Substance misuse Flashcards

1
Q

What alcohol related conditions might lead someone turning up at A&E?

A
Alcohol related injury
Alcohol withdrawal
Alcohol overdose
Suicide attempts precipitated by alcohol
MI
Liver failure
Oesophageal bleeds (varicele bleeds) due to vomiting
Varicose veins (portal hypertension)
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2
Q

Are you likely to become dependant on alcohol if you binge drink every Friday and Saturday?

A

No. You pretty much have to drink an amount everyday.

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3
Q

Which organs become tolerant to alcohol?

A

Liver and the brain. Those who are alcohol dependant rely on it to function cognitively.

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4
Q

What the signs and symptoms of alcohol withdrawal?

A
Nausea
Retching
Tremor
Tachycardia
Affected gait
Seizures
DT (deliruim tremens) - acute confusion, hallucinations (insects on the floor, snakes on the curtains), intense fear often accompanies the hallucination
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5
Q

Why are delirium tremens common on the ward?

A

Because alcoholics are often admitted to the ward for other reasons, but they have no access to alcohol on the ward.

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6
Q

When do delirium tremens normally start?

A

Normally not until 72 hours after the last drink.

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7
Q

When do seizures due to alcohol withdrawal usually occur?

A

About 36 hours after their last drink.

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8
Q

Why are alcoholics more likely to develop varicose veins?

A

Portal hypertension from liver failure and cirrhosis.

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9
Q

Why might alcoholics be more likely to bleed?

A

Liver failure due to cirrhosis therefore not able to make enough clotting factors.

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10
Q

What is Wernicke’s encephalopathy and why are alcoholics more likely to develop it?

A

It is a loss of short term memory caused by thiamine deficiency. Alcoholics often neglect eating and therefore end up with a deficiency in any number of vital vitamin and amino acids.

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11
Q

What is Korsakoff’s syndrome?

A

It is the permanent form of Wernicke’s encephalopathy (loss of short term memory), also caused by thiamine deficiency.

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12
Q

What are questions that you would want to ask someone who you suspect might be alcohol dependant?

A

How much do you drink?
How many times a week?
What happens if you don’t drink during a day?
Do you ever drink in the morning?

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13
Q

What signs might be seen during a physical examination of someone who is alcohol dependant?

A
Peripheral neuropathy
Ascites
Bruising
Gynecomastia
Hepatomegaly
Splenomegaly
Lack of coordination
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14
Q

What might blood tests reveal in an alcoholic?

A
Raised LFTs
Raised gamma GT
Raised AST
Raised IgA
Raised bilirubin
Abnormal clotting factor levels
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15
Q

What drug might you give an alcohol dependant individual to help them with alcohol withdrawal?

A

Chlordiazepoxide (benzodiazepine )

or lorazepam or diazepam

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16
Q

What does GHB stand for?

A

Gamma-hydroxybutyrate

17
Q

Is mephedrone a stimulant or a depressant?

A

Stimulant

18
Q

What is crystal meth?

A

A long acting amphetamine

19
Q

What are the common psychological effects of crystal meth?

A
Psychosis
Paranoia
Anxiety
Depression
Violence
Suicide
20
Q

What are the withdrawal signs and symptoms of heroine and other opiates?

A

Sweats (cold and clammy),
Pupil dilatation (are constricted when using)
(stuff coming out from everywhere e.g. nose, mouth, bum, eyes ect.)

Goosebumps 
Nausea
Retching
Abdominal pain
Diarrhoea
Muscle cramps and spasms
Yawning
Lacrimation
Rhinorrhoea
Tachycardia
21
Q

What is the serious consequence of heroine overdose?

A

Death through respiratory depression

22
Q

What is the antidote to heroine?

A

Naloxone

23
Q

What is the most common blood borne virus in intravenous drug users in the UK?

A

Hepatitis C

24
Q

What percent of intravenous drug users have HIV in the UK?

A

Less than 1%

25
Q

How is dependence syndrome diagnosed?

A

3 or more of the following within previous year:

  1. Strong desire or compulsion to take the substance
  2. Difficulties in controlling substance behaviour
  3. Physiological withdrawal state when reducing dose or stopping
  4. Signs of tolerance: increased quantities needed to provide same effect as before
  5. Neglect of other interests and activities due to time spent acquiring and taking substance or recovering from effects
  6. Persistence with substance use despite clear awareness of harmful consequences