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Flashcards in Medical Impacts of Alcohol Deck (47)
1

How many units of alcohol are in a spirit?

25ml

2

How many units of alcohol are in a small glass of wine?

125ml (2 units)

3

How many units of alcohol are in a large glass of wine?

250ml (3-4 units)

4

How many units of alcohol are in a bottle of wine?

10 units

5

What are the drinking recommendations?

14 units per week for both males and females

6

What is increasing due to alcohol related incidents?

Major admissions

7

What disease is rising because of alcohol?

Liver disease

8

What is the liver?

Major organ
Second biggest organ in body, 1.5 kg

9

How does the liver metabolise?

Material absorbed from G.I.T (gastroinstenial tract)
Storage of glycogen
Release of glucose

10

What does the liver do?

Protein synthesis (albumin
Inactivation of hormones, drugs
Excretion of waste
Produce bile
Produces clotting factors

11

What are the lobes of the liver?

Right lobe
Left lobe
Caudrate lobe
Quadate lobe

12

What does the ductus venousous do?

removes blood away from liver in baby

13

Where is bile produced?

The liver

14

Where is bile stored and concentrated?

Gallbladder

15

Where does bile pass out?

Through the cystic duct

16

What types of death involve alcohol?

Acute intoxication
Chronic alcoholism
Accidents
Suicide
Homicides

17

How is the post-mortem exam carried out for alcohol related deaths?

History
External
Internal
Samples (i.e. femoral artery/ vessels- 3 samples one in the right one in the left and another)

18

What is the world record for alcohol in blood?

>1500mg/100ml of blood

19

What is acute alcohol intoxication?

Tolerance
0-100 dizzy and delightful- euphoria

20

What is the effects of 100-300 mg/100ml of blood?

Drunk and disorderly

21

What is the effects of >300 mg/100ml of blood?

Increasing danger of death

22

What does alcohol do to the brainstem?

Direct respiratory depressant effect
o Aspiration of vomit
o Cardiac arrhythmia- heart beats irregularly (can kill)

23

What deaths can be related to alcohol incidents?

Trauma- accidents
Fire deaths
Drowning

24

What are the post mortem findings for acute alcohol intoxication?

Usually only congestion of the lungs- oedema (swelling in lungs)
Vomit in airways
? Evidence of chronic alcoholism
Pre-existing disease- drug abuse
Traumatic injury- stabs, bruises, gun shot wounds
Burns?

25

What is chronic alcoholism?

Extremely potent drug
Widespread effects
All systems of the body are affected

26

What are the post mortem findings for death caused by chronic alcoholism?

General appearance- red face, bulbous nose, “beer belly”
Bruises- damage liver, damage clotting factors
Jaundice (yellowing)/spider naevi (more than 5 above level of heart=drink too much)/ gynaecomastia (male specifically, “man boobs”)
Ascites (swelling of absominal cavity)/ oedema

27

What is jaundice?

Accumulation of bilirubin in the skin
Breakdown product of haemoglobin (Hb)
Damaged liver cells (hepatocytes) do not function adequately

28

What is ascites?

Accumulation of fluid in the abdominal cavity
Due to portal hypertension and decreased proteins in the blood (albumin esp.)

29

What is spider naevi?

Skin lesion
Small central blood vessels with radiating smaller vessels
Affects the face, chest, and upper limbs
Sign of chronic liver disease

30

What can happen internally in the central nervous system?

Intracranial bleeding
Cerebellar atrophy
Wernicke-Korsakoff psychosis (nystagmus (eyes jumping about), ataxia (can’t walk properly), amesia (memory loss), confabulation (making up stories), hallucinations)
Delerium tremens (DTs)- shakes

31

What is intracranial bleeds?

Subdural haemorrhage
Extradural haemorrhage
Intracerebral haemorrhage

32

What is extradural haemorrhage?

o Damage to pterion
o Space between the skull and the dura
o Skull fractures- at what site? Pterion
o What vessel is most likely to rupture? Middle meningeal artery
o Usually a simple fall
o Lucid interval
o Neurosurgical drainage necessary
o Alcoholics and elderly

33

What is intracerebral haemorrhage?

o Increased of haemorrhagic stroke if clotting is abnormal and the vessels are inherently weakened, blood loss
o Weaker, blood pressure rises
o Increased risk of hypertensive stroke

34

What can happen internally in the cardiovascular system?

o Increased in blood pressure
o Is that good for the arteries?
o Alcoholic cardiomyopathy
Dilated chambers
Enlargement of the cardiac myocytes
Patchy fibrosis (thickening) in the interstitium

35

What can happen internally in the gastrointestinal system?

o Destroy stomach
o Gastric ulcer/ gastritis (swelling of stomach)
o Mallory-Weiss tear- tear between stomach and oesophagus
o Pancreatitis (acute/chronic)
o Malabsorption- don’t eat well

36

What is the pancreas dual purpose?

Exocrine and endocrine functions?

37

What are the exocrine functions of the pancreas?

99% of pancreas, many digestive enzymes, biocarbonate ions

38

What are the endocrine functions of the pancreas?

Islets of Langerhans- hormones, insulin, glucagon, somatosin

39

What are the acute effects of pancreatitis?

Direct toxic effects
Acute- pain/ nausea/ vomiting/ metabolic (Na+, Cl-, Bicarbonate ions)/ shock/ death
Acute- haemorrhagic/ necrotic pancreas

40

What are the chronic effects of pancreatitis?

Chronic- pain/ weight loss/ malabsorption/ diabetes
Chronic- fibrotic

41

What is the internal composition of the liver?

o Alcoholic hepatises- yellowing of eyes
o Fatty degeneration
o Cirrhosis- kills, destroys structure of liver, increases fibrotic tissue, increases blood pressure
o Portal hypertension
o Liver failure

42

What is alcoholic hepatitis?

Alcoholic hepatitis is hepatitis (inflammation of the liver) due to excessive intake of alcohol. It is usually found in association with fatty liver, an early stage of alcoholic liver disease, and may contribute to the progression of fibrosis, leading to cirrhosis.

43

What is fatty degeneration of the liver?

o Enlarged smooth liver
o Common cause of death
o ? Mechanism- metabolic imbalance
o Blood alcohol level low/absent- damage done in past

44

What is cirrhosis?

o Destroys structure of hepatocytes
o Younger patients
o Liver shrunk and nodular

45

What is portal hypertension?

o Restriction of blood flow
o Increased blood pressure in and around liver
o Back pressure- dilated veins
o Oesophageal varices
o Splenomegaly- back pressure into spleen, enlarged
o Ruptured varices- bleed to death
o Haematemesis- vomit blood
o Black stools- bleeding in GIT tract
o Haemorrhage- can be fatal

46

What are oseophageal varices?

Destroys architecture- blood cant go through the liver, causes increased blood pressure, causes an increased back pressure towards oesophagus

47

What causes liver failure?

o Signs of chronic liver failure
o Jaundice
o Ascites
o Bleeding tendency
o Infections
o Cirrhosis/ splenomegaly/ varices/ malnutrition