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Year 4 Psychiatry > Substance misuse > Flashcards

Substance misuse Flashcards

1
Q

What are the four main types of alcohol problems?

A
  1. Excessive consumption
  2. Alcohol-related disabilities
  3. Problem drinking
  4. Alcohol dependence
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2
Q

What are the gastrointestinal problems associated with excessive drinking? (8)

A
  1. Nausea and vomiting
  2. Gastritis
  3. Peptic ulcers
  4. Mallor-Weiss tears
  5. Oesophageal varices
  6. Malnutrition/vitamin deficits
  7. Alcoholic hepatitis/cirrhosis
  8. Acute pancreatitis
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3
Q

In addition to the GI problems associated with alcohol, what other problems does it cause? (5 categories)

A
  1. Cardiovascular - arrhythmias, hypertension
  2. Haematological - iron deficiency anaemia, folate deficiency, vitamin K deficiency (impaired clotting)
  3. Cancer - oropharynx, oesophagus, pancreas, liver, lungs
  4. Accidents and trauma
  5. Foetal alcohol syndrome in pregnancy
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4
Q

What are the features foetal alcohol syndrome? (6)

A
  1. Microcephaly
  2. Ocular hypertelorism
  3. Mild to moderate learning disabilities
  4. Stabismus
  5. Pectus excavatum
  6. Cardiac murmurs
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5
Q

How many times higher is the rate of suicide in chronic heavy alcohol drinks compared to the general population?

A

50 times greater

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6
Q

What causes Korsakov’s syndrome?

A

Thiamine (vitamin B1) deficiency secondary to alcohol abuse (normally)

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7
Q

What causes Wernicke’s encephalopathy?

A

Thiamine B1 deficiency

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8
Q

What are the most important clinical features of Wernicke’s? (5)

A
  1. Opthalmoplegia
  2. Nystagmus
  3. Ataxia
  4. Clouding of consciousness
  5. Peripheral neuropathy
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9
Q

What are the social problems associated with alcohol misuse?

A
  1. Relationship breakdown
  2. Poor performance at work
  3. Crime
  4. Accidents and trauma
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10
Q

What is the triad of Wernicke’s encephalopathy? (3)

A
  1. Ophthalmoplegia
  2. Ataxia
  3. Confusion
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11
Q

What are the complications of chronic alcohol intake?

A
  1. Alcoholic liver disease
  2. Hepatic encephalopathy
  3. Acute pancreatitis
  4. Chronic pancreatitis
  5. Wernicke’s encephalopathy
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12
Q

What are the three stages of alcoholic liver disease?

A
  1. Steatosis (fatty liver)
  2. Hepatitis (inflammation/necrosis)
  3. Cirrhosis (fibrosis)
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13
Q

What does cirrhosis cause? (5)

A
  1. Portal hypertension
  2. Ascites
  3. Jaundice
  4. Variceal haemorrhage
  5. Hepatocellular carcinoma
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14
Q

When does alcohol withdrawal first begin to occur?

A

4-12 hours post decrease/abstinence - peaks at 24-36 hours after the last drink

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15
Q

What are the signs/symptoms of mild/moderate alcohol withdrawal? (8)

A
  1. Nausea
  2. Irritability
  3. Shakiness
  4. Depression
  5. Fatigue
  6. Anxiety
  7. Coarse tremor
  8. Excitability
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16
Q

What are the symptoms of major withdrawal from alcohol? (6)

A
  1. Severe anxiety and irritability
  2. Insomnia
  3. Tachycardia
  4. Hypertension
  5. Fever
  6. Auditory/visual hallucinations
17
Q

When does delirium tremens typically onset?

A

3 days since last drink

18
Q

What are the components of delirium tremens and what can it lead to? (3)

A
  1. Hallucinations
  2. Confusion
  3. Seizures
    …can lead to Wernicke’s encephalopathy
19
Q

What are the two treatments normally given in alcohol withdrawal?

A
  1. Chlordiazepoxide (benzodiazepine)

2. Pabrinex

20
Q

What type of drug is amphetamine - as in what does it act on?

A

CNS stimulant - increases levels of dopamine and noradrenaline

21
Q

What effect do amphetamines cause? (4)

A
  1. Active, alert, confident
  2. No need for sleep, improved focus
  3. Reduces appetite
  4. Tachycardia, tachypnoea, dilated pupils, pyrexia
22
Q

Which amphetamine is abused as a study aid?

A

Ritalin (methylphenidate)

23
Q

What are the unwanted effects of amphetamine use?

A
  1. Panic attacks
  2. Depression
  3. Aggression, paranoia
  4. Hallucinations, psychosis
  5. Dependency
  6. Seizures, tremors
24
Q

How are methamphetamines different to amphetamines?

A

Greater dopamine release from baseline

Year 4 Psychiatry (14 decks)

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