Case 3 Flashcards
(214 cards)
Dependence syndrome
3 or more of the following symptoms:
withdrawal state evidence of tolerance lack of control strong desire neglect of alternative interests persist despite harmful consequences
Negative reinforcement behaviours
Relief of bad symptoms - starting to drink alcohol again due to unpleasant withdrawal symptoms
Positive reinforcement behaviours
Bring about good symptoms - drinking alcohol for euphoric feeling of being intoxicated
How does smoking bring about release of dopamine?
Nicotine binds to nicotinic (ACh) receptors in mesolimbic reward system. Activation of dopamine cells = release of dopamine.
Dopamine pathway is involved in…
Reward, pleasure and euphoria
Serotonin pathway is involved in…
Mood
Memory
Sleep
Cognition
Mallory Weis Syndrome
Gastro-oesophageal laceration due to alcoholism, bulimia or any other condition causing violent vomiting.
Causes painful haematemesis.
Korsakoff’s Syndrome
Persistent amnesia due to chronic alcoholism
Transmission of Hep A
Faeco oral
Risk factors for Hep A
Poor sanitation
Gay men
Travellers
Prevention of Hep A
Vaccination
Hand washing
Food/water hygiene
Hepatitis E
Very similar to Hep A but very rare.
Associated with animal contact.
Treatment for Hep A
No specific treatment - spontaneous clearance by immune system.
Signs/Symptoms of Hep A
Fever
Malaise
Jaundice
Transmission of Hep B
Blood (assoc with needle stick injury and IV drug use)
Sexual (semen)
Vertical
Acute Hep B can become chronic, what is the chance of HBV becoming chronic?
95% in neonates
<5% in adults
Definition of chronic HBV
Failure to clear after 6 months
Effects of chronic HBV
End stage liver disease - portal hypertension/ascites, bleeding oesophageal varices, liver failure
Vaccination is available for which forms of hepatitis
A and B
Transmission of Hep C
Blood and vertical
Acute Hep C can become chronic. What is the chance of Hep C becoming chronic?
85% (15% will recover)
What is the risk of liver cirrhosis in Hep C?
20%/year of individuals with Hep C will get cirrhosis of the liver
Hepatitis D
Only presents WITH Hep B
Very high incidence of cirrhosis development
Features of liver cirrhosis
Ascites and oedema Impaired immunity Oesophageal Varices Splenomegaly Testicular atrophy Gynaecomastia Spider Naevi