Alcohol

Question 1

How many units in a bottle of wine?

Answer 1

9.2 units.

Question 2

How many units in a glass of whisky?

Answer 2

1 unit.

Question 3

How many units in a pint of beer?

Answer 3

1 unit.

Question 4

How many units in 1L of spirits?

Answer 4

37 units.

Question 5

How many units of alcohol is recommended every week?

Answer 5

14 units.

Question 6

State 2 features of alcohol dependence.

Answer 6

1) Liver problems (liver inflammation) - fatty liver progress to cirrhosis.
2) CNS - psychiatric problems, anxiety, Korsakoff’s psychosis +/- Wernicke’s encephalopathy.
3) Gut - obesity, gastric erosions, peptic ulcers, varices, pancreatitis, oesophageal ruptures.
4) Blood - anaemia, GI bleeding, folate deficiency.
5) Heart - arrhythmia, hypertension.
6) Reproduction - men (impotence, retarded ejaculation, premature ejaculation), women (vaginal dryness, inability to orgasm may result).

Question 7

State 2 features of chronic alcohol use.

Answer 7

1) GIT - causes fat accumulation (in liver), inflammation leads to alcohol hepatitis, cirrhosis (fibrous scar tissue develops), can inflame pancreas
2) CVD - small amounts can reduce the risk of cardiovascular disease, large amounts (increased BP, heart attack)
3) Neoplasia - increased chance of throat, larynx, oesophagus, upper stomach cancer

Question 8

State 2 complications of alcohol in pregnancy.

Answer 8

1) Fetal alcohol syndrome (FAS) - babies have smaller heads, heart defects 2) Alcohol related neurodevelopmental disorder (ARND) - babies appear normal but have learning/behavioural problems.

Question 9

What does an alcohol assessment score of over 20 indicate?

Answer 9

Increased risk of delirium tremens.

Question 10

State the cause of Wernicke’s Encephalopathy.

Answer 10

Hypothalamic, thalamic damage and cerebral atrophy due to thiamine damage.

Question 11

State a symptom of Wernicke’s Encephalopathy.

Answer 11

Confusion. Ataxia. Tachycardia. Hypothermia. Opthalmoplegia (paralysis of muscles of eye).

Question 12

State a treatment of Wernicke’s Encephalopathy.

Answer 12

Pabrinex (replace thiamine).

Question 13

State a cause of Korsakoff’s Syndrome.

Answer 13

Permanent damage to the areas of the brain involved with memory due to thiamine damage.

Question 14

State a symptom of Korsakoff’s Syndrome.

Answer 14

Loss of memory of recent events. Disorientation/confusion. Confabulation (invent new memories).

Question 15

Define hepatic encephalopathy.

Answer 15

Liver fails therefore nitrogenous waste (ammonia) builds up in circulation (cerebral oedema).

Question 16

State the a stage of hepatic encephalopathy.

Answer 16

Stage 1 - altered mood, sleep disturbance
Stage 2 - increased drowsiness, confusion
Stage 3 - restless, incoherent, hyperreflexia
Stage 4 - coma

Question 17

Define the alcoholic hepatitis.

Answer 17

Inflammation of the liver following excessive alcohol.

Question 18

State a clinical features of alcoholic hepatitis.

Answer 18

Loss of appetite. Nausea/vomiting. Hepatomegaly. Fatigue/weakness. Fever.

Question 19

State a sign of alcoholic hepatitis.

Answer 19

Fluid accumulation in abdomen (ascites). Jaundice (yellow of the skin and eyes).

Question 20

State 2 factors which can predispose alcohol immunosuppressive (increases chance of infection).

Answer 20

Pneumonia. Spontaneous bacteremia. Meningitis. Endocarditis. UTI.

Question 21

State one effect of alcohol ketoacidosis.

Answer 21

1) Stimulates ketogenesis - elevated anion group metabolic acidosis
2) Stimulates hypoglycaemia (reduces gluconeogenesis, reduces insulin secretion)
3) Stimulates hypomagnesaemia (reduces confusion, seizures)

Question 22

State a symptom of alcohol ketoacidosis.

Answer 22

Starvation. Vomiting. Abdominal pain. Seizures. Confusion. Tremours. Dehydration.

Question 23

State medication used for the management of alcohol conditions.

Answer 23

Pabrinex (thiamine deficiency).

Question 24

State a drug used in alcohol withdrawal.

Answer 24

Benzodiazepine - diazepam, chloridiazepoxide.

Question 25

State the 2 main drugs used in alcohol dependence.

Answer 25

1) Acamprosate - used to prevent relapse to reduce craving.
2) Disulfiram - produces acute sensitivity to alcohol resulting in unpleasant reactions (nausea, chest pain, vomiting, dizziness)

Question 26

Where is 70-80% of alcohol absorbed?

Answer 26

In the small intestine.

Question 27

State a factor affecting alcohol absorption.

Answer 27

Concentration of drink. Food in stomach. Pylorospasm (spasm of valves).