Alcohol Flashcards
(186 cards)
1
Q
Which specific alcohol is found in drinks
A
Ethanol
2
Q
What makes an alcohol
A
The OH group in the compound
Different number of carbons make different alcohols - methanol, ethanol, propanol etc.
3
Q
What percentage of the population are teetotal
A
Around 10%
They don’t drink at all
4
Q
What classes someone as a sensible/social drinker
A
For men and women it’s 14 units per week
This equates to 2-3 units per day
Within the guidliens
5
Q
What classes someone as a heavy drinker
A
For men it is consuming more than 7 units per day
For women its more than 5 units per day
More than 14 units
6
Q
What classes someone as a problem drinker
A
Heavy drinkers (M>7, F>5) but it is starting to affect their day to day life
7
Q
What classes someone as a dependent drinker
A
Someone who consumes more than 8-10 units per day
8
Q
What is considered hazardous drinking
A
Consuming more than 14 units of alcohol per week
9
Q
What is considered dangerous drinking
A
Consuming more than 35 units per week
10
Q
What is considered safe drinking
A
Less than 14 units per week
Around 2-3 units per day
11
Q
How does the alcoholism cost the UK economy
A
Absenteism Unemployment Offences RTAs Health - increased healthcare needs Premature death
Costs around 2 billion
12
Q
How does the alcohol industry and drinking benefit the UK economy
A
Excise duty
Exports
Jobs
Brings in about £7 billion - which is most than the estimated cost of alcoholism
13
Q
Which areas of life/society can be affected by alcohol
A
Minds Bodies Families Communities Societies Economies - both a benefit and a harm
Pretty much everything
14
Q
Cultural difference are thought to impact drinking behaviour - true or false
A
True
Thought to be due to cultural beliefs, social norms and expectations more than chemical actions of alcohol
In the UK, US, Aus it is associated with violent and antisocial behaviour whilst in the Mediterranean it has a more peaceful/harmonious rep
15
Q
In which countries is alcohol associated with violent and antisocial behaviour
A
UK
US
Australia
Scandinavia
16
Q
Which countries have a positive cultural view alcohol
A
Mediterranean and southern Europe - Italy, Spain, France, Greece
South America
They all associated with peaceful, harmonious drinking behaviour
17
Q
List features of societies that have a positive view of alcohol
A
Society embraces sensible drinking
Drinking integrated into society & culture
Normal activity, to liven up
Drinking often part of working day
Open, uninhibited, outdoor drinking places
Positive beliefs & expectations
18
Q
List features of societies that have a negative view of alcohol
A
Society has ambiguous, ambivalent & uneasy relationship with alcohol Drinking marks end of working day Drinking behaviour is antithesis of work Closed, secluded, insular indoor places Negative beliefs & expectations
19
Q
Describe a social drinker
A
Drinks occasionally or regularly (in moderation)
Drink at safe levels 2-3 u/d
Benefits outweigh risks (probably)
20
Q
How does risk of morbidity and mortality change as alcohol consumption does
A
As alcohol consumption rises so does the risk
Small reduction in risk for social drinkers but trend consistent above this
21
Q
Describe a heavy drinker
A
Most drink heavily & regularly
Some drink heavily & irregularly (binge)
Exceed sensible limits (typically >8 u/d)
Will cause problems if maintained
22
Q
Describe a problem drinker
A
Drinking causes problems in personal or social adjustment
Continues to drink heavily despite these problems
Problems can be overcome by stopping
Starting to become addicted
23
Q
Describe alcohol dependence
A
Aware of compulsion to drink
Prominent drink seeking behaviour
Tolerance to its effects - drinking a lot but effect is the same
Withdrawal syndromes on stopping
Avoidance of withdrawal - reinforces drink seeking behaviour
Social, psychological & physical problems
24
Q
In which type of drinking behaviour would you see withdrawal
A
Alcohol dependence
Occurs on stopping so they avoid doing so
25
What are the criteria for alcohol dependence
```
Heavy drinking (typically >10 u/d)
Tolerance
Withdrawal syndromes (addiction)
Inability to stop drinking
Abnormal blood tests - GGT, CDT, MCV
```
26
Which blood tests can indicate alcohol dependence
GGT
CDT
MCV
27
What is the definition of alcohol dependence
Persistent drinking which interferes with person’s health, legal position, personal relationships, or means of livelihood
28
How is alcohol content usually expressed
% alcohol by volume (% ABV)
ml of alcohol/100ml
29
How do you calculate the amount of alcohol consumed in ml
Volume Consumed (ml) x % ABV
30
How do you calculate the amount of alcohol consumed in g
Volume Consumed (ml) x % ABV x 0.79 (g/ml)
31
How much does 1ml of pure alcohol weigh
0.79g
32
What is a UK alcohol unit
10 ml or 8 g pure alcohol
33
Give examples of single unit drinks
Half pint of weak beer (3.5%)
Small (<100 ml) glass of wine (12%)
Small (28 ml) measure of spirits (40%)
34
What is the typical %ABV for beer
Beer contains 3–8% alcohol v/v (average = 4.5%)
Pint is usually around 2 units - depends on strength
35
What is the typical %ABV for wine
Wine contains 10-13% alcohol v/v (average 12%)
| Size of glass and strength vary
36
What is the typical %ABV for spirits
Most spirits contain 40% alcohol v/v
Singe unit measure is 25ml
Scottish whiskey measure is 35ml - 1.4 units
37
Which factors can accelerate gastric emptying
Tolerance
| Gastrectomy
38
Which factors can slow gastric emptying
Food in the stomach - main contributor
| Certain drugs
39
Where is alcohol absorbed in the body
20% from stomach
| 80% from small intestine
40
What determines the rate of alcohol absorption
The rate of gastric emptying
Higher rate = greater absorption (more is absorbed in intestine)
The type of drink - strength, effect of congeners
41
What effect does food have on alcohol absorption
It reduces the rate and extent of absorption to around 2/3 of the fasting value
Some alcohol is oxidized by the food reducing extent of absorption
Don't get as drunk, as fast - alcohol conc will be lower
42
How long does alcohol absorption to be completed
Complete within 1-3h
Usually peaks after 1 hour
Based on 1 unit
43
Which alcohols are absorbed quickly
Champagne - due to bubbles and high conc
| Bubbles stimulate blood flow and intestinal linings = faster absorption
44
Which alcohols are absorbed s lowly
Beer - low conc and effect of congeners
| Neat spirits - they irritate the stomach
45
What are congeners
They are other alcohols, carbs, yeast products found in alcohol
Slow down absorption
46
The Co equation assumes what
100% absorption and instant distribution
| This does not happen in life so is a theoretical level
47
How is BAC reported
As mg of alcohol /100ml of blood
48
How do you work out the Co
Weight alcohol consumed (g) x 100
All divided by Body Wt (kg) x W.F.
Widmark equation
49
What are the 3 phases of alcohol kinetics
Absorption phase - rising phase
Distribution phase - peak of the curve
Elimination phase - drops again
50
What is the typical rate of alcohol elimination
10–20 mg alcohol /100 ml blood / h
Therefore average is 15 (roughly a unit per hour)
Can be up to 40 in alcoholics
51
Alcohol levels in arterial blood rise and fall faster & sooner
than in venous blood - true or false
TRUE
52
Are alcohol levels in breath closer to arterial BAC or venous BAC
Arterial
53
What is the normal ratio of BAC:BrAC
2300 : 1
| Much higher in blood than in breath
54
When does alcohol become present in the breath
1-2 hours after drinking
| Some is transferred from blood to alveoli
55
How can VHAC be used
It can be used to corroborates PM BAC
| Not done in life as obviously cannot take sample from a living person
56
Can VHAC be used to estimate BAC
No
Cannot reliably predict BAC from VHAC
However, can be used for corroboration
57
Describe the relationship between VHAC and BAC in different phases
During absorption BAC > VHAC
| At equilibrium BAC < VHAC (ratio 0.8)
58
What does the urinary alcohol concentration represent
The average of several hours excretion
| This is because the urine pools in the bladder and collects
59
Describe the relationship between UAC and BAC in different phases
UAC < BAC during absorption phase - start of drinking
| UAC > BAC during elimination phase -
60
Which ratios are used to compare UAC and BAC
BAC : UAC = 0.75 : 1
| UAC : BAC = 1.3 : 1
61
Describe the blood supply and drainage of the kidneys
Renal Artery supplies blood to kidney
Blood filtered by kidney tubules - toxins filtered out into urine
Renal Vein drains blood from kidney
62
How is alcohol distributed around the body
It dissolves in water and is distributed via the bloodstream
Taken up from blood by the tissues in proportion to their water content
63
Which tissues take up the most alcohol during distribution
More alcohol removed from blood into water rich bone & muscle
This is why leaner people have a greater volume of distribution = muscle is water rich
64
Which tissues take up the least alcohol during distribution
Less alcohol removed from blood by fatty tissue
More remains in bloodstream
This is why obese individuals have greater alcohol concentration as not as big a volume of distribution
65
What determines the blood alcohol concentration
How much alcohol is consumed (mass, g)
The volume of distribution - increases with body size and if lean
The greater these 2 factors the lower the alcohol conc.
66
How does body composition affect water content
A larger body weight will have higher water content
A lean person with more muscle will have a high water content than an obese person (high fat)
Really depends on the build as well
More water = greater volume of distribution
67
How do you calculate lean body mass
Weight x the Widmark factor
68
What determines the volume of distribution
Lean body mass
| Have a higher body water content
69
What does the Widmark Factor represent
It is a proportion of body water
| More you have (e.g. lean person) = greater the factor
70
What is the Widmark Equation used for
It gives rough estimate of BAC after alcohol consumption
| assuming instantaneous 100% absorption
71
What is the Widmark Equation
C0 = Wt alcohol consumed (g) x 100 / Body Wt (kg) x W.F.
72
What are the mean experiment Widmark Factors
0. 68 for men (e.g. 68% of body is water)
| 0. 55 for women
73
How is Widmark Factor calculated
Calculate for an individual from sex, height, weight via an online chart
74
How is BAC at a specific time calculated
C at T hours = Co – (β x T)
β is the elimination rate
T is time in hours
This takes into account the alcohol that has been eliminated
75
How do you convert BAC to BrAC
BAC divided by 2.3 = BrAC
76
How do you convert BrAC to BAC
BrAC x 2.3 = BAC
77
How do you convert BAC to UAC
BAC / 0.75 = UAC
78
How do you convert UAC to BAC
UAC x 0.75 = BAC
79
How do you convert BAC to VHAC
BAC/ 0.8
80
How do you convert VHAC to BAC
VHAC x 0.8
81
What is the legal alcohol limit for driving in England
35 micrograms alcohol/100ml of breath
80mg/100ml blood
107mg/100ml urine
82
What is the legal alcohol limit for driving in Scotland
22 micrograms alcohol/100ml of breath
50mg/100ml blood
67mg/100ml urine
83
Does BrAC correlate more with arterial BAC or venous BAC
Arterial - it rises and falls earlier
| Venous lags behind
84
Describe the relationship between venous BAC and BrAC + arterial BAC
It depends on the time since drinking began
Venous BAC lags behind
If less than 60 mins BrAC and ABAC > VBAC (absorption phase)
60-120mins BrAC and ABAC = VBAC (equilibrium phase)
Post absorption (elimination) BrAC and ABAC < VBAC
85
Where is most alcohol broken down
90% is broken down in liver
| Small amounts lost in breath, sweat and urine
86
What is the rate of elimination of alcohol
10-20 mg alcohol per 100ml of blood per hour
Average is 15
Can be increased by tolerance - 40mg/100ml/h in alcoholics
(liver is better at processing alcohol as it's used to it)
87
How do you calculate the amount of alcohol eliminated in T hours
rate of elimination x T
T = time in hours
B= rate of elim
88
Describe how alcohol is metabolised in the liver
Ethanol is broken down to acetaldehyde by alcohol DH (also catalase and MEOS)
This is broken down again by DH to acetate
Acetate is converted into uric acid, ketones, triglycerides (can be measured in blood) and CO2+H20
89
How does exercise affect alcohol metabolism
Increases it so BAC drops faster
| However, it is not a significant effect
90
What are the 3 main stages of intoxication
Excitement (BAC <100 mg%)
Confusion (BAC 100-200 mg%)
Stupor (BAC >200 mg%)
91
What causes the excitement phase of intoxication (BAC <100mg%)
Depression of higher inhibitory cortical function
92
What causes the confusion phase of intoxication (BAC 100-200 mg%)
Depression of limbic system (memory, orientation)
Depression of cerebellum (coordination, speech)
93
What causes the stupor phase of intoxication (BAC >200mg%)
Depression of upper brainstem (RAS - conscious level)
Depression of lower brainstem (breathing & vasomotor centers)
94
Alcohol affecting the cerebral cortex has what effect
Excitement and disinhibition
95
Alcohol affecting the limbic system has what effect
Memory
Confusion
Disorientation
96
Alcohol affecting the cerebellum has what effect
Incoordination
| Slurring
97
Alcohol affecting the hypothalamus and pituitary has what effect
Hypothermia
98
Alcohol affecting the upper brain stem has what effect
Coma
99
Alcohol affecting the medulla has what effect
Respiratory and vasomotor depression
| Death
100
List the features of the excitement phase of intoxication (BAC <100mg%)
Loquacious, vivacious, sense of well being
Loss of emotional restraint
Forget animosities, converse with abandon (friendly)
Less critical, loss of moral integrity
Feeble jokes
Easy affection
Able to pull yourself together if need be - override with conscious thought
101
List the features of the confusion phase of intoxication (BAC 100-200 mg%)
Come to grief over long words, slight slurring
Loss of fine motor control, blurred vision
Poor performance of coordinated motor acts (eg driving and writing)
Confused by tasks requiring thought & concentration
Emotional upsets, boasting, loud, coarse
Anger & violence may appear - may be dependent on company
Emotions stirred by company
102
List the features of the stupor phase of intoxication (BAC >300mg%)
```
Dead drunk
Aroused only by strong stimuli
Anaesthetic & unfeeling
Flushed, drooling, snoring
Simulates head injury (may coexist)
```
Can lead to coma and death
103
List potential dangers of severe intoxication
```
Hypotension (low BP)
Hypothermia
Inhalation of vomit (loss of gag reflex)
Haematemesis (vomiting blood)
Trauma
Death
```
104
Acute intoxication can mimic which other disease processes
```
Head injury
Neurological disease
Diabetic hypoglycaemia
Epilepsy & related states
Drug intoxication (often coexist)
```
105
List symptoms of a hangover
Headache, malaise, nausea, tremor
106
What causes a hangover
Toxic effects of alcohol metabolites & congeners on brain & GI tract
Hypoglycaemia plays a big part - particularly early on
Dehydration
107
Hangover's are self-limiting - true or false
True
| Temporary
108
How does drunk driving contribute to RTAs
D&D involved in 10% of all RTAs and 20% of fatal RTAs
Injures around 30,000 per year
Increased incidence on Friday and Saturday nights
109
How does alcohol impact driving performance
Decreased muscular control & coordination
Increased reaction times
Impaired peripheral vision
Inability to judge speed & distance - crucial to driving
Inability to deal with unexpected events
Falsely increased confidence - think they're okay to drive/ are driving well
110
How does alcohol impact relative accident risk
It increases it
| More pronounced in young, inexperienced drivers
111
List the legal limits for driving in different countries
80 mg% in England & Wales, Ireland, Malta, Lux
50 mg% in Scotland, most Europe, USA
20mg% in Sweden, Estonia & Poland
0 in Czech, Slovakia & Hungary
112
Is it an offence to drink drive
YES
Driving quality is irrelevant - all to do with BAC
Stated in the Road Traffic Act section 4 and 5
113
In which situations can a police officer take a roadside screening breath test
If they suspect the driver has:
Been drinking
Committed a moving traffic offence
Been intoxicated at the time of an accident
114
Describe the RTA arrest procedure for a drunk driver
```
A person will be arrested & taken to police station if they:
Are unfit through drink or drugs
Have provided a positive roadside test
or
have refused to take a roadside test
```
Will then have to provide more samples
115
If a person is arrested for suspected drink driving what samples must they provide at the police station
2 evidential breath samples on CAMIC (can be done by police)
OR
A specimen of blood for analysis (must be done by doctor - might be a delay)
116
Which devices are approved for taking evidential breath samples
CAMIC or Lion devices approved
117
Which of the 2 breath samples is used by the police as the true level
The lower of the 2
118
What happens if someone in England or Wales has a BrAC of 35-50 (just over limit)
The driver can replace the sample with either blood or urine to be more accurate (police decide which)
Not an option in Scotland
119
How is an evidential blood sample taken in drink driving case
Taken by Forensic Physician, with driver’s consent
Part of sample is offered to driver - can get it analysed privately for defence
Lab analysis by Gas Chromatography
6mg% (or 6% if > 100mg%) deducted to allow for lab error
120
Who takes the evidential blood sample taken in drink driving case
Forensic physician
121
How soon after an incident must a urine sample be taken
Must be taken within an hour
122
How is an evidential urine
| sample taken in drink driving case
```
Taken within an hour of incident
Must first empty the bladder
Then collect next smallest volume of urine which can be naturally voided
Part of sample is offered to driver
Lab analysis by GC
```
123
What happens if an suspected drunk driver fails to provide a sample
Constitutes an offence similar to drinking and driving
124
List the potential defence for being over the limit whilst driving
```
Post accident drink
Drinks laced
Inhalation of alcohol vapour - rare
Disease slowing elimination
Medication
Skin contamination (wipes at sample site etc.)
Specimen mix up
In vitro artefact
Alcohol on medicines
IV in hospital
```
125
Describe the defence of post-accident drinking (hip flask defence)
If person can prove that he/she consumed alcohol after he had ceased to drive and that if he had not done so he would not have exceeded the limit then they may be found innocent
Burden of proof is on the defence - hard to prove
126
Which drugs can affect driving
Illegals - Opiates, cannabis, diazepam, stimulants
Prescription drugs
Over the counter drugs
127
How does the court decide if a person was unfit to drive
Witness observations of driving manner
Medical assessment
Toxicological analysis
128
Is consent required to take a blood/urine sample from a suspected drunk driver
YES
129
What aspects of medical history important in drink driving cases
Diabetes, asthma, epilepsy, stroke, head injury
Psychiatric conditions
Alcohol, drugs & medication history
130
What aspects of physical examination important in drink driving cases
Demeanour, breath, pupils, coordination, etc
131
If a person does not consent to a alcohol sample, what else can be noted
Simple observations about their condition
132
If a person is arrested for drug driving what is included in the medical assessment
```
Fitness for detention
Medical condition mimicking intoxication
Impairment of ability to drive
Likelihood of drug intoxication
Dr may advise blood/urine sample if exam suggests drug impairment
```
133
Can the police demand a sample for drugs in driving case
No
| Dr can advise it though if exam suggests it
134
List features of alcohol dependence
```
Aware of compulsion to drink
Prominent drink seeking behaviour
Tolerance to its effects
Withdrawal syndromes on stopping
Avoidance of withdrawal
Social, psychological & physical problems
```
135
What environmental factors can lead to alcoholism
```
Availability
Peer pressure
Occupation
Stress
Competitive lifestyle
Unemployment
```
136
What personal/constitutional factors can lead to alcoholism
```
Low self esteem
Habit
Boredom
Loneliness
Anxiety & depression
Ethnicity
```
137
How long does alcohol withdrawal take to set in/pass
Onset 6-12 h
Peak 48 h
Lasts few days
138
List features of alcohol withdrawal
```
Tremor
Nausea & vomiting
Malaise
Headache
Insomnia
Weakness
Sweating
Tachycardia
Hypertension
Anxiety, depression and irritability
Withdrawal fits
Transient hallucinations - DT
```
Will feel awful
139
How do you manage alcohol withdrawal
There is a chart that scores the severity - higher score is more severe
Chlordiazepoxide - dose dependent on score
(keeps them comfy)
Require monitoring
140
Which body systems are affected by alcohol
```
Gastrointesitnal tract
Liver
Cardiovascular system
Central & peripheral nervous system
Endocrine
Many others (except fat!)
```
141
Which GI conditions can alcoholism cause
```
Oesophagitis, Mallory-Weiss tears
Gastritis, duodenitis, peptic ulcer
Malabsorption
Diarrhoea
Pancreatitis
```
142
How can alcohol affect the liver
```
Fatty change - early and reversible
Alcoholic hepatitis
Cirrhosis
Liver failure - jaundice & clotting failure
(progresses through these stages)
```
Portal hypertension & oesophageal varices (can be fatal)
Liver cancer - quite rare
143
How can alcohol affect the cardiovascular system
Arrhythmias (& sudden death)
Alcoholic cardiomyopathy - enlarged, globular heart, rare
Wet Beri-Beri - vit B deficiency
Hypertension
144
Which CNS symptoms can be caused by alcohol
```
Acute intoxication
Blackout
Withdrawal syndromes
Wernicke’s encephalopathy
Korsakoff’s syndrome
Cerebellar degeneration
Cerebral atrophy (alcoholic dementia)
Alcoholic hallucinosis
Peripheral neuropathy
```
145
How does Wernicke's encephalopathy present
Disorientation & eye problems
146
How does Korsakoff's syndrome present
short term memory loss & confabulation
147
How can alcohol use affect nutrition
```
Early obesity (additional calories)
Later malnutrition - alcohol is their major intake
Vitamin deficiencies
Vitamin B group, e.g. Thiamine, folate
```
148
How can alcohol use affect reproduction
Male impotence
Female menstrual & fertility problems
Miscarriage & foetal alcohol syndrome
Baby can be born with alcohol dependence
149
Which metabolic disturbances can be caused by alcohol
```
Hypoglycaemia
Hyperlipidaemia
Hyperuricaemia
Potassium, Magnesium, Phosphate
Lactic acidosis
Alcoholic ketoacidosis
```
150
List some of the psychological complications of alcohol use
```
Anxiety & depression
Suicide risk
Alcoholic dementia
Alcoholic hallucinosis
Pathological jealousy
Sexual dysfunction
```
151
List some of the social complications of alcohol use
```
Marital & family problems
Domestic violence
Work problems
Unemployment
Road traffic accidents
Crime
```
152
What kills alcoholics
Acute alcohol intoxication
Trauma - prone to it, RTA, accidents etc.
Alcohol related disease
Incidental natural disease
Some obscure mechanisms - lack of signs (e.g. arrhythmias)
153
Describe the mechanism behind death from alcohol intoxication
Brain stem depression
Positional asphyxia
Inhalation of vomit
154
What is considered fatal alcohol intoxication
Fatal level very variable
>250 mg% in non tolerant person
Alcoholics are tolerant to high levels (average fatal level is 450 mg%)
155
How can UAC exceed BAC in someone who dies from alcohol intoxication
Urinary alcohol conc (UAC) > BAC if death follows prolonged coma
156
How are PM alcohol levels measured
Blood
Urine
Vitreous
Compared for corroboration and confidence
157
What can cause artefactual alcohol levels PM
PM alcohol redistribution - unabsorbed from stomach can redistribute
PM microbial alcohol production
158
How can alcohol redistribute after death
Passive diffusion of unabsorbed alcohol from
stomach or aspirated vomitus in airways
Redistributes to the central vessels
159
Which vessels does alcohol redistribute to PM
Central vessels
| Heart, IVC, pulmonary artery and aorta (closer to stomach so can be affected by redistribution PM)
160
Describe the difference between PM alcohol concentration in the central and peripheral vessels
<400% difference between central vessels & peripheral (femoral) vein
161
Describe PM microbial alcohol production
Bacteria & yeasts present in blood convert glucose & lactate into alcohol
Longer they've been dead the more is produced
162
List factors that favor PM microbial alcohol production
warmth, Hyperglycaemia, septicaemia, abdominal trauma
163
Does PM microbial alcohol production occur in the sample tubes too
Yes it can occur invitro
| However, further in vitro elevation prevented by tube preservative & refrigeration of sample
164
How long does it take for PM microbial alcohol production to occur
Levels <70 mg/100 ml can occur within few days (<150 in some cases)
165
What types of trauma are more likely under the influence of alcohol
```
RTA
Falls
Hypothermia
Fire
Drowning
Abuse
Suicide
Homicide
Accidental death
```
166
List signs of hypothermia
Pink discolouration of knees, hips & elbows (writhing and crawling on ground)
Abrasions from crawling
Stomach (Wischnewski) ulcers - arranged in lines where the folds were
Urinary catecholamines (Adrenaline, NA)
167
Why might a crime scene look suspicious in cases of hypothermia
Outdoors – disturbed scene (due to scrabbling around which is common)
Paradoxical undressing - can look like sexual assault
Indoors – “Hide & Die” Syndrome
Victim will pull furniture, bedding on top of themselves
168
List some alcohol related disease
```
Cardiomyopathy
Arrhythmia
Cirrhosis
Liver failure
GI haemorrhage
Varices
Pneumonia
```
169
List some obscure causes of alcoholic death
Arrhythmias (prolonged QT on ECG)
Vagal neuropathy
Alcoholic ketoacidosis
Hypoglycaemia
Catecholamine surge due to acute intoxication or withdrawal
Electrolyte disturbances - magnesium deficiency
170
What terms are now used in the place of alcoholism
Alcohol dependence
| Alcohol misuse
171
What is the chemical formula of ethanol
C2H5OH
172
Is binge drinking considered hazardous
Yes
| It is more harmful than consuming the same amount of alcohol over more days of the week
173
Describe the trend in numbers of each 'alcohol consumption level'
Greatest number is social and sensible drinkers
| As the drinking becomes heavier the numbers decrease - still a significant group!
174
Can alcohol have a beneficial effect
Potentially
| Some studies have shown small amounts can be beneficial
175
How does tolerance occur
Seen in alcohol dependence
| The cells become so used to the presence of alcohol that they are able to overcome its effects (become tolerant to it)
176
What causes withdrawal
Sudden cessation causes a rebound effect in the alcohol tolerant nerve cells
They become over-excitable which leads to the withdrawal symptoms
177
What is GGT
Gamma-glutamyl transferase Liver enzymes
It can indicate liver damage
Raised in alcoholics
178
What is CDT
Carbohydrate-deficient transferrin
Protein which becomes raised in the blood of alcoholics
Causes a flurry of excitement
179
How is MCV affected in alcoholism
It is raised in alcoholics
180
What is a pint in ml
568ml
181
How quickly are neat spirits absorbed
Slowly
They irritate the stomach lining
This produces more mucus which forms a barrier and slows absorption
182
How does alcohol circulate through the body
Swallowed into the stomach and then passed to the small intestine - absorption
Bloodstream takes it to the liver - first organ reached so more toxic effect
Then blood moves it to the heart
Can then be distributed to the rest of the body (brain, lungs, kidneys)
183
Is there a legal driving limit for drugs
Not really
Some drugs are starting to gain levels in legislations
Will instead be prosecuted for impaired driving
184
Why must the bladder be emptied first before providing an evidential urine sample
the urine collected there will be the average of the past several hours
Could be higher or lower than the current level
Therefore you let the bladder refill so it is more indicative of current state
185
Which type of pneumonia is common in alcoholics
Lobar
186
What is paradoxical undressing
When someone is experiencing hypothermia they can begin to feel hot and will undress themselves
