Clinical Perspective

Question 1

how is alcohol withdrawal managed with

Answer 1

diazepam

Question 2

mild alcohol withdrawal time frame

Answer 2

12-36 hours

Question 3

mild alcohol withdrawal symptoms

Answer 3

tremor
sweating
raised HR and BP

Question 4

moderate alcohol withdrawal time frame

Answer 4

12 hours - 5 days

Question 5

moderate alcohol withdrawal symptoms

Answer 5

confusion

seizures (increased risk if already susceptible)

Question 6

severe alcohol withdrawal time frame

Answer 6

12 hours - 7+ days

Question 7

symptoms of severe alcohol withdrawal

Answer 7

DTs

Question 8

effects of alcohol on the brain and NS

Answer 8

anaesthetic

slurred speech

Question 9

effects of alcohol on muscles

Answer 9

peripheral neuropathy
compression neuropathy (temporary myelin damage)
myopathy

Question 10

does alcohol increase oestrogen?

Answer 10

yes

Question 11

wernicke’s encephalopathy

Answer 11

thiamine deficiency causes the triad of:

1. eye movements (lateral nystagmus)
2. ataxic gait
3. confusion

Question 12

Korsakoff’s syndrome

Answer 12

cerebral atrophy with amnesia and confabulation

Question 13

cardiac effects of alcohol

Answer 13

• CAD (lipid synthesis and increased BP)
• dilated cardiomyopathy (negative inotrope)
• arrhythmias

Question 14

effects on the liver

Answer 14

cascade of steatosis > hepatitis > cirrhosis > portal hypertension > hepatocellular carcinoma

Question 15

management of portal hypertension

Answer 15

abstinence
vitamins
nutrition
beta blockers
lactulose
rifamixin
TIPPS
transplant