3: Biochemistry of alcohol Flashcards Preview

CLASP: Alcohol 2017/18 > 3: Biochemistry of alcohol > Flashcards

Flashcards in 3: Biochemistry of alcohol Deck (29)
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1

Which GI disease is alcohol a common cause of?

Acute and chronic pancreatitis

2

What are two enzymes used as indicators for pancreatitis?

Amylase

Lipase

3

What does GGT levels do in response to alcohol consumption?

Increases

4

In chronic alcoholism, MCV (mean corpuscular volume) is (increased / decreased).

increased

5

Why do triglyceride levels increase during excessive drinking?

Increased lipid synthesis in the liver

6

What tests can be used to see if a patient is a chronic drinker?

Gamma GT (GGT)

MCV

Triglycerides

7

What tests are done for a patient who comes to hospital in a coma?

Blood glucose tested (for hypoglycaemia)

Serum osmolality

8

How do you calculate serum osmolality?

Serum osmolality roughly equals 2 x [Na+]

 

9

How is serum osmolality used to prove a patient is in an alcoholic coma?

Osmolal gap Measured osmolality calculated osmolality

Big gap = ethanol contributing to osmolality

10

What tests are carried out to pinpoint the cause of a patient's abdominal pain?

Amylase

LFTs

11

differential for abdominal pain:

Acute pancreatitis

Alcoholic hepatitis

Peptic ulcers +/- perforation

Portal hypertension --> Ascites +/- peritonitis

12

If amylase is raised in a patient with abdominal pain, what is the likely diagnosis?

Pancreatitis

13

 

ALT (alanine aminotransferase)

  • found in the LIVER hepatocytes
  • released in response to DAMAGE

14

ALP (alkaline phosphatase)

  • found in LIVER, BONE, KIDNEYS, SMALL INTESTINE
  • differentiate liver and bone by testing GGT

15

Gamma GT

  • found in the liver, BD, GB
  • too sensitive to be diagnostic but can be used to confirm liver damage when ALT is raised

16

Albumin

  • produced by liver
  • decreases in inflammatory disease

17

Prothrombin time

  • clotting factors produced by the liver - gives an indication of liver function
  • ALSO gives a measure of tendency to bleed

18

What tests would be carried out for someone whose main complaint is vomiting?

U&Es

LFTs

Amylase

ABGs

19

What is commonly seen on the U&Es of an alcohol user who is vomiting?

Low sodium

Low potassium

?High urea and creatinine, reflect reduction in glomerular function

20

in gut

vomiting: loss of H+ and Cl-, gain in bicarbonate

-> metabolic alkalosis

21

in duodenum:

opposite, bicarbonate lost

22

in normal patients, acid-base impact limiting as fluid lost from both stomach and small intestine and cancels out

in people with pyrloric stenosis, no small intestine fluid lost --> metabolic alkalosis

23

example:

metabolic alkalosis (vomiting, high bicarbonate)

respiratory acidosis to compensate (hypoventilate to raise CO2 which is acidic)

but body has limited ability to do this cuz you will die from hypoxia

so acid base abnormality is partially compensated metabolic alkalosis

24

What tests should be done in a patient who presents with haematemesis?

U&Es

LFTs

PTR

Lactate

25

urea production increases when protein consumption does i.e red meat

26

urea is classically raised in haematemesis because you're absorbing your own blood

27

hyponatremia when aldosterone and adh work together because the ratio of water to sodium is greater

i.e more water reabsorbed than sodium

spironolactone - aldosterone antagonist - causes low sodium and high potassium

28

ethanol is a competitive inhibitor with methanol and polyethylene glycol (antifreeze) - used to treat toxic alcohol poisoning

29

38 - money slide