Biochemistry of Alcohol Flashcards
what 3 markers are used to determine chronic alcoholism
GGT, MCV and triglycerides
GGT
induced by ethanol along with CP450. Too sensitive to be used on its own
MCV
raised in chronic alcohol excess
triglycerides
High levels of acetyl CoA – inc. fatty acid synthesis and dec. fatty acid metabolism – triglyceride accumulation in liver
what 2 markers are used in an unconscious patient with suspected acute alcohol intoxication
glucose and serum osmolality
use of glucose in unconscious patients
to exclude hypoglycaemia
what is the simplest formula for serum osmolality
2 x [Na]
use of serum osmolality in unconscious patient
the gap between the calculated and measured osmolality can indicate another substance in the patients blood (ethanol) in this case the measured would be higher than the calculated
what 2 markers are used in Abdominal Pain in a Patient with Known Alcohol Related Health Issues
amylase and LFT
amylase in patient with abdominal pain and suspected acute alcohol intoxication
differential diagnosis is extensive, raised amylase can indicate acute pancreatitis
what is ALT a marker of
liver damage rather than function - released by hepatocytes when they release their contents
where is alkaline phosphate present
liver, bone, small intestine, kidney and placenta
what is the problem with GGT
too sensitive - can be used to reflect enzyme induction
what does albumin measure
protein synthesis. falls in the systemic inflammatory response
what does PT measure
clotting cascade - bleeding tendency
what 4 markers are used in vomiting in a Patient with Known Alcohol Related Health Issues
U&Es, LFT, amylase, ABG
what are the differenital diagnoses for vomiting patients
acute gastritis, oesophageal stricture, pyloric stenosis
what does prolonged vomiting cause
metabolic alkalosis (for every H ion lost in the stomach a HCO3 is gained) and low chloride conc
normally what fluid is lost from the stomach and duodenum during vomiting
acidic fluid from the stomach and alkaline from the duodenum
what happens when patients with pyloric stenosis vomit
only fluid from the stomach is lost - metabolic alkalosis
why is the ability for the lungs to compensate for severe metabolic alkalosis limited
hypoventilating quickly leads to hypoxia
what 4 markers are used in haematemesis in a Patient with Known Alcohol Related Health Issues
U&E, lactate PFT, PTR
what is the use of lactate as a marker in haematemesis
alcohol blocks the Krebbs cycle causing anaerobic metabolism - the end product of this is lactate which causes sore muscles
why do you measure urea in a patient with haematemesis
If you digest your own blood the protein in it is metabolised. urea is the end product of protein metabolism
