Biochemistry of Alcohol Flashcards

1
Q

what 3 markers are used to determine chronic alcoholism

A

GGT, MCV and triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

GGT

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

MCV

A

raised in chronic alcohol excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

triglycerides

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

A

glucose and serum osmolality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

use of glucose in unconscious patients

A

to exclude hypoglycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the simplest formula for serum osmolality

A

2 x [Na]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

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

A

amylase and LFT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

amylase in patient with abdominal pain and suspected acute alcohol intoxication

A

differential diagnosis is extensive, raised amylase can indicate acute pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is ALT a marker of

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

where is alkaline phosphate present

A

liver, bone, small intestine, kidney and placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the problem with GGT

A

too sensitive - can be used to reflect enzyme induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what does albumin measure

A

protein synthesis. falls in the systemic inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does PT measure

A

clotting cascade - bleeding tendency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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