ALCOHOL

Question 1

why do females have a lower tolerance than men

Answer 1

males have higher lean body mass so more blood

females have less alcohol dehydrogenase

Question 2

what is alcohol metabolised to

Answer 2

alcohol –> acetaldehyde–> acetate –> CO2 + H2O

Question 3

what 2 enzymes are involved in alcohol metabolism

Answer 3

alcohol dehydrogenase

aldehyde dehydrogenase

Question 4

2 organs where alcohol metabolism takes place

Answer 4

liver (90%)

pancreas

Question 5

how long after consumption does blood alcohol peak

Answer 5

60 mins

Question 6

why does drinking regularly improve tolerance

Answer 6

up regulation of alcohol dehydrogenase

other pathways activated, H ions produced

Question 7

why do some SE Asian people suffer from flushing and headaches after consuming alcohol

Answer 7

they have little/ineffective aldehyde dehydrogenase

Question 8

what ethnic groups have low alcohol dehydrogenase

Answer 8

Japanese, aborigines, eskimos

Question 9

why do high conc spirits eg vodka NOT have the fastest rate of absorption

Answer 9

they irritate the gastric mucosa delaying emptying so decreasing absorption

Question 10

aerated/non aerated drinks are absorbed faster

Answer 10

aerated

Question 11

what drinks have the fastest absorption

Answer 11

sherries (20-30% conc) on empty stomach

Question 12

what 2 drugs increase gastric emptying and absorption

Answer 12

antihistamines and metoclopramide

Question 13

Visible signs of the effect of alcohol

Answer 13

palmar erythema
caput medusae
Dupuytrens contracture (not specific to alcohol use)

Question 14

what is dupuytrens contracture

Answer 14

benign fibrosis of palmar fascia of fingers

Question 15

role of thiamine

Answer 15

maintains peripheral nerves

Question 16

what deficiency can result due to chronic alcohol use and how does this present

Answer 16

thiamine

foot/wrist drop

Question 17

Vit B1 deficiency can cause what disease + how does it present

Answer 17

Wernickle-Korsakoff syndrome
weird eye movements
ataxic gait
memory loss

Question 18

how does alcohol affect the heart

Answer 18

dilated cardiomyopathy

negative inotrope: decreased contractility so increased HR to maintain CO

Question 19

binge drinking can have what affect on heart

Answer 19

holiday heart syndrome
supra ventricular arrhythmia
resolves spontaneously

Question 20

what disease of the heart can a thiamine deficiency cause

Answer 20

Wet Beri Beri: peripheral vasodilatation + arteriovenous shunting = high output cardiac failure

Question 21

persistent vomiting causes metabolic acidosis/alkalosis

Answer 21

alkalosis

Question 22

why does alcohol cause us to pee more

Answer 22

alcohol inhibits ADH so decreased water reabsorption in distal tubule

Question 23

how does alcohol affect the liver

Answer 23

steatosis: fatty liver
steatohepatitis: fatty + inflammation
cirrhosis: lipid build up in hepatocytes, toxic material builds up can cause portal hypertension

Question 24

what can severe hepatitis cause

Answer 24

hepatorenal failure

Question 25

alcohol poses the biggest risk to what type of cancer

Answer 25

hepatocellular carcinoma

Question 26

in cirrhosis what cells trap hepatocytes

Answer 26

interstitial cells of Ito/stellate cells

Question 27

how does alcohol ketoacidosis present

Answer 27

low glucose, high ketones

Question 28

affect of alcohol on the lungs

Answer 28

aspiration pneumonia: superior segment of right lower lobe, infection pneumonitis: inflammation, no infection, sterile gastric contents

Question 29

consequences of portal hypertension

Answer 29

oesophageal varices --> GI bleed splenomegaly haemorrhoids dilated subcut vessels: spider naevi, carat meduse hepatic encephalopathy: ammonia build up crosses BBB

Question 30

how does alcohol cause reflex oesophagitis

Answer 30

it relaxes smooth muscle so relaxed LOS

Question 31

what is Barretts oesophagus

Answer 31

metaplastic change squamous --> columnar epithelium risk of malignancy red velvety oesophagus

Question 32

a person vomitting continuously is at risk of?

Answer 32

mallory weiss tear

Question 33

what is boerhaovee syndrome

Answer 33

oesophagus ruptures

Question 34

complications of alcohol withdrawal

Answer 34

hallucinations delirium tremens seizures Wernicke korsakoff

Question 35

1 unit = ? mls ethanol

Answer 35

10 mils

Question 36

define hazardous drinking

Answer 36

>14 units <35 units female < 50 units male

Question 37

define harmful drinking

Answer 37

``` >/= 35 units female >/= 50 units male ```

Question 38

treatment of alcohol intoxication to detoxify patient

Answer 38

Chlorodiazpoxide

Question 39

side effects of chlorodiazpoxide

Answer 39

kindling effect: symptoms worse after every withdrawal high relapse cognitive impairment

Question 40

name 3 preventative relapse treatment

Answer 40

disulfiram naktrexone acomprosate

Question 41

action of disulfiram

Answer 41

physiological detterant 'Antabuse' inhibits aldehyde dehydrogenase anticraving affect, increases dopamine

Question 42

action of acomprosate

Answer 42

acts on GABA + glutamate transmission corrects neurotransmission imbalance decreases cravings

Question 43

action of naltrexone

Answer 43

blocks opiod receptors | decreases rewarding effect

Question 44

how is alcohol excreted

Answer 44

sweat, urine, lung

Question 45

3 causes of chronic pancreatitis

Answer 45

gallstones, alcohol, idiopathic

Question 46

how does alcohol cause chronic pancreatitis

Answer 46

scarring sclerosis pseudocyst (not epithelial lining)