Alcohol & the Liver Flashcards Preview

Gastrointestinal > Alcohol & the Liver > Flashcards

Flashcards in Alcohol & the Liver Deck (28):
1

How does alcohol cause neurological effects?

it interacts with the lipid bilayer of neurons and makes it leak sodium and potassium depressing the activity of neurons

2

What are the alcoholic signs?

neurological disturbances, jaundice, altered breath, oesophageal varices, feminisation, extensively scarred liver, portal hypertension, enlarged collateral vessels, ascites, hand tremor, hypogonadism, easy bruisability, muscle wasting, oedema, infertility in women, impotence in men

3

What are the different types of alcohol induced liver damage?

fatty liver, alcoholic hepatitis and cirrhosis

4

Is fatty liver reversible?

yes

5

What percentage of liver functioning hepatocytes are required for normal liver function?

40%

6

What percentage of alcohol enters blood from the stomach?

30%

7

Is alcohol metabolised in the stomach?

a little bit - there is some alcohol to dehydrogenase in gastric mucosa - more in males than females

8

What slows alcohol absorption in the stomach?

fat in food

9

What enzyme converts ethanol to acetaldehyde?

alcohol dehydrogenase

10

What is a biproduct of this reaction?

NADH

11

What is the result of the increase in NADH?

represses gluconeogenesis and leads to hypoglycaemia

12

How else can ethanol be converted to acetaldehyde?

CYP2E1 metabolism

13

How do you develop tolerance to alcohol?

upregulating CYP2E1

14

Why are women more affected by alcohol?

because alcohol does not distribute in fat

15

How long does it take for the body to clear one standard drink?

an hour

16

Why can this rate not be increased?

Because alcohol dehydrogenase works at vmax after 2 drinks

17

Why should patients on warfarin not drink alcohol?

because the CYP2E1 is up regulated so drugs will have less effect

18

What causes alcohol induced liver damage?

neglecting dietary intake of antioxidants, alcohol interferes with transport of glutathione, increased use of CYP2E1, alcohol promotes absorption of iron - all of these cause increased free radicals, also acetaldehyde reacts with proteins and compromises their function

19

What is Wernicke Korsakoff syndrome?

thiamin deficiency due to poor nutrition and alcohol metabolism

20

What are the symptoms of Wernicke Korsakoff syndrome?

nystagmus, wide step, confusion, hypothermia, amnesia, confabulation

21

What converts acetylaldehyde to acetate?

two forms of aldehyde dehydrogenase - ALDH2 is the mitochondrial form that is more important

22

What causes Asian flush?

an inactive variant of ALDH2

23

What is disulfiram?

A drug which inhibits ALDH used to treat alcoholics - causes tachycardia, nausea and vomiting when drinking

24

What is a gene that contributes to alcohol addiction?

dopamine D2 receptor

25

What are the signs of alcoholism on physical examination?

spider naevi, palmar erythema, gynaecomastia, feminisation of hair patterns, testicular atrophy, muscle wasting, enlarged liver, enlarged spleen, metabolic flap

26

What liver enzymes would be elevated in alcoholic liver disease?

GGT, ALT and CDT

27

How does alcohol cause dehydration?

by depressing the pituitary gland leading to decreased production of anti diuretics

28

What is foetal alcohol syndrome?

irreversible birth disorders brought on by drinking alcohol during pregnancy