Alcohol Flashcards
(27 cards)
What is the cause of alcoholic ketoacidosis?
Often alcoholics will not eat regularly and may vomit food that they do eat, leading to episodes of starvation. Once the person becomes malnourished, after an alcohol binge the body can start to break down body fat, producing ketones. Hence the patient develops a ketoacidosis.
How does alcoholic ketoacidosis present/
It typically presents with a pattern of:
Metabolic acidosis
Elevated anion gap
Elevated serum ketone levels
Normal or low glucose concentration
What is the treatment of alcoholic ketoacidosis?
The most appropriate treatment is an infusion of iotonic saline with dextrose& thiamine. Thiamine is required to avoid Wernicke encephalopathy or Korsakoff psychosiss
How does alcoholic liver disease affect LFTS?
gamma-GT is characteristically elevated
the ratio of AST:ALT is normally > 2, a ratio of > 3 is strongly suggestive of acute alcoholic hepatitis
How is alcoholic hepatitis managed?
Glucocorticoids
What is used to assess if patients will benefit from glucocorticoid in alcoholic hepatits?
Maddrey’s discriminant function (DF) based on prothrombin time and bilirubin concentration
When should dextrose fluid be withheld?i
If severe hypokalemia is present, treat potassium levels first
What is used for longterm alcoholism dependency?
Disulfiram
Acamprosate
Topiramate
What are the NICE guidelines for daily alcohol consumption in women to diagnose NAFLD?
Less than 20g (2.5 units) per day
This is the threshold used to diagnose non-alcoholic fatty liver disease in women.
What are the NICE guidelines for daily alcohol consumption in men to diagnose NAFLD?
Less than 30g (3.75 units) per day
This is the threshold used to diagnose non-alcoholic fatty liver disease in men.
What does NAFLD stand for?
Non-Alcoholic Fatty Liver Disease
NAFLD is a condition characterized by excess fat accumulation in the liver without significant alcohol consumption.
Fill in the blank: The cut-off for diagnosing NAFLD in women is _______ per day.
20g (2.5 units)
Fill in the blank: The cut-off for diagnosing NAFLD in men is _______ per day.
30g (3.75 units)
What to do if NAFLD is found incidentally?
Enhanced liver fibrosis blood test to assess for more severe liver disease
What does elf test include?
combination of hyaluronic acid + procollagen III + tissue inhibitor of metalloproteinase 1.
How long does delirium tremens take to set in?
48 -72 hours
How long does Wernicke’s encephalopathy take to set in?
Occurs over time from poor intake of thaiamine
How to differentiate between Wernicke’s and delirium tremens?
Wernicke’s will have triad of confusion, ophthalmoplegia, and ataxia
Delirium tremens will have hallucinations, autonomic instability like BP and heart rate dysregulation andonfuon c si
Which vitamin is involved in Wernicke’s?
Vitamin B1
what can cause jaundice, pale stools and intermittent abdominal pain for several months?
Obstructive jaundice arising rmo things like:
Mirrizi’s syndrome causes an obstructive jaundice due to compression of the common bile duct secondary to the present of gallstones in the cystic duct
Which drug can cause oesophagitis in pneumonia treatment?
Doxycycline
-> patient should take it with large glass of water in upright position
What is pellagra caused by?
Vitamin B3 deficiency
What is pellagra-like syndrome?
Same clinical resentation but arises from malasborptive or genetic disorders
