toxic disorders

Question 1

alcohol ETOH

Answer 1

blood alcohol content is in grams per 100 mls blood
1 g per 100 mls is 1%
BAC depends on BW, amt ETOH consumed, time elapsed since consumption

Question 2

BAC- mood and behavior

Answer 2

.05% euphoria
.05-.1% excitation and ataxia
.1-.2% drowsiness, loss of inhibitions, imparied judgement, confusion, slurred speech
.2-.3% stupor
.3-.4% anesthesia, coma, death d/t resp center shutdown

Question 3

chronic alcohol use

Answer 3

liver- hepatitis and cirrhosis
stomach- gastritis and ulcers
heart- cardiomyopathy, HTN
pancreas- pancreatitis
body-nutritional deficiencies

Question 4

peripheral neuropathy

Answer 4

exact pathogenesis unclear
may be accompanied by thiamine deficiency B vitamin
related to total lifetime accumulation of alcohol

Question 5

clinical presentation

Answer 5

mild-severe
loss of ms bulk, diminished ankle reflexes, distal sensory changes
LE>UE

Question 6

chronic alcohol use

Answer 6

brain effects show up as atrophy
thalamus and hypothalamus
cerebellum
pons
cerebral cortex
PNS neuropathies

Question 7

Alcohol withdrawal

Answer 7

DTs (delirium tremens)- severe
anorexia, nausea, insomnia, disorientation, confusion hallucinations
convulsions and sometimes death

Question 8

delirium tremens

Answer 8

confusion, diarrhea, insomnia, nightmares, disorientation, agitation, severe autonomic instability (fever, tachycardia, HTN)
48-96 hrs up to 10 days since last drink

Question 9

DTs occurrence

Answer 9

5-10% alcoholics will have them

35% will die if not treated

Question 10

Wernike-Korsakoff encephalopathy

Answer 10

caused by alcohol ingestion

CNS

Question 11

Wernike’s syndrome

Answer 11

chronic alcohol abuse
caused by chronic alcoholism
ataxic gait, nystagmus, confusion, apathy, disorientation

Question 12

korsakoff psychosis

Answer 12

pt in SNF for life
loss of long-term memory
inability to learn new info
confabulation

Question 13

Medical management

Answer 13

abstain from alcohol

expect mild improvement