effects of alcohol on the body Flashcards
What are the common signs found on general examination in chronic alcohol abusers?
- Palmar erythema
- Dupuytren’s contracture
- Caput medusae
- spider naevi
What condition common to alcoholic patients is palmar erythema associated with?
liver cirrhosis
Dupuytren’s contracture is caused by fibrosis of the _____ _____ of the fingers
flexor tendons
Caput medusae arise due to ____ _____
portal hypertension
What is subdural haematoma?
bleeding in the subdural space of the brain common in alcohilics
Ataxia (an abnormally shaky gait) and abnormal eye movements are characteristic of _______ ___________
Wernicke’s syndrome
Loss of memory, often coupled with attempts to mask it (confabulation), is known as _____ _______
Korsakoff’s syndrome
What is the main site of infection in aspiration pneumonia?
right lower lobe
What effects does chronic alcohol abuse have on the heart? How is it brought on?
dilated cardimyopathy
-alcohol is a negative inotrope - it reduces contractility. This is compensated by increase heart rate
How does alcohol ingestion affect fat metabolism in the liver?
- increased peripheral free fatty acid is delivered to the liver
- NAD is converted by alcohol to NADH, which stimulates lipid synthesis
- mitochondrial oxidation of free fatty acids is reduced by alcohol
- transport of fat out of hepatocytes is reduced (due to impaired intracellular tubulin)
What is the presentation of acute alcoholic steatohepatitis?
- fever
- liver tenderness
- jaundice
What is the histopathology of alcoholic steatohepatitis?
- acute inflammatory cell infiltration
- cellular steatosis
- hepatocyte ballooning
- Mallory’s hyaline (pink inclusion in cytoplasm)
What is Boerhaave syndrome?
Oesophageal rupture resulting from protracted vomiting
The tearing of the eosophageal muocsa is known as…
Mallory-Weiss tear
What is Barret’s oesophagus?
change of the normal squamous epithelium to the columnar lined mucosa in response to repeat insult from gastric contents
Oesophageal varice formation is reversible if treated before rupture (T/F)
False
-treatment is symptomatic - e.g. banding upon rupture
Fat necrosis, scarring and pseudocyst formation in the pancreas arises due to ____ _____
chronic pancreatitis
How do pseudocysts differ from cysts?
cysts are lined by epithelial cells
What is the pathophysiology of alcohol-induced peripheral neuropathy?
- burning pain and weakness are present
- due to direct damage to peripheral nerves and thiamine deficiency
Thiamine deficiency resulting in cytotoxic oedema in Mamillary bodies is…
Wernicke’s Encephalopathy
Cerebral atropnhy resulting from Wernicke’s syndrome is…
Korsakoff syndrome
What are the characterisitcs of Korsakoff syndrome?
- Anterograde amniesia (no retention of new information)
- Retrograde amnesia (episodic memory)
- Confabulation
How does chronic alcohol consumption result in Cardiomyopathy?
- Alcohol imparis ventricular function by impairing Ca homeostasis and mitochondrial function
- Chronic inflammation leads to fibrosis of myofibrils
- negative inotropic effect leads to compensatory increased contraction rate, causing dilated cardiomyopathy
How does alcohol cause arrhythmias?
- direct negative inotropic effect
- dilated caridomyopathy leads to atrial and ventricular arrhythmias
Alcohol related Steatohepatitis is irreversible (T/F)
False
reversible with cessation of drinking
What are the common complications associated with alcoholic hepatitis?
Renal failure
Bleeding
Infections
What is the cause of Hepatic Encephalopathy?
Ammonia
- portosystemic shunting through collaterals results in failure to clear toxins
- ammonia crosses the BBB
What is the treatment for Hepatic encephalopathy?
Beta blockers
Lactulose
Rifaximim
TIPS (transjugular intrahepatic portosystemic shunt)
Which metabolite of ethanol is carcinogenic?
Acetaldehyde
How does acetladehyde make its way into systemic circulation?
Excess alcohol use chronically leads to circumvention of the portal circulation. Alcohol is metabolised by ADH in stomach and UGI mucosa. no Aldehyde Dehydrogenase is present, thus acetaldehyde remains. unmetabolised
What drugs can be used to support reduction of alcohol consumption?
Acamprosate - reduces cravings
Naltrexone - reduced desire for alcohol
Disulfiram - aversion therapy
Nalmefene - opioid antagonist
