Biochemistry of Alcohol Flashcards

1
Q

Why do we measure CK?

A

Alcohol is toxic to muscle

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2
Q

How acute pancreatitis manifest?

A

Bouts of abdominal pain and significantly raised amylase

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3
Q

Where is lipase specific to?

A

The pancreas

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4
Q

What other than the alcohol itself can cause unconsciousness in drunk people?

A

Hypoglycaemia

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5
Q

What effect does alcohol have on gamma GT?

A

It raises it

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6
Q

Why is MCV raised in chronic alcohol excess?

A

Increased synthesis of red blood cells

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7
Q

What effect does alcohol have on triglycerides?

A

It raises their levels due to increased synthesis on the liver

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8
Q

What markers are looked at to determine if someone is a chronic alcoholic?

A

GGT, MCV, triglycerides

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9
Q

How do you determine if a coma is due to alcohol?

A

Measure serum osmolarity

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10
Q

How do you calculate serum osmolarity?

A

Use concentrations of measured electrolytes-simplest formula is 2[Na]

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11
Q

What is the osmol gap and what does it indicate?

A

Difference between calculated osmolarity and measured osmolarity; shows that something that hasn’t been measured is causing the gap (ie alcohol)

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12
Q

What is ethylene glycol found in?

A

Antifreeze, often used in attempted suicide

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13
Q

What are methanol and ethylene glycol classed as and why are they important?

A

Toxic alcohols-can also cause osmol gap

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14
Q

What is ALT?

A

Found especially in liver, released from hepatocytes, marker of liver damage rather than function

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15
Q

Where is ALP found?

A

Liver (bile canaliculi), bone (osteoblasts), kidneys (proximal tubules), small intestine (epithelium)

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16
Q

Where is gamma GT found and what does it show?

A

Found in liver, kidneys, pancreas and prostate; can reflect enzyme induction (sensitive)

17
Q

What is albumin?

A

Synthesised in liver, half life of three weeks, falls in systemic inflammatory response, not useful as marker of current liver function

18
Q

What is the prothrombin ratio?

A

Clotting factors synthesised in liver, half life of 3-4 days, indicator of current liver synthetic function, shows bleeding tendency

19
Q

What does a raised bilirubin cause?

A

Jaundice

20
Q

What are the differentials of abdominal pain in an alcoholic?

A

Acute pancreatitis, alcoholic hepatitis, peptic ulceration +/- perforation, ascites +/- peritonitis

21
Q

What are the markers for alcoholic abdominal pain?

A

Amylase, LFTs, ascites fluid analysis

22
Q

What are the differentials of vomiting in an alcoholic?

A

Acute gastritis, oesophageal stricture, pyloric stricture

23
Q

What is looked at to assess the severity of vomiting?

A

U & Es, ABG, LFTs, amylase

24
Q

What are the differentials for haematemesis in an alcoholic?

A

Acute gastritis, Mallory-Weiss tear, peptic ulceration +/- perforation, oesophageal varices

25
Q

What investigations are done to assess haematemesis?

A

Prothrombin ratio, LFTs, U & Es, Lactate