Which GI disease is alcohol a common cause of?
Acute and chronic pancreatitis
What are two enzymes used as indicators for pancreatitis?
What does GGT levels do in response to alcohol consumption?
In chronic alcoholism, MCV (mean corpuscular volume) is (increased / decreased).
Why do triglyceride levels increase during excessive drinking?
Increased lipid synthesis in the liver
What tests can be used to see if a patient is a chronic drinker?
Gamma GT (GGT)
What tests are done for a patient who comes to hospital in a coma?
Blood glucose tested (for hypoglycaemia)
How do you calculate serum osmolality?
Serum osmolality roughly equals 2 x [Na+]
How is serum osmolality used to prove a patient is in an alcoholic coma?
Osmolal gap = Measured osmolality - calculated osmolality
Big gap = ethanol contributing to osmolality
What tests are carried out to pinpoint the cause of a patient's abdominal pain?
differential for abdominal pain:
Peptic ulcers +/- perforation
Portal hypertension --> Ascites +/- peritonitis
If amylase is raised in a patient with abdominal pain, what is the likely diagnosis?
ALT (alanine aminotransferase)
- found in the LIVER hepatocytes
- released in response to DAMAGE
ALP (alkaline phosphatase)
- found in LIVER, BONE, KIDNEYS, SMALL INTESTINE
- differentiate liver and bone by testing GGT
- found in the liver, BD, GB
- too sensitive to be diagnostic but can be used to confirm liver damage when ALT is raised
- produced by liver
- decreases in inflammatory disease
- clotting factors produced by the liver - gives an indication of liver function
- ALSO gives a measure of tendency to bleed
What tests would be carried out for someone whose main complaint is vomiting?
What is commonly seen on the U&Es of an alcohol user who is vomiting?
?High urea and creatinine, reflect reduction in glomerular function
vomiting: loss of H+ and Cl-, gain in bicarbonate
-> metabolic alkalosis
opposite, bicarbonate lost
in normal patients, acid-base impact limiting as fluid lost from both stomach and small intestine and cancels out
in people with pyrloric stenosis, no small intestine fluid lost --> metabolic alkalosis
metabolic alkalosis (vomiting, high bicarbonate)
respiratory acidosis to compensate (hypoventilate to raise CO2 which is acidic)
but body has limited ability to do this cuz you will die from hypoxia
so acid base abnormality is partially compensated metabolic alkalosis
What tests should be done in a patient who presents with haematemesis?
urea production increases when protein consumption does i.e red meat
urea is classically raised in haematemesis because you're absorbing your own blood
hyponatremia when aldosterone and adh work together because the ratio of water to sodium is greater
i.e more water reabsorbed than sodium
spironolactone - aldosterone antagonist - causes low sodium and high potassium
ethanol is a competitive inhibitor with methanol and polyethylene glycol (antifreeze) - used to treat toxic alcohol poisoning
38 - money slide