] is available the form of injectable IM suspension given every 4 weeks
naltrexone (vivitriol)
42
most concerning side effect of naltrexone
hepatotoxicity **should be avoided in patients with active liver disease
43
[...] has the side effect of opioid overdose
naltrexone
44
not metabolized by the liver, and therefore safe for patients with liver disease
acamprosate
45
can be used in patients receiving opioid maintenance or pain therapy
acamprosate
46
[...] standard drinks per day is considered hazardous for men
4
47
[...] standard drinks per day is considered hazardous for women
2
48
[males/females] demonstrate the highest incidence of AUD
males
49
increased [...] and [...] activity is associated with euphoria and pleasure
dopamine and opioid
50
inhibitory neurotransmitter associated with anti-anxiety effects produced by alcohol
GABA
51
amino acid that binds to glutamate receptors involved in memory and learning
NMDA
52
how does alcohol induce "blackouts"?
acute decreased NMDA activity causes memory lapses
53
indirectly increased in the mesocorticolimbic system by alcohol
dopamine
54
during withdrawal NMDA activity is [...]
increased
55
during withdrawal opioid activity is [...]
decreased
56
opioid activity is acutely [...] by alcohol use
increased
57
what causes craving?
decreased opioid activity during withdrawal
58
increased [...] and [...] activity is associated with euphoria and pleasure
dopamine and opioid
59
elevation of MCV and mild anemia are consistent with
folate deficiency
60
shown to reduce craving and relapse drinking and promotes sustained abstinence from chronic, severe drinking
acamprosate
61
psychological symptoms of AWS
anxiety psychomotor agitiation hallucinations insomnia
62
physiological symptoms of AWS
tremor autonomic hyperactivity (sweating, tachycardic) nause vomiting seizures
63
first line treatment to decreases severity of AWS
benzodiazepines
64
why is disulfiram contraindicated in acute withdrawal?
it interferes with the metabolism of alcohol leading to accumulation of acetylaldehyde **need to abstain for at least 12 hrs
65
supplemental thiamine can be administered to alleviate risk of
Wernicke's encephalopathy
66
alcoholism is commonly associated with deficiency of [...] vitamins
B
67
[...] deficiency can precipitates central and peripheral neurodegeneration
thiamine
68
associated with CNS symptoms such as confusion, visual and tactile hallucinations, and tremors but not peripheral and optical disturbances
delirium tremens
69
indirectly elevates dopamine levels in the nucleus accumbens
alcohol
70
[...] is associated with microencephaly and intellectual disability
fetal alcohol exposure
71
what percentage of death from external causes is due to alcohol?
45%
72
standard drinks are [...] grams of pure alcohol
14
73
screening instrument designed to be developmentally appropriate for teens
CRAFFT
74
has high sensitivity in detecting both alcohol and substance abuse disorders in teens
CRAFFT
75
general alcohol screening questionnaire designed for adults
CAGE
76
used to screen for risk drinking in pregnancy
TWEAK
77
risk drinking in pregnancy is defined as
1 oz or more of alcohol per day
78
synthetic compound shown to reduce craving and encourage abstinence
acamprosate
79
used to mitigate AWS but has no effect on craving
diazepam
80
creates aversive reaction to alcohol but has no direct effect on craving
disulfiram
81
mu opioid receptor antagonist used to help reduce relapse in the treatment of AWS
naltrexone
82
what form is naltrexone (reVia) administered in?
pill once per day
83
what form is naltrexone (vivitrol) administered in?
IM injection 1x per month
84
taurine analog
acamprosate
85
what class of medications are first line for AWS?
sedative hypnotics
86
reduced [...] in women concentrates alcohol within the blood relative of men the same size
body water
87
what neural system mediates the rewarding properties of abused drugs?
mesocorticolimbic pathway
88
toxic metabolite of alcohol
acetylaldehyde
89
reinforcing effects of alcohol occur through action on opiate receptors in the
ventral tegmental area

M&M Test 1 (15 decks)

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