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RB Y2 CLASP - Alcohol > Biochemistry of Alcohol > Flashcards

Biochemistry of Alcohol Flashcards

1
Q

what 3 markers are used to determine chronic alcoholism

A

GGT, MCV and triglycerides

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2
Q

GGT

A

induced by ethanol along with CP450. Too sensitive to be used on its own

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3
Q

MCV

A

raised in chronic alcohol excess

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4
Q

triglycerides

A

High levels of acetyl CoA – inc. fatty acid synthesis and dec. fatty acid metabolism – triglyceride accumulation in liver

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5
Q

what 2 markers are used in an unconscious patient with suspected acute alcohol intoxication

A

glucose and serum osmolality

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6
Q

use of glucose in unconscious patients

A

to exclude hypoglycaemia

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7
Q

what is the simplest formula for serum osmolality

A

2 x [Na]

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8
Q

use of serum osmolality in unconscious patient

A

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

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9
Q

what 2 markers are used in Abdominal Pain in a Patient with Known Alcohol Related Health Issues

A

amylase and LFT

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10
Q

amylase in patient with abdominal pain and suspected acute alcohol intoxication

A

differential diagnosis is extensive, raised amylase can indicate acute pancreatitis

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11
Q

what is ALT a marker of

A

liver damage rather than function - released by hepatocytes when they release their contents

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12
Q

where is alkaline phosphate present

A

liver, bone, small intestine, kidney and placenta

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13
Q

what is the problem with GGT

A

too sensitive - can be used to reflect enzyme induction

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14
Q

what does albumin measure

A

protein synthesis. falls in the systemic inflammatory response

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15
Q

what does PT measure

A

clotting cascade - bleeding tendency

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16
Q

what 4 markers are used in vomiting in a Patient with Known Alcohol Related Health Issues

A

U&Es, LFT, amylase, ABG

17
Q

what are the differenital diagnoses for vomiting patients

A

acute gastritis, oesophageal stricture, pyloric stenosis

18
Q

what does prolonged vomiting cause

A

metabolic alkalosis (for every H ion lost in the stomach a HCO3 is gained) and low chloride conc

19
Q

normally what fluid is lost from the stomach and duodenum during vomiting

A

acidic fluid from the stomach and alkaline from the duodenum

20
Q

what happens when patients with pyloric stenosis vomit

A

only fluid from the stomach is lost - metabolic alkalosis

21
Q

why is the ability for the lungs to compensate for severe metabolic alkalosis limited

A

hypoventilating quickly leads to hypoxia

22
Q

what 4 markers are used in haematemesis in a Patient with Known Alcohol Related Health Issues

A

U&E, lactate PFT, PTR

23
Q

what is the use of lactate as a marker in haematemesis

A

alcohol blocks the Krebbs cycle causing anaerobic metabolism - the end product of this is lactate which causes sore muscles

24
Q

why do you measure urea in a patient with haematemesis

A

If you digest your own blood the protein in it is metabolised. urea is the end product of protein metabolism

25
Q

what effect does alcohol have on ADH levels

A

decrease them

26
Q

what effect does vomiting have on sodium levels

A

hyponatraemia - aldosterone is secreted causing Na to be retained (and water follows) - ADH is secreted causing water to be reabsorbed net effect is loss of Na

27
Q

where is aldosterone secreted from

A

adrenal gland

28
Q

what is spironolactone in relation to aldosterone

A

antagonist

29
Q

spironolactone effects

A

low Na and high K

30
Q

what substance is present in anti freeze and is often used in suicidal patients

A

ethylene glycol

31
Q

what is used to treat ethylene glycol

A

ethanol - preferentially metabolised by alcohol dehydrogenase

32
Q

how to calculate alcohol units

A
  • 1 unit = 10ml 100% alcohol
  • eg 70cl 40% = 28 units
33
Q

effects of alcohol by concentration - <100, 100-200, >200

A
  • <100 – excitement, fun, disinhibited, still in some control
  • 100-200 – slurring of speech, blurred vision, falls, wide emotions
  • >200 – stupor. Difficult to rouse, loud snoring
  • Dangerous if brain stem is inhibited – decreased consciousness and breathing
34
Q

action of antabuse

A

inhibits aldehyde dehydrogenase - unpleasant reaction to alcohol

RB Y2 CLASP - Alcohol (3 decks)

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