READ ME / 1: Acute alcohol intoxication

Question 1

Thanks for using my flashcards, hope you find them useful!

If you spot any errors or have suggestions, please let me know by clicking the speech bubble or sending me a message. It’s really helpful.

Question 2

The questions are written using the official Dundee lectures, so you might find it useful to have them open in the background in case you get stuck.

Question 3

I write the questions based on what I think the important facts are, but not everything is relevant. Don’t waste your time learning tiny details.

Question 4

On the other hand, this isn’t everything you need to know - back it up with stuff from tutorials, other people’s questions, Youtube videos, Oxford handbooks etc.

Question 5

There’s a good chance that older decks will be inaccurate (lectures and guidelines change year to year) so I’ll try to update them in the future.

Break a leg 👍

Question 6

Alcohol is a ___.

Answer 6

drug

Question 7

What is the functional group found in alcohol molecules?

Answer 7

OH

hydroxyl

Question 8

Methanol is ___ and (should / shouldn’t) be consumed.

Answer 8

toxic

shouldn’t

Question 9

Where may methanol occasionally be found?

Answer 9

Home brew alcohol

Question 10

What is methanol metabolised into?

Answer 10

Formaldehyde (fixes tissue)

> Formic acid (dissolves you)

Question 11

What is the main symptom of methanol poisoning?

Answer 11

Blindness

Question 12

How is methanol poisoning treated?

Answer 12

Ethanol +/- dialysis

Question 13

What enzyme metabolises both methanol and ethanol?

Answer 13

Alcohol dehydrogenase

Question 14

By which principle does drinking ethanol help with methanol poisoning?

Answer 14

Competitive inhibition by ethanol

i.e it competes with methanol for the alcohol dehydrogenase enzymes

Question 15

Which group of women are advised not to drink alcohol?

Answer 15

Pregnant women

Question 16

Why does drinking on a full stomach reduce the rate of alcohol absorption?

Answer 16

Reduced gastric emptying

So more alcohol is metabolised in the stomach instead of being absorbed into the bloodstream

Question 17

What is the recommended weekly intake of alcohol for men and women?

Answer 17

14 units

Question 18

If a patient is consuming alcohol regularly over a week, they should have several ___ days.

Answer 18

rest

Question 19

Alcohol is soluble in ___.

Answer 19

water

Question 20

Alcohol absorption in the stomach is ___.

Where in the GI tract is mainly responsible for alcohol absorption?

Answer 20

minimal

Small bowel

Question 21

Which drugs increase the rate of gastric emptying and therefore increase the rate at which alcohol is absorbed in the small bowel?

Answer 21

Antihistamines (inc. rate of emptying)

Metoclopramide (for gastroparesis, inc. rate of emptying)

Domperidone (“”)

Question 22

Drinking high concentrations of alcohol will result in it being absorbed (more quickly / more slowly).

Why?

Answer 22

more slowly

Irritates gastric mucosa > delays empyting

Question 23

What drinks are aerated and tend to be absorbed quickly?

Answer 23

Champagne, prosecco etc.

Question 24

Do women have a lower tolerance for alcohol than men?

Answer 24

Yes

Question 25

Why do females have a lower tolerance for alcohol than men?

Answer 25

**Males have a leaner body mass on average** More water \> greater volume for dilution **Females have lower alcohol dehydrogenase activity as well**

Question 26

Which enzyme, which metabolises alcohol, do females have less of compared to men?

Answer 26

**Alcohol dehydrogenase**

Question 27

Where is most alcohol metabolised?

Answer 27

**Liver**

Question 28

Apart from the liver, where else is alcohol metabolised?

Answer 28

**Pancreas** **Brain**

Question 29

Apart from in the urine, where else is alcohol excreted?

Answer 29

**Breath** **Sweat** **Stool**

Question 30

Alcohol is removed from the blood at **15mg/100ml/hour** - how many units is this roughly equivalent to?

Answer 30

**1 unit per hour**

Question 31

Alcohol concentration peaks **\_\_\_ hour** after consumption.

Answer 31

**one**

Question 32

Because blood concentration of alcohol decreases linearly, what shouldn't you do the morning after heavy drinking?

Answer 32

**Drive**

Question 33

Certain ethnic groups have reduced levels of which enzyme? Which groups?

Answer 33

**Alcohol dehydrogenase** Aborigines, eskimos etc.

Question 34

Why do some people flush and feel sick after drinking alcohol?

Answer 34

**Low levels of ALDEHYDE dehydrogenase** - acetaldehyde is unpleasant and toxic

Question 35

Which drugs, used to manage chronic alcoholism, cause flushing and nausea in people who then drink alcohol?

Answer 35

**Aldehyde dehydrogenase inhibitors** e.g disulfiram (Antabuse)

Question 36

Why do you achieve a higher alcohol tolerance the more alcohol you drink?

Answer 36

**Alcohol dehydrogenase activity UPREGULATED**

Question 37

Which alternate pathway of alcohol metabolism is activated in chronic drinkers? Which family of proteins does it require?

Answer 37

**MEOS pathway** **Cytochrome P450 family**

Question 38

What is one of the biggest risk factors for head and neck cancers?

Answer 38

**Alcoholism**

Question 39

Which three biochemical processes are impaired by chronic alcoholism?

Answer 39

**Gluconeogenesis** **Kreb's Cycle** **Fatty acid oxidation**

Question 40

Why may you get **sore** after a night of heavy drinking?

Answer 40

**Kreb's Cycle inhibited** **Switch to anaerobic metabolism** **Production of lactic acid**

Question 41

Which two processes start in the liver when blood glucose is low during a night of heavy drinking?

Answer 41

**Gluconeogenesis** **Glycogenolysis** using fat, proteins etc.

Question 42

Why do you get the munchies after a night of heavy drinking?

Answer 42

**Hypoglycaemia**

Question 43

People with which condition should be careful when heavy drinking?

Answer 43

**Diabetes**

Question 44

Why does drinking alcohol make you gain weight?

Answer 44

**Fatty acid oxidation impaired** **Excess lipid synthesis** Plus the alcohol contains loads of calories anyway

Question 45

Both alcoholic and diabetic ketoacidosis involve a metabolic acidosis due to the buildup of ketones in the blood. What is the thing differentiating these two diseases?

Answer 45

**Diabetic ketoacidosis** - **hyperglycaemia** **Alcoholic ketoacidosis** - little/no hyperglycaemia

Question 46

Alcohol is a CNS **(stimulant / depressant)**.

Answer 46

**depressant**

Question 47

The level of which neurotransmitter is increased by alcohol consumption?

Answer 47

**GABA**

Question 48

The CNS effects of alcohol consumption are \_\_-dependent.

Answer 48

**dose**

Question 49

Why is unconsciousness dangerous in someone who is acute intoxicated?

Answer 49

**Swallowing impaired** **Vomiting** **Aspiration pneumonia** (brush up on lung lobes)

Question 50

Why else may you die while acutely intoxicated?

Answer 50

**Trauma** (misadventure, falls, fighting etc.) **Vomiting** (metabolic alkalosis, Mallory-Weiss tear, Boerhavve syndrome (gastric tear), acute pancreatitis)

Question 51

Does alcohol make you pee more?

Answer 51

**Yes**

Question 52

Why does alcohol make you pee more?

Answer 52

**Sheer volume consumed**

Question 53

Which hormone, responsible for water reabsorption, is **inhibited** by alcohol?

Answer 53

**ADH / Vasopressin**

Question 54

What is the result of the inhibition of ADH by alcohol?

Answer 54

**Reduced water reabsorption** **Higher volume of less concentrated urine**

Question 55

Why does acute intoxication give you the sensation of a heavy heartbeat?

Answer 55

**Negative inotrope** (reduced contractility) ## Footnote **So heart rate increases to maintain cardiac output**

Question 56

Binge drinking of alcohol can cause a spontaneous supraventricular tachycardia - what is this condition called?

Answer 56

**Holiday heart syndrome**

Question 57

What are the factors contributing to headache after drinking alcohol?

Answer 57

**Congeners** - i.e the substances used to make alcohol smell a certain way ## Footnote **Serotonin** **Dehydration** **Acetic acid**

Question 58

Apart from chemicals in alcohol, what contributes to a hangover after acute intoxication?

Answer 58

**Dehydration**

Question 59

Any drug which inhibits ____ may see some use as a hangover cure.

Answer 59

**prostaglandins**

Question 60

Why do some people who drink alcohol have heartburn the next morning?

Answer 60

**Alcohol is a smooth muscle relaxant** \> inhibition of lower oesophageal sphincter (also snoring), gastric acid irritates oesophageal mucosa