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CLASP: Alcohol 2017/18 > READ ME / 1: Acute alcohol intoxication > Flashcards

READ ME / 1: Acute alcohol intoxication Flashcards

1
Q

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.

A
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2
Q

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.

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3
Q

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.

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4
Q

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.

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5
Q

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 👍

A
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6
Q

Alcohol is a ___.

A

drug

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7
Q

What is the functional group found in alcohol molecules?

A

OH

hydroxyl

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8
Q

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

A

toxic

shouldn’t

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9
Q

Where may methanol occasionally be found?

A

Home brew alcohol

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10
Q

What is methanol metabolised into?

A

Formaldehyde (fixes tissue)

> Formic acid (dissolves you)

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11
Q

What is the main symptom of methanol poisoning?

A

Blindness

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12
Q

How is methanol poisoning treated?

A

Ethanol +/- dialysis

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13
Q

What enzyme metabolises both methanol and ethanol?

A

Alcohol dehydrogenase

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14
Q

By which principle does drinking ethanol help with methanol poisoning?

A

Competitive inhibition by ethanol

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

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15
Q

Which group of women are advised not to drink alcohol?

A

Pregnant women

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16
Q

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

A

Reduced gastric emptying

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

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17
Q

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

A

14 units

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18
Q

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

A

rest

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19
Q

Alcohol is soluble in ___.

A

water

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20
Q

Alcohol absorption in the stomach is ___.

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

A

minimal

Small bowel

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21
Q

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

A

Antihistamines (inc. rate of emptying)

Metoclopramide (for gastroparesis, inc. rate of emptying)

Domperidone (“”)

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22
Q

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

Why?

A

more slowly

Irritates gastric mucosa > delays empyting

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23
Q

What drinks are aerated and tend to be absorbed quickly?

A

Champagne, prosecco etc.

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24
Q

Do women have a lower tolerance for alcohol than men?

A

Yes

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25
Q

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

A

Males have a leaner body mass on average

More water > greater volume for dilution

Females have lower alcohol dehydrogenase activity as well

26
Q

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

A

Alcohol dehydrogenase

27
Q

Where is most alcohol metabolised?

A

Liver

28
Q

Apart from the liver, where else is alcohol metabolised?

A

Pancreas

Brain

29
Q

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

A

Breath

Sweat

Stool

30
Q

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

A

1 unit per hour

31
Q

Alcohol concentration peaks ___ hour after consumption.

A

one

32
Q

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

A

Drive

33
Q

Certain ethnic groups have reduced levels of which enzyme?

Which groups?

A

Alcohol dehydrogenase

Aborigines, eskimos etc.

34
Q

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

A

Low levels of ALDEHYDE dehydrogenase - acetaldehyde is unpleasant and toxic

35
Q

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

A

Aldehyde dehydrogenase inhibitors

e.g disulfiram (Antabuse)

36
Q

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

A

Alcohol dehydrogenase activity UPREGULATED

37
Q

Which alternate pathway of alcohol metabolism is activated in chronic drinkers?

Which family of proteins does it require?

A

MEOS pathway

Cytochrome P450 family

38
Q

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

A

Alcoholism

39
Q

Which three biochemical processes are impaired by chronic alcoholism?

A

Gluconeogenesis

Kreb’s Cycle

Fatty acid oxidation

40
Q

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

A

Kreb’s Cycle inhibited

Switch to anaerobic metabolism

Production of lactic acid

41
Q

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

A

Gluconeogenesis

Glycogenolysis

using fat, proteins etc.

42
Q

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

A

Hypoglycaemia

43
Q

People with which condition should be careful when heavy drinking?

A

Diabetes

44
Q

Why does drinking alcohol make you gain weight?

A

Fatty acid oxidation impaired

Excess lipid synthesis

Plus the alcohol contains loads of calories anyway

45
Q

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?

A

Diabetic ketoacidosis - hyperglycaemia

Alcoholic ketoacidosis - little/no hyperglycaemia

46
Q

Alcohol is a CNS (stimulant / depressant).

A

depressant

47
Q

The level of which neurotransmitter is increased by alcohol consumption?

A

GABA

48
Q

The CNS effects of alcohol consumption are __-dependent.

A

dose

49
Q

Why is unconsciousness dangerous in someone who is acute intoxicated?

A

Swallowing impaired

Vomiting

Aspiration pneumonia (brush up on lung lobes)

50
Q

Why else may you die while acutely intoxicated?

A

Trauma (misadventure, falls, fighting etc.)

Vomiting (metabolic alkalosis, Mallory-Weiss tear, Boerhavve syndrome (gastric tear), acute pancreatitis)

51
Q

Does alcohol make you pee more?

A

Yes

52
Q

Why does alcohol make you pee more?

A

Sheer volume consumed

53
Q

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

A

ADH / Vasopressin

54
Q

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

A

Reduced water reabsorption

Higher volume of less concentrated urine

55
Q

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

A

Negative inotrope (reduced contractility)

So heart rate increases to maintain cardiac output

56
Q

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

A

Holiday heart syndrome

57
Q

What are the factors contributing to headache after drinking alcohol?

A

Congeners - i.e the substances used to make alcohol smell a certain way

Serotonin

Dehydration

Acetic acid

58
Q

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

A

Dehydration

59
Q

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

A

prostaglandins

60
Q

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

A

Alcohol is a smooth muscle relaxant

> inhibition of lower oesophageal sphincter (also snoring), gastric acid irritates oesophageal mucosa

CLASP: Alcohol 2017/18 (8 decks)

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