Alcohol Withdrawal Flashcards Preview

Sam: Hospital Medicine > Alcohol Withdrawal > Flashcards

Flashcards in Alcohol Withdrawal Deck (29)
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1
Q

Insomnia, tremulousness, mild anxiety, GI upset, anorexia, headache, diaphoresis, and palpitations are all symptoms of?

A

Mild to moderate alcohol withdrawal

2
Q

What is a banana bag? and what is in it that is extra important in alcohol withdrawal patients?

A

IVF, dextrose, vitamins, minerals, and THIAMINE

3
Q

What labs must we monitor during alcohol withdrawal?

A

CMP with magnesium and phosphorus levels!

4
Q

What will electrolytes look like during withdrawal?

A

Hypo everything

Hyponatremia, hypokalemia, hypomagnesemia, hypophosphatemia

5
Q

What class of medications are we going to give alcohol withdrawal patients?

A

BENZO’S!

Diazepam (Valium)

6
Q

What is Delirium tremens different than common alcohol withdrawal?

A

It has the symptoms of acute alcohol withdrawal PLUS

delirium (encephalopathy), hallucinations, tachycardia, hypertension, and hyperthermia

7
Q

How long after a patient’s last drink to DT’s set in?

A

48-96 hours

8
Q

How long can DT’s persist?

A

5 days

9
Q

Sustained drinking, prior DT episodes, age greater than 30, concurrent illness, positive significant withdrawal symptoms in presence of elevated blood alcohol level are all risk factors for?

A

DTs

10
Q

True or False

Sent DT patients to the behavioral health unit

A

FALSE

11
Q

What unit should we send DT patients to?

A

CCU

12
Q

What other specialists should be involved in a patient with DTs care?

A

Critical care, neurology, psychiatry

13
Q

Acute brain disorder causing petechial hemorrhaging and necrosis in midbrain structures?

A

Wernicke encephalopathy

14
Q

What is the classic triad of Wernicke’s?

A

Encephalopathy/delirium, gait ataxia, oculomotor dysfunction

15
Q

True or False

If you are unsure if a patient has Wernicke’s, we shouldn’t treat it because we could end up doing more damage

A

FALSE

When in doubt, TREAT.
Untreated can lead to coma and death.

16
Q

How do we treat Wernicke’s encephalopathy?

A

parenteral thiamine

17
Q

Administration of what can precipitate WE?

A

glucose

18
Q

Consequence of untreated or repeated episodes of WE; chronic, late neuropsychiatric disorder

A

Korsakoff’s

19
Q

What are 3 characteristics of Korsakoff’s?

A

Cognitive impairment, retrograde and anterograde amnesia, and brain imaging positive for atrophy

20
Q

Can we diagnose Korsakoff’s?

A

No – we need specialized neurocognitive testing – specialty referral and evaluation

21
Q

Caused by nutritional deficiency and neurotoxic effects of chronic alcohol use

A

Cerebellar deficiency

22
Q

Gait ataxia, poor gross motor coordination, inability to handwrite, dysarthria are all symptoms of?

A

Cerebellar deficiency

23
Q

Does cognitive capability remain intact in cerebellar deficiency?

A

Yes

24
Q

What is the prognosis of cerebellar deficiency?

A

May improve slightly with abstinence and good nutrition but is largely irreversible

25
Q

Alcoholic hallucinations usually occur in about how many hours after a patients last drink?

A

24 hours

26
Q

Numbness, paraesthesia, burning dysesthesia, loss of reflexes, and jerky muscle spasms are symptoms of?

A

Peripheral neuropathy

27
Q

How do we treat peripheral neuropathy?

A

Abstinence, thiamine PO, maximize nutrition

28
Q

Weakness, pain, tenderness, and swelling of affected muscles are symptoms of?

A

Myopathy

29
Q

What other medical issues is myopathy associated with?

A

Rhabdomyolysis, dysphagia, and heart failure