Biochemistry of Alcohol Flashcards
Why do we measure CK?
Alcohol is toxic to muscle
How acute pancreatitis manifest?
Bouts of abdominal pain and significantly raised amylase
Where is lipase specific to?
The pancreas
What other than the alcohol itself can cause unconsciousness in drunk people?
Hypoglycaemia
What effect does alcohol have on gamma GT?
It raises it
Why is MCV raised in chronic alcohol excess?
Increased synthesis of red blood cells
What effect does alcohol have on triglycerides?
It raises their levels due to increased synthesis on the liver
What markers are looked at to determine if someone is a chronic alcoholic?
GGT, MCV, triglycerides
How do you determine if a coma is due to alcohol?
Measure serum osmolarity
How do you calculate serum osmolarity?
Use concentrations of measured electrolytes-simplest formula is 2[Na]
What is the osmol gap and what does it indicate?
Difference between calculated osmolarity and measured osmolarity; shows that something that hasn’t been measured is causing the gap (ie alcohol)
What is ethylene glycol found in?
Antifreeze, often used in attempted suicide
What are methanol and ethylene glycol classed as and why are they important?
Toxic alcohols-can also cause osmol gap
What is ALT?
Found especially in liver, released from hepatocytes, marker of liver damage rather than function
Where is ALP found?
Liver (bile canaliculi), bone (osteoblasts), kidneys (proximal tubules), small intestine (epithelium)
Where is gamma GT found and what does it show?
Found in liver, kidneys, pancreas and prostate; can reflect enzyme induction (sensitive)
What is albumin?
Synthesised in liver, half life of three weeks, falls in systemic inflammatory response, not useful as marker of current liver function
What is the prothrombin ratio?
Clotting factors synthesised in liver, half life of 3-4 days, indicator of current liver synthetic function, shows bleeding tendency
What does a raised bilirubin cause?
Jaundice
What are the differentials of abdominal pain in an alcoholic?
Acute pancreatitis, alcoholic hepatitis, peptic ulceration +/- perforation, ascites +/- peritonitis
What are the markers for alcoholic abdominal pain?
Amylase, LFTs, ascites fluid analysis
What are the differentials of vomiting in an alcoholic?
Acute gastritis, oesophageal stricture, pyloric stricture
What is looked at to assess the severity of vomiting?
U & Es, ABG, LFTs, amylase
What are the differentials for haematemesis in an alcoholic?
Acute gastritis, Mallory-Weiss tear, peptic ulceration +/- perforation, oesophageal varices
What investigations are done to assess haematemesis?
Prothrombin ratio, LFTs, U & Es, Lactate
