Alcohol - the clinicians perspective Flashcards

1
Q

What are the symptoms of mild alcohol withdrawel?

A
Fine tremor
Sweating
Anxiety
Hyperactivity
Tachycardia
Hypertension 
Anorexia
Nausea
Retching
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2
Q

What are the symptoms of moderate alcohol withdrawel?

A
Coarse tremor
Shaking
Agitation
Confusion 
Disorientation 
Paranoia
Seizures
Hallucinations
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3
Q

What are the symptoms of severe alcohol withdrawl?

A
Severe agitation 
Anxiety 
Confusion 
Tactile visual hallucinations 
Circulatory collapse and death
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4
Q

What type of seizure is an alcohol withdrawal seizure?

A

Generalised tonic clonic seizure

Clustered over a few hours

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5
Q

What is peripheral neuropathy?

A

Sensorimotor axonal polyneuropathy

Causes burning, pain and weakness

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6
Q

What is compression neuropathy?

A

Temporary damage to myelin sheath (saturday night palsy)

Radial nerve compression at humeral head

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7
Q

What sort of myopathy can occur after an acute binge?

A

Myalgia, proximal weakness, swollen tender muscles due to a raised CK

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8
Q

What sort of myopathy can occur with chronic alcoholism?

A

Painless, proximal weakness and atrophy, normal CK, low K and PO4

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9
Q

What is wernikes encephalopathy?

A

Thiamine deficiency and cytotoxic oedema in mamillary bodies

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10
Q

What is the triad of wenickes encephalopathy?

A

Occular dysfunction (nystagmus and opthalmoparesis)
Ataxic gait
Acute confusion

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11
Q

What is korsakoff syndrome?

A

Cerebral atrophy resulting from WE

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12
Q

What are the symptoms of korsakoff syndrome?

A

Anterograde amnesia
Confabulation
Lack of insight
Abstinence and nutrition for treatment

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13
Q

How does chronic alcoholism cause cardiomyopathy?

A

Impaires ventricular function (calcium homeostasis, mitochrondrial effects, signal transduction)
Prolonged exposure leads to chronic inflammation/ fibrosis of myofibrils

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14
Q

What arrhythmias can occur with acute alcohol intoxication?

A

AF, SVT (holiday heart)

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15
Q

What arrhythmias can occur with chronic alcohol intoxication?

A

Electrolyte imbalance can lead to a long QT

Dilated cardiomyopathy can lead to atrial and ventricular arrhythmias

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16
Q

What is the pathogenesis for regular heavy drinking?

A

Fat accumulation in hepatocytes
Inflammation
Fibrosis
Cirrhosis

17
Q

What is alcohol related hepatits?

A

Acute, lifethreatning manifestation
Parenchymal inflammation and hepatocyte damage
Jaundice, coagulopathy and liver failure

18
Q

What is the pathogenesis for alcohol related cirrhosis?

A

Progressive fibrosis
Architectural distortion
Cirrhosis
Portal hypertension

19
Q

What is compensated alcohol related cirrhosis?

A

Compensated - normal liver function and normal physical function

20
Q

What is decompensaed alcohol related cirrhosis?

A

Impaired synthetic function, ascited and encephalopathy

21
Q

What are the treatments for alcohol cirrhosis?

A
Abstinence
Vitamins
Nutrition
Endoscopic
Pharma - Bblockers, lactulose, rifaximin
Radiological - TIPPS
Surigcal - transplant
22
Q

What is a brief intervention?

A

Feedback on person’s alcohol use and any related harm
Clarification as to what constitutes low risk consumption
Info on harms associated with risk alcohol use
Benefits of reducing intake

23
Q

What are the pharmacological interventions that can reduce alcohol consumption?

A

Acamprosate - reduces cravings
Naltrexone - reduces desire for alcohol
Disulfiram - aversion therapy drug - produces a similar reaction of metrondiazole with alcohol
Nalmefene - opioid antagonist