Alcohol Related Disease Flashcards Preview

07. Year 2: Alimentary System > Alcohol Related Disease > Flashcards

Flashcards in Alcohol Related Disease Deck (49)
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1

Diseases from what system have the greatest mortality compared to the rest?

Liver diseases

2

Do woman or men metabolise alcohol slower?

Women

3

What causes a variation in alcohol toxicity?

Genetic variation

4

What is the pathway of ethanol metabolism?

Ethanol -> Acetaldehyde -> Acetate

5

What enzyme converts ethanol into acetaldehyde?

Alcohol dehydrogenase

6

What enzyme converts acetaldehyde into acetate?

Acetaldehyde dehydrogenase

7

What effects does alcohol have on the liver?

Steatosis (fatty liver)

Steatohepatitis (fatty liver with inflammation)

8

What does steatosis describe?

Process describing abnormal retention of lipids within a cell or organ

9

What is steatohepatitis?

Type of fatty liver disease characterised by inflammation of the liver with concurrent fat accumulation in the liver

10

What are causes of steatohepatitis?

Neutrophil infiltration

Fibrosis, cirrhosis (build up of scar tissue)

11

When taking a history to do with alcohol liver disease what acrynm should be remembered?

CAGE:

Have you ever felt the need to CUT down

Have you been ANNOYED by criticism of your drinking

Have you felt GUILTY about your drinking

Do you need an EYEOPENER

12

How much beer, wine and spirits is 1 unit of alcohol?

Half pint of beer

Small glass of wine

Single measure of spirit

13

14

What questionaire is used to determine alcoholism?

FAST questionaire

15

A score of what is FAST positive on a FAST questionaire?

3 or more

16

What do you do if someone gets a score of 3 or more on a FAST questionaire?

Complete remaining audit questions to obtain a full AUDIT score

17

When doing a full AUDIT score on a FAST questionaire, what is considered to be increasing risk, higher risk and possible dependence?

8-15 is increasing risk

16-19 is higher risk

20+ is possible dependence

18

What are physical findings for alcoholic liver disease?

Majority have no physical findings until advanced liver disease

Signs of chronic liver disease (spider naevi, palmar erythema, gynaemocastia, loss of axillary and pubic hair, ascites, encephalopathy)

Jaundice

Muscle wasting

19

What can be seen in lab tests for alcoholic liver disease?

Asparate amino transferase (AAT) > alanine amino transferase (ALT), ratio > 2

Raised gamma glutamyl transferase

Macrocytosis

Thrombocytopenia (low platelets)

20

What imaging is done to look for a fatty liver?

Ultrasound scan

21

What is hepatic encephalopathy?

Decline in brain function that occurs due to severe liver disease

22

How is the severity of hepatic encephalopathy graded?

1 to 4

Where 1 is mild confusion and 4 is a coma

23

What is the aetiology of hepatic encephalopathy?

Infection

Drugs

Constipation

GI bleed

Electrolyte disturbance

24

What should be excluded before diagnosing hepatic encephalopathy?

Infection

Hypoglycaemia

Intra-cranial bleed

25

What is the treatment of hepatic encephalopathy?

Bowel clear out, lactulose, enemas

Antibiotics

Supportive (ITU, airway support, NG tube for meds)

26

What does SBP stand for?

Spontaneous bacterial peritonitis

27

What is spontaneous bacterial peritonitis (SBP)?

Development of bacterial infection in the peritoneum, despite the absence of obvious source for the infection

28

What are symptoms and signs of spontaneous bacterial peritonitis?

Abdominal pain

Fever, rigors

Renal impairment

Signs of sepsis such as tachycardia and temperature

29

What investigations should be done for spontaneous bacterial peritonitis (SBP)?

Ascitic tap:

fluid protein and glucose levels

cultures

white cell content

30

What is the neutrophil count for spontaneous bacterial peritonitis?

> 0.25 x 109/L