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*Psychiatry > Symposium 2 - Alcohol > Flashcards

Symposium 2 - Alcohol Flashcards

1
Q

What are the low-dose effects of alcohol?

A

Euphoria
Reduced anxiety
Relaxation
Sociability

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2
Q

What are the high dose effects of alcohol?

A 
Intoxication
Impaired attention/judgement
Nystagmus
Flushing
Unsteadiness
Disinhibition
Mood instability
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3
Q

How is alcohol dependence diagnosed?

A

3 or more for >1mo of:

  • Cravings/compulsions
  • Difficulty controlling use
  • Primacy
  • Increased tolerance
  • Withdrawal
  • Persistence despite consequences
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4
Q

How is harmful alcohol use diagnosed?

A

Pattern of use to physical/mental health

Use >1mo or repeatedly over 12 months

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5
Q

What are the symptoms of alcohol withdrawal?

A 
Tremor
Weakness
N+V
Anxiety
Seizures
Confusion
Agitation
Death
Delirium tremens
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6
Q

What is delirium tremens?

A

Withdrawal state:
Confusion, tremor, agitation, hallucinations, sleeplessness
5% mortality
48-72hrs after alcohol cessation

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7
Q

How does Delirium tremens cause death?

A 
Cardiovascular collapse
Infection
Hyperthermia
Seizures
Self harm
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8
Q

What problems are associated with alcohol overuse?

A 
Physical/mental health
Relationships
Employment
Financial issues
Legal issues
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9
Q

What mental health issues are associated with alcohol use?

A 
Anxiety
Depression
Sleep disruption
Morbid jealousy
Alcoholic Hallucinosis
Deliberate self-injury
Suicidal  thoughts
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10
Q

What cancers are associated with alcohol overuse?

A

Mouth
Oesophagus
Liver

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11
Q

What physical conditions are associated with alcohol overuse?

A 
Brain damage - Korsakoffs/Wernicke's
Chest infections
Liver damage
Neuropathy
Immunosuppression
Hypertension
Gastritis/ulcers
Pancreatitis
Impotence/infertility
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12
Q

What are the neurological issues caused by alcohol overuse?

A

(Thiamine deficiency)
Wernicke’s Encephalopathy
Korsakoff’s Psychosis

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13
Q

What are the symptoms of Wernicke’s Encephalopathy?

A

Confusion
Ataxia
Ophthalmoplegia
Nystagmus

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14
Q

What are the symptoms of Korsakoff’s Psychosis?

A

Impairment of recent/remote memory to immediate recall
No cognitive impairment or anterograde amnesia
Impaired learning
Disorientation
Nystagmus
Ataxia

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15
Q

How can alcohol overuse impact relationships?

A

Aggression
Morbid jealousy
Poor parenting/neglect
Loss of friendships/social support

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16
Q

What screening tools are used for alcohol overuse?

A

CAGE
AUDIT
FAST
PAT (A&E)

17
Q

What are the CAGE screening tool questions?

A

Have you tried to Cut down?
Have you felt Annoyed by criticism of your drinking?
Have you felt Guilty by drinking?
Have you felt the need to have an Eye-opener?

18
Q

How does alcohol affect sleep?

A

Encourages sleep
Disrupts REM (poor long-term memory formation)
Blackouts

19
Q

How does alcoholic hallucinosis present?

A

Typically insulting auditory hallucinations

20
Q

How is alcohol overuse managed?

A 
Practical advice
Education
Harm reduction
Holistic approach
Medication
21
Q

What factors are associated with holistic management for alcoholism?

A 
Support for patient and family
Psychological help (e.g. CBT, group therapy)
Social work input 
Skills training
Community Support
Inpatient or residential treatment
Medication
22
Q

What medications are used for alcoholism?

A

Thiamine (prevent Wernicke-Korsakoff)
Benzodiazepines (Manage withdrawal)
Disulfiram (Aversion/deterrant)
Anti craving drugs

23
Q

What are the main roles of the liver?

A 
Metabolise carbohydrates, fats, proteins 
Storeage 
Synthesis 
Collect waste
Produce bile
Metabolise drugs
24
Q

When is AST > ALT?

A

Active alcohol consumption

Liver cirrhosis

25
Q

How is fatty liver diagnosed?

A

USS Liver - hyperechoic

26
Q

What are the CVS impacts of alcoholism?

A 
Arrythmia
Heart failure
Thrombosis
Vascualr disease
HTN
Dilated cardiomyopathy
27
Q

How does alcohol affect the immune system?

A

Bone marrow suppression
Neutrophil chemotaxis
Increased cancer risk

28
Q

What is the progression of alcohol related liver disease?

A 
Normal liver
Fatty liver (steatosis)
Steatohepatitis
Fibrosis
Liver cirrhosis
29
Q

What are the indications on examination of chronic alcohol use?

A 
Elevated Gamma GT
Elevated ferritin
Low platelets
Macrocytosis
Enlarged smooth liver on AUSS
30
Q

What are the symptoms of alcoholic hepatitis?

A 
Fatty change
Hepatomegaly
Jaundice
Abdominal pain 
Fever
Hepatic decompensation
31
Q

How is alcoholic hepatitis managed?

A 
Glasgow Alcoholic Hepatitis score
Steroids 
Infection management
Nutrition
Abstinence
32
Q

What does a Glasgow Alcoholic Hepatitis score imply?

A

28 day survivial?
<9 = 87%
>9 = 46%

33
Q

What are the main complications of cirrhosis?

A

Encephalopathy
Variceal haemorrhage
Ascites
Hepatocellular Carcinoma

34
Q

How does abstinence effect cirrhosis survival rates?

A

5y survival if abstinent - 65%

Otherwise - 35%

*Psychiatry (18 decks)

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