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My CLASP alcohol > CLASP > Flashcards

CLASP Flashcards

1
Q

What are some of the key facts about methanol?

A
  • toxic
  • can be home a side product of home brew
  • in anti-freeze
  • can cause renal failure or blindness
  • metabolised to formaldehyde then to formic acid
  • treat poisoning with ethanol
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2
Q

What are some of the key facts about ethanol?

A
  • rate of drunkness is proportional to lean muscle mass
  • is absorbed in the small bowel
  • women have less alcohol dehydrogenase
  • spirits irritate gastric mucosa
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3
Q

What is the ethanol metabolism chemical pathway?

A

Ethanol——-alcohol dehydrogenase—–>acetaldehyde

Acetaldehyde——aldehyde dehydrogenase—–>acetate

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4
Q

Where is most of the alcohol metabolised?

A

the liver (90%)

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5
Q

At what numerical rate is the alcohol removed from the liver?

A

15mg/100ml/hour

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6
Q

What does decreased aldehyde dehydrogenase cause and how can this be used?

A
  • decreased aldehyde dehydrogenase means increased aldehyde ====nausea
  • a drug called Antabuse can decrease activity of aldehyde dehydrogenase so alcoholics will not want to drink alcohol
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7
Q

What effect does alcohol have on water and ADH?

A
  • inhibits ADH
  • less water reabsorption
  • clearer urine
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8
Q

What effect does alcohol have on the heart?

A
  • decreased heart force (-ve inotrope)

- increased HR to maintain CO

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9
Q

What heart condition can binge drinking cause?

A

SVT (ie holiday heart)

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10
Q

What are hangover headaches caused by?

A
  • dehydration
  • acetic acid
  • serotonin
  • other substances known as congeners
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11
Q

What is the medical name for hangover headaches?

A

veisalgia cephalgia

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12
Q

What two changes will be seen on a blood test that suggest alcoholism?

A
  • high gGT

- abnormal clotting

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13
Q

What is hazardous drinking?

A

level of alcohol that increases the risk of harmful consequences (<35u for w, <50u for m)

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14
Q

What is harmful drinking?

A

causes mental/ physical damage (>35u for w, >50u for m)

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15
Q

What are the features of alcohol dependence?

A

strong desire to drink

difficulties controlling the use of alcohol

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16
Q

What are some of the assessments of alcohol dependence?

A
  • DSM-5 = alcohol use disorder from mild to severe
  • DSM-4 = alcohol abuse and dependence
  • CIWA-AR = used for alcohol withdrawal
  • AUDIT by WHO
  • Severity of alcohol dependence questionnaire
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17
Q

What is the drug used for withdrawal and what are the possible side effects?

A
  • Chlordiazepoxide

side effects= relapse, withdrawal worsening, cognitive issues, seizure etc

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18
Q

What are the other drugs that can be used for alcohol dependence?

A
  • Acamprosate (decrease cravings)
  • Naltrexone (decrease desire for alcohol)
  • Disulfiram (aversion therapy)
  • Nalmefene (opioid antagonist)
19
Q

What does alcohol act as biochemically?

A
  • postive allosteric modulator

- at the GABAa receptors which causes the channel to be kept open which in turn causes inhibition of neural firing

20
Q

What does alcohol cause the release of?

A

dopamine which causes rewarding effects

21
Q

What is the mesocorticolimbic pathway?

A
  • ethanol binds to GABAa
  • decreased cell firing by increase in GABAa activity
  • decreased glutamate receptor activity
  • decreased GABA release
  • decreased inhibition
  • increased firing of different neurone
  • dopamine made
22
Q

What effect does alcohol have on GABA and its release of molecules?

A
  • w/out ethanol GABA is released so there is inhibition via Cl- channels
  • w/ ethanol the channels open so there is MORE inhibition
23
Q

What does chronic consumption of alcohol do to GABA?

A

the receptors internalise and when there is no ethanol, there is increased likelihood of seizures

24
Q

What drug is used to decrease seizure possibility?

A

Lorazepam which replaces the action of ethanol so decreases the likelihood of seizures

25
Q

What are the symptoms of alcohol withdrawal?

A
  • mild= 12-36hrs… tremor, sweating, anxiety
  • moderate= 12hrs-5days… shakes, seizures, paranoia
  • severe= 12hrs-7days… hallucinations, collapse, death
26
Q

What is Wernicke encephalopathy?

A

this is due to alcohol abuse

- there is decreased thiamine so there will be confusion, ataxic gait and ocular dysfunction

27
Q

What is Korsakoff syndrome?

A

this is due to alcohol abuse

- there is decreased thiamine so there will be memory loss and confabulation

28
Q

What heart condition can alcohol cause?

A

dilated cardiomyopathy

29
Q

What can cirrhosis lead to?

A 
varices
ascites
everted umbillicus
hepatocellular carcinoma
spider nevi
30
Q

Where is alcohol absorbed, metabolised and excreted?

A

absorbed in the stomach and SI
metabolised in the liver
excreted in the lungs, sweat and urine

31
Q

What does thiamine do?

A
  • ATP production
  • normal nerve conduction
  • maintenance of neural membranes
32
Q

What are the alcohol unit guidelines for breastfeeding?

A

no more than 2 units a week

33
Q

What are the cancers that are most associated with alcohol?

A
  • mouth/throat
  • oesophageal
  • stomach
  • breast
  • bowel
  • liver
34
Q

What are the most important blood tests for these side-effects of alcoholism?

A
  • pancreatitis= amylase
  • heart muscle damage = troponin
  • alcoholic in general = gGT, MCV, triglycerides
35
Q

What is the best test for ?alcohol causing a coma?

A
  • serum osmolality
  • this measures the osmolal gap (difference between measured and calculated osmolality) which can be caused by ethanol, methanol etc
36
Q

What is the best test for ?alcohol causing abdominal pain?

A
  • LFTs and amylase

- this could be acute pancreatitis, alcoholic hepatitis, peptic ulcer or ascites which can come with peritonitis

37
Q

What is the best test for ?alcohol causing vomiting?

A
  • U&Es, LFTs, amylase and ABG

- this could be acute gastritis, oesophageal structure or pyloric stenosis

38
Q

What happens to the acid-base change in vomiting?

A
  • normally there is H+ lost so HCO3- into the blood, the reverse happens in the duodenum so there is no pH change
  • !!in pyloric stenosis there is more HCO3- into blood as no change in duodenum
39
Q

What is the best test for ?alcohol causing haematemeiss?

A
  • U&E, LFTs, PTR and lactate

- this can be caused by acute gastritis, M-W tear, peptic ulcer with perf or varices

40
Q

What is the treatment for ascites?

A

spironolactone which works on aldosterone

41
Q

What cells are in the portal tract?

A

hepatocytes are not in the portal tract

lymphocytes are in the portal tract

42
Q

What condition has a high ALP but normal other LFTs?

A

bone disease

43
Q

Where does aspiration pneumonia tend to occur?

A

superior segment

right lower lobe

44
Q

What classifies as a binge drink?

A

> 8u for m or w in one day

My CLASP alcohol (1 decks)

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