Symposium - Alcohol Misuse Flashcards
1
Q
Through what mechanisms does alcohol contribute to mortality in the following age groups:
- 16 to 34
- 34 to 64
- 64+
A
- 16-34 years
- Accidents/traumas
- Self-harm and suicide
- Alcohol intoxication (poisoning)
- 34-64 years
- Alcohol related liver disease
- 64+
- Alcohol related cancers
2
Q
What are the principles of the WHO global alcohol strategy?
A
- Availability
- Regulation of marketing
- Price controls (cheapest alcohol)
- Leadership and mentoring
- Early identification and advice
3
Q
What are the effects of alcohol at low and high doses?
A
- Low doses
- Euphoria, reduced anxiety, relaxation, sociability
- High doses
- Intoxication (the pathological state produced by a drug, serum, alcohol or any toxic substance), basically poisoning
- Impaired attention and judgement, unsteadiness, flushing, nystagmus, mood instability, disinhibition, slurring, stupor, unconsciousness
4
Q
What is intoxication?
A
- Intoxication (the pathological state produced by a drug, serum, alcohol or any toxic substance), basically poisoning
5
Q
What is used to grade alcoholism?
A
ICU-10
6
Q
What are the different grades of alcoholism?
A
-
Harmful use
- Pattern of use causing damage to physical or mental health
- Use > 1 month or repeatedly over 12 months
-
Dependence
- 3 or more of the following for >1month or repeatedly over 12 months
- Cravings/compulsions to take
- Difficulty controlling use
- Primacy
- Increased tolerance
- Physiological withdrawal on reduction/cessation
- Persistence despite harmful consequences
- 3 or more of the following for >1month or repeatedly over 12 months
-
Withdrawal state
- Group of symptoms of variable clustering and severity on complete/relative withdrawal of a psychoactive substance, after persistent use of that substance
- Tremor, weakness, nausea, vomiting, anxiety, seizures, confusion, agitation, death
- Delirium tremens
- Profound confusion, tremor, agitation, hallucinations, delusions, sleeplessness, autonomic over-activity
- Death – cardiovascular collapse, infection, hyperthermia, seizures of self-injury
- Usually 48-72 hours after alcohol stopped
7
Q
What is the criteria for the following grades:
- harmful use
- dependence
- withdrawal state
A
- Harmful use
- Pattern of use causing damage to physical or mental health
- Use > 1 month or repeatedly over 12 months
- Dependence
- 3 or more of the following for >1month or repeatedly over 12 months
- Cravings/compulsions to take
- Difficulty controlling use
- Primacy
- Increased tolerance
- Physiological withdrawal on reduction/cessation
- Persistence despite harmful consequences
- 3 or more of the following for >1month or repeatedly over 12 months
- Withdrawal state
- Group of symptoms of variable clustering and severity on complete/relative withdrawal of a psychoactive substance, after persistent use of that substance
- Tremor, weakness, nausea, vomiting, anxiety, seizures, confusion, agitation, death
- Delirium tremens
- Profound confusion, tremor, agitation, hallucinations, delusions, sleeplessness, autonomic over-activity
- Death – cardiovascular collapse, infection, hyperthermia, seizures of self-injury
- Usually 48-72 hours after alcohol stopped
8
Q
What is seen in delirium tremens?
A
- Profound confusion, tremor, agitation, hallucinations, delusions, sleeplessness, autonomic over-activity
- Death – cardiovascular collapse, infection, hyperthermia, seizures of self-injury
- Usually 48-72 hours after alcohol stopped
9
Q
When does delirium tremens usually begin?
A
- Usually 48-72 hours after alcohol stopped
10
Q
What are some examples of problems that alcohol can cause?
A
- Physical health
- Affects every part of your body, every organ system
- Find examples below
- Mental health
- Depression
- Sleep disruption
- Morbid jealousy
- Alcohol hallucinosis
- Deliberate self-injury
- Suicidal thoughts/acts
- Relationships
- Aggression
- Marital difficulties
- Poor parenting
- Loss of friendships and social supports
- Employment, financial
- Legal
11
Q
What are some health conditions directly related to alcohol?
A
- Wernicke’s encephalopathy
- Confusion, ataxia, opthalmoplegia, nystagmus
- Koraskoff’s psychosis
- Prominent impairment of recent and remote memory, preservation of immediate recall, impaired learning and disorientation
- May exhibit nystagmus and ataxia
- Due to thiamine deficiency
12
Q
Wernicke’s encephalopathy - clinical featrures
A
- Confusion, ataxia, opthalmoplegia, nystagmus
13
Q
Koraskoff’s psychosis - clinical features
A
- Prominent impairment of recent and remote memory, preservation of immediate recall, impaired learning and disorientation
- May exhibit nystagmus and ataxia
14
Q
Karoskoff’s psychosis - aetiology
A
- Due to thiamine deficiency
15
Q
What are some screening tools for alcoholism?
A
- CAGE (2 or more indicates alcohol problem)
- Have you tried to Cut down
- Have you felt Annoyed by people critisising your drinking
- Have you felt Guilty about drinking
- Have you felt the need to have an Eye opener
- AUDIT (alcohol use disorders identification test)
- FAST (4 questions)
- PAT (Paddington Alcohol Test) – used in A and E
20
Q
What organ systems are affected by alcohol?
A
Each organ system is affected, particular the liver
25
Q
What scoring system is used to grade acute alcoholic hepatitis?
A
GAHS score
26
Q
What does the GAHS score consider?
A
35
Q
Why is thiamine so important for metabolism?
A
Thiamine is used at multiple points as co-factor
