Basic D&A 1 Flashcards
Delirium tremens is a diagnosis of exclusion. True or False?
True. Exclude other contributing factors of delirium by screening for:
Wernickes / drug intoxication or withdrawal / head injury / subdural haematoma / metabolic disturbances / sepsis / hepatic / hypoxia /
Shane Warne(icke) is on other drugs, and falls causing a head injury with subdural haematoma.
He knocks over a metal bowl (metabolic) filled with septic livers which falls on his head causing hypoxia.
This makes him go psycho!
Define hazardous use of alcohol
A pattern of alcohol consumption increasing risk of health harms.
Generally this includes:
- Adults drinking >2 std drinks daily or >4 std drinks on a single occasion
- Children, especially <15
- Pregnant or breastfeeding women
What are the NHMRC guidelines for safe levels of drinking in adults?
For acceptable lifetime risk: No more than 2 std drinks daily for both men and women. After this the lifetime risk of death from alcohol related disease or injury is greater than 1/100, and continues to increase with every drink.
For single Occassion risk: No more than 4 std drinks on a single occasion. Risk of injury doubles after this and increases rapidly with each drink.
What are the NHMRC guidelines for drinking in children?
Alcohol affects brain development, increases risk of alcohol problems later in life, and +++ risk of risky or antisocial behaviour. Children <15 should be abstinent. If 16-17 then only in low amounts and should be supervised by adults in a safe environment.
What are the NHMRC guidelines for alcohol in pregnant or breastfeeding women?
Abstinence is safest for women who are pregnant, planning to be pregnant, or breastfeeding.
Risks include mainly neurodevelopmental abnormalities in pregnancy, or adverse effects on lactation, infant behaviour (eg. Feeding) and psychomotor development
Define alcohol use disorder (DSM V)
Alcohol use disorder is the revised term which covers both the old definitions of abuse and dependence. 2 or more of the following features within 12 months:
Luke was an IMP CONTROLLER. He lost control of them so he tried to CUT them DOWN but without success. He worked so hard he CRAVED some beer so he SAILED to the ALIENS (SALIENCE) to get some. They were black aliens so he was inTOLERANT to them but wanted to buy beer anyway so he went to the atm to WITHDRAW some money. On the way he got in a car accident, but CONTINUED TO DRINK DESPITE HARMS. 1-3, mild was he. 4-5, barely alive. 6 and more he was out the door.
“Luke ended up drinking more and longer than what he intended. He tried to cut down without success, and felt like he was losing CONTROL. Whenever he tried he had such strong CRAVINGS, such that it was taking SALIENCE in his life because he was spending so much time on it. So he continued to drink but he needed more because he was becoming TOLERANT to it. He would drive drunk to WITHDRAW more cash to buy alcohol, despite multiple accidents, CONTINUING despite harms to both his health, social and work life.”
He ended up trying to kill himself on the floor with knives (4-5) which only MODERATELY hurt him. So he SEVEREd himself with some dicks (6).
Define alcohol withdrawal (DSM V)
Alcohol withdrawal is a cluster of symptoms involving CNS hyperactivity which occurs within hours-days of ceasing or reducing heavy and prolonged drinking AND 2 or more of:
“A THIN GAP”: Autonomic hyperactivity (tachycardia, diaphoresis), Transient hallucinations (Auditory, visual or tactile), Hand tremor, Insomnia, Nausea, Generalized tonic clinic seizures, Anxiety, Psychomotor agitation.
