Substance Misuse

Question 1

Define alcohol misuse

Answer 1

consumption of alcohol sufficient to cause physical, psychiatric or social harm

Question 2

What would you see on examination of alcohol dependent pt

Answer 2

spider naevi, gyno, portal systemic hypertension, oedema

Question 3

what is wernickes. how treat. what does it progress to

Answer 3

thiamine deficiency causing mental confusion, ataxia and ophthalmoplegia
progresses to korsakoff psychosis (amnesic disorder)

Question 4

manage alcohol dependence

Answer 4

detox with vitamins and electrolytes and chlordiazepoxide to prevent seizures and reduce withdrawal
Motivational interviewing
Alcoholics anonymous
Address social issues
Disulfiram

Question 5

What is delirium tremens. manage

Answer 5

psychosis that occurs during withdrawal in alcoholics
Symptoms - hallucinations, confusion, delusions, seiures, hyperthermia, cvs collapse
treatment - ABCDE, treat hypoglycamia, sedate with BZDs, IV thiamine

Question 6

Manage illict drug usage

Answer 6

Detox, motivational interviewing, harm minimisation

Question 7

what can you replace heroin with

Answer 7

methadone