Medical Consequences of Alcohol Excess

Question 1

alcohol guidelines per week

Answer 1

14 units a week

over three or more days

Question 2

acute effects of alcohol consumption

Answer 2

CNS (accidents, violence)

GI (oesophagitis, gastritis/ulceration)

RESP (overdose, aspiration)

Question 3

chronic effect of alcohol consumption

Answer 3

GI (stomach, liver, pancreas)

CARDIO (hypertension, cardiomyopathy, MI, stroke)

CNS (neuropathies, cerebellar degeneration, dementia, wernicke-korsakoff’s syndrome)

Question 4

foetal alcohol syndrome

Answer 4

> 10% of children exposed in utero

7-14 drinks/week (particularly >5 per occasion) can cause moderate damage

growth deficiency, mental retardation/intellectual impairment, attentional learning disabilities and behavioural problems

Question 5

signs of chronic liver disease

Answer 5

stigmata - spider, fetor, encephalopathy

‘synthetic division’

prolonged prothrominbin time, hypoalbumienaeia

Question 6

portal hypertension

Answer 6

caput medusa

hypersplenism

thrombocytopenia

Question 7

grading of cirrhosis

Answer 7

Childs-turcotte-pugh

model for end stage liver disease (MELD)

serum bilirubin, creatine, INR - 3 moth mortality

Question 8

alcoholic hepatitis

Answer 8

recent excess alcohol
bilirubin >80nanomol/l
exclusion of other liver disease
AST<500 (AST:ALT ratio >1.5)\

hepatomegaly, fever, leucocytosis, hepatic bruit

Question 9

madders discriminant function

Answer 9

score>32 correlates 45% mortality at 28 day

Question 10

glasgow alcoholic hepatitis score

Answer 10

age, WCC, urea, PT ratio, bilirubin