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GI > Understanding alcohol misuse > Flashcards

Understanding alcohol misuse Flashcards

1
Q

What are the alcohol guidelines?

A

not more than 14 units per week

spread the drinking over three days or more if you drink as much as 14 units a week

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2
Q

what is a unit of alcohol?

A

8 grams or 10 mls of PURE alcohol

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3
Q

How do you calculate the number of units in a drink?

A 
              1000

here if it was 14% ABV use 14 in the calculation NOT 0.14

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4
Q

Generally, what measures are equivalent to 1 unit?

A

a glass of wine

half a pint of beer

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5
Q

What is the difference between hazardous and harmful drinking?

A

Harmful drinking involves drinking more alcohol than hazardous
harmful drinking is drinking beyond 35 units per week

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6
Q

What age group does the most binge drinking?

A

16-24

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7
Q

What is the binge drinking trend?

A

going down

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8
Q

What us the alcohol harm paradox?

A

low socioeconomic groups consume less alcohol than higher socioeconomic groups but experience greater alcohol related harm

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9
Q

Alcohol has become less affordable? t or F?

A

False - become 60% MORE affordable

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10
Q

How many units constitutes to binge drinking?

A

men > 8units per day

women > 6 units per day

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11
Q

what has the trend for alcohol related deaths been?

A

it has increased from previous years but now stabilising

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12
Q

when does drinking become too much?

A

when it causes or elevates the risk of alcohol related problems
or complicates the management of other health problems

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13
Q

name some organ systems that alcohol can harm and how it harms them

A

mouth cancer
CVS: high blood pressure, atheroma, CHD
GI: gastritis, peptic ulcers, liver cirrhosis, hepatitis, fatty liver, pancreatitis
GU: impotence, spontaneous abortion
CNS: impaired judgement, psychosis, dementia, headaches, blackout, Wernike’s encephalopathy, stroke

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14
Q

What are the ACUTE effects of XS alcohol

EXAM

A
  • accidents and injury
  • coma and death from respiratory depression
  • aspiration pneumonia
  • oesophagitis/gastritis
  • pancreatitis
  • hypoglycaemia
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15
Q

what are the CHRONIC effects of XS alcohol?

EXAM

A
  • pancreatitis
  • hypertension
  • peripheral neuropathy
  • liver cirrhosis, fatty liver, hepatitis
  • coronary heart disease
  • dementia
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16
Q

name some effects of alcohol withdrawal

A
  1. tremulousness
  2. activation syndrome - tremulousness, agitation, rapid heart beat and high BP
  3. seizures eg grand mal
  4. hallucinations - visual or tactile
  5. delirium tremens - tremors, agitation, confusion, disorientation, hallucinations, sensitivity to light and sound, seizures (medical emergency)
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17
Q

which disease from drinking alcohol leads to the greatest alcohol related deaths?

A

alcoholic liver disease

18
Q

what are the top 5 reasons for alcohol related deaths?

A 
alcoholic liver disease 
fibrosis and cirrhosis of the liver 
mental and behavioural disorders 
accidental poisoning 
alcoholic cardiomyopathy
19
Q

What are the alcohol related conditions that cost the NHS most?

A

mental and behavioural disorders
cardiovascular disease
cancer
alcoholic liver disease

20
Q

what does foetal alcohol syndrome result in?

A
  1. pre and post natal growth retardation
  2. CNS abnormalities eg mental retardation, irritability, incoordination, hyperactivity
  3. craniofacial abnormalities
  4. congenital defects of the eyes, ears, mouth, CVS, GU, skeleton and increased incidence of birthmarks and hernias
21
Q

what are the facial features of foetal alcohol syndrome?

A 
thin upper lip
upturned nose 
hypoplastic jaw 
microcephaly 
smooth philtrum
22
Q

what are the psychosocial effects of XS alcohol consumption?

A 
interpersonal relationships 
problems at work 
criminality 
social disintegration 
driving offences
23
Q

how can alcohol affect interpersonal relationships?

A

violence
rape
depression or anxiety

24
Q

identify public health recommendations in relation to alcohol POLICY EXAM QUESTION

A

think PAM for Policy

  1. price - make alcohol less affordable
  2. availability - licensing and import allowances
  3. marketing - limit exposure to advertising
25
Q

identify public health recommendations in relation CLINICAL PRACTICE - EXAM QUESTION

A
  1. resources for screening and brief interventions
  2. supporting children and young people age 10-15
  3. screening young people and adults
  4. extended brief interventions for young people and adults eg motivational interviewing
  5. referral for specialist treatment
26
Q

give examples of primary prevention strategies for alcohol

A

health education - know your limits binge drinking campaign
drinkaware - alcohol labelling
THINK! drink driving campaign
restriction on alcohol advertising by Ofcom
minimum pricing

27
Q

what effects could minimum pricing have?

A

deaths could fall
reduction in hospital admission
reduction in crime
financial savings

28
Q

what are the secondary preventions for alcohol?

A 
screening and intervention
explore alcohol consumption: ask about it routinely, use screening questions and tools, feedback to the pt whether you think their drinking is a problem or not 
detect problem drinking eg on lab tests 
CAGE questions 
AUDIT tool 
FAST
29
Q

what are the screening questions and tools for alcohol?

A

clinical interview - ask a single question about heavy drinking
FAST- fast alcohol screening test
AUDIT - Alcohol use disorders identification test
CAGE questions

30
Q

what is at risk drinking = hazardous?

A

a pattern of drinking which brings about the RISK of physical or psychological harm

31
Q

what is alcohol abuse = harmful drinking?

A

a pattern of drinking which is LIKELY TO CAUSE physical or psychological harm

32
Q

what is (alcohol) dependence?

A

a set of behavioural, cognitive and physiological responses that can develop after repeated substance use

33
Q

what are the signs that a pt has alcohol abuse?

A 
has the pt's drinking REPEATEDLY caused: 
role failure -eg at work 
risk of bodily harm 
run-ins with the law 
relationship trouble

yes to one or more of these in the past year = alcohol abuse
then asses the pt for dependence

34
Q

What are the signs that a pt has alcohol dependence?

A

shown tolerance
shown signs of withdrawal
failed attempts to stick to drinking limits
spent a lot of time drinking
spent less time on activities that had been previously important
kept drinking despite the problems it is causing

yes to 3 or more in the past year = dependence

35
Q

what are the pharmacological treatments for alcohol dependence?

A

Acamprosate calcium
Disulfiram (Antabuse)
Nalmefene
Naltrexone - also in drug dependence

DANN treats alcohol dependence

36
Q

what are the psychological treatments for alcohol dependence?

A

CBT

social support eg alcoholics anonymous

37
Q

what are the questions in the AUDIT C questionnaire?

A
  1. how OFTEN do you have a drink containing alcohol
  2. how MANY UNITS of alcohol do you drink on a typical day when you are drinking
  3. how often have you had ≥6 units if female or ≥ 8 units if male on a single occasion in the last year?
38
Q

How is the AUDIT score calculated and what actions are taken for each score group?

A

AUDT C (3 Ques) + AUDIT (& Qs)
0-7: low risk and no intervention is required
8-15: increasing risk - brief advice
16-19: higher risk - brief advice and/or extended brief advice
20+: possible dependence and refer to services

39
Q

What are the CAGE questions?

A
  1. have you ever felt you should Cut down on you drinking
  2. have people Annoyed you by criticising your drinking?
  3. Have you ever felt bad or Guilty about your drinking
  4. have you ever taken a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?

2 or more yes = likely drinking problem

40
Q

what score on the FAST test is FAST positive and what would you do if this was the case?

A

≥ 3 is fast positive

if FAST positive complete AUDIT questions to get a full AUDIT score

41
Q

name and describe a system of doing brief intervention for at-risk drinking

A

FRAMES - summary of motivational interviewing
Feedback: on the risks and negative consequences of substance use. Seek the pt’s reaction and listen.
Responsibility: Emphasize that the individual is responsible for making his or her own decision about his/her drug use.
Advice: Give straightforward advice on modifying drug use.
Menu of options: Give menus of options to choose from, fostering the client’s involvement in decision-making.
Empathy: Be empathic, respectful, and non-judgmental.
Self-efficacy: Express optimism that the individual can modify his or her substance use if they choose.

GI (15 decks)

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