Lecture 10 Symposium 3 Alcohol and Health Flashcards
Define Harmful Use during acute intoxication presentation
Pattern of use causing damage to physical or mental health >1 month or repeatedly over 12 months
Define Dependence during acute intoxication presentation
Cravings Difficulty controlling use Primacy Increased tolerance Physiological withdrawal symptoms
What is the Alcohol Withdrawal State
Tremor Weakness Nausea Vomiting Anxiety Seizures Confusion Agitation Delirium Tremens
What are the symptoms of Delirium Tremens
Profound confusion Tremor Agitation Hallucinations Delusions Sleeplessness Autonomic over-activity
What causes Wernicke’s encephalopathy and Korsakoff’s Psychosis
Thiamine deficiency
What are the symptoms of Wernicke’s encephalopathy
Confusion
Ataxia
Ophthalmoplegia
Nystagmus
What is Korsakoff’s Psychosis
– Prominent impairment of recent and remote memory, preservation of immediate recall, no general cognitive impairment, retrograde and anterograde memory, impaired learning and disorientation, may exhibit nystagmus and ataxia
Name 4 screening tools for alcohol use
CAGE
PAT
FAST
AUDIT
How is Wernicke-Korsakoff syndome prevented
Thiamine parental
What medication can be given to manage alcohol withdrawal
Benzodiazepines, commonly Chlordiazepoxide
What medication can be used to aversion and deterrent
Disulfiram (Antabuse)
What medication can be administered for anti-craving
- Acamprosate (Campral)
- Naltrexone
- Nalmefene
- (Baclofen)
What is the progression of liver disease
Fatty Liver Disease
Liver Cirrhosis
Hepatic Liver Disease
What is the formula to work out the osmolal gap
(2XNa + urea + glucose) =
What does the osmolal gap determine
An increase in the osmotic gap (greater than 10) indicates the presence of other substances such as toxic alcohols, aspirin, or mannitol.
How do you work our the anion gap
(Na + K) - (HCo3 + Cl)
What does the anion gap determine
The anion gap blood test is used to show whether your blood has an imbalance of electrolytes or too much or not enough acid
What is the pathophysiology of Alcohol Ketoacidosis
Excess alcohol is metabolised and drives NADH+ production
This drives ketone production
This impairs glucose neogenesis and metabolism of lactate
What are the 2 consequences of Alcohol Ketoacidosis
Hypoglycaemia
Acidosis
How do you stabilise d patient that is experiencing Wernicke-Korsakoff’s syndrome
IV fluids
IB formation of vitamin B1 (pabrinex)
How does alcohol affect thiamine
Alcohol blocks the duodenal uptake of thiamine
Thiamine deficiency can lead to a build up of what
Lactacte
If you ever see an unexplained lactic acidosis what should you administer
Thiamine
In Fatty Liver Disease what is the level of bilirubin, ASE/ALT and Gamma GT
Hyperbilirubinaemia and mild elevation of transaminases (AST/ALT). Gamma GT is elevated in a majority of patients.
In Alcoholic Hepatitis what is the ration of AST:ALT
> 2
In chronic alcohol misusers what would the magnesium and phosphate levels look like
Low due to malnourishment
