Scotland is the UK country with the (highest / lowest) rate of alcohol-related deaths.
highest
Which sex has the higher rate of alcohol-related deaths?
Males
Alcohol-related disease is a large financial ___ on the NHS.
burden
How many hospital admissions per year are related to alcohol?
> 1 million
What factors affect the impact of alcohol consumption on health?
Age
Gender
BMI
Drinking patterns
Volume of alcohol consumed
Length of time (infrequent, frequent, chronic)
What may chronic alcoholics experience 6-8 hours after their last drink?
Alcohol withdrawal
The severity of alcohol withdrawal symptoms depends on the degree of the patient’s alcohol ___.
dependence
The presentation of which condition, following alcohol withdrawal, should be treated as a medical emergency?
Delirium tremens
How is alcohol withdrawal assessed in the wards?
Which drug is then used to manage it?
Assessed at set intervals for symptoms and scored
Chlordiazepoxide / diazepam
What are some “positive” brain/NS effects of alcohol?
Sedative, mild anaesthetic
Pleasurable
Sense of wellbeing, reduced inhibitions, euphoria
What are some negative behavioural effects of alcohol intoxication?
Accidental injury
Aggression
Drowsiness
Slurred speech, unsteadiness
Loss of consciousness
A common neuro presentation of alcohol withdrawal is ___.
seizures
Alcohol can precipitate seizures in patient who are known to have ___.
epilepsy
What are some nerve/muscle consequences of heavy drinking?
Peripheral neuropathy - alcohol damages peripheral nerves + nutrient deficiencies
Compression neuropathy - e.g falling asleep on your own arm
Myopathy - muscle pain, both acute and chronic
What is the reversible condition caused by thiamine deficiency in heavy drinkers?
What are the symptoms?
How is it treated?
Wernicke’s encephalopathy
Ataxia, unsteadiness, abnormal eye movements
Thiamine replacement therapy
What is the irreversible condition caused by thiamine deficiency in heavy drinkers?
What is the exact pathology?
What are the symptoms?
Korsakoff syndrome
Cerebral atrophy
Memory loss, confabulation
How is Korsakoff syndrome treated?
No cure - abstinence from alcohol and adequate nutrition
Which common neuro disease is common in chronic drinkers?
Dementia
Which type of stroke commonly presents in chronic drinkers?
Haemorrhagic stroke
People who drink alcohol in moderation seem to have a(n) (increased / reduced) risk of coronary artery disease.
reduced
Which kind of cardiomyopathy is seen in chronic drinkers?
Dilated cardiomyopathy
Why does alcohol cause dilated cardiomyopathy?
Impaired ventricular function
Chronic inflammation
Fibrosis
Which arrythmias may be seen in acutely intoxicated patients?
Atrial fibrillation
Holiday heart syndrome (supraventricular tachycardia)
Chronically, alcohol excess may lead to which arrythmia?
Long QT syndrome
Alcohol is the leading cause of ___ disease.
liver
What is the pathomechanism of cirrhosis in regular heavy drinkers?
Regular heavy drinking
> Steatosis
> Inflammation (acute -> chronic)
> Fibrosis
What liver disease is almost universal in heavy drinkers and is reversible with abstinence?
Alcoholic fatty liver disease i.e steatosis
What is an acute, life-threatening liver disease associated with heavy drinking?
What are the symptoms?
How is it treated?
Alcoholic hepatitis
Jaundice, coagulopathy (heavy bleeding), fever etc.
Abstinence and nutrition, wait and see
Is alcoholic hepatitis the same as cirrhosis?
No, acute life-threatening presentation typically seen in young people
What develops alongside cirrhosis?
Portal hypertension
A lot of people don’t know they have cirrhosis because their disease is ___.
compensated
What are the signs of decompensated cirrhosis?
Ascites
Encephalopathy
Jaundice
Portal hypertension signs (varices inc. spider naevi and caput medusae)
Cutaneous signs (erythema, Dupuytren’s)
Decompensated cirrhosis is a disease associated with high ___.
mortality
What must be maintained in a patient with liver disease?
Abstinence and nutrition
Cirrhosis patients have an increased risk of developing ___ ___.
hepatocellular carcinoma
Which cancers are associated with alcohol consumption?
Head and neck
Oesophageal
Liver
Breast
Colorectal
Which metabolite of ethanol is thought to be carcinogenic?
Acetaldehyde
so the more alcohol you drink, the more “” metabolised at sites other than the liver and the greater your risk of cancer
The level of which hormone is higher in alcohol drinkers?
What disease may this fact be associated with?
Oestrogen
Breast cancer
What consultation tactic can be used to talk to patients about their alcohol intake?
Brief intervention
Patients can also be referred to alcohol ___ services.
support
What are some drugs which can be used to help patients with abstinence from alcohol?
Acamprosate
Disulfiram
Naltrexone
