Alcohol Misuse

Question 1

What are the methods used in motivational enhancement therapy?

Answer 1

• Reflective listening and expression of empathy.
• Developing a discrepancy between the patients most deeply held values and their current behaviour.
• Sidestep resistance by responding with empathy.
• Building confidence and helping the patient see that change is possible.

Question 2

What score in the audit questionnaire suggests hazardous drinking?

Answer 2

8 - 14

Question 3

What score in the audit questionnaire suggests harmful drinking?

Answer 3

15 - 19

Question 4

What score in the audit questionnaire suggests possible dependence on alcohol?

Answer 4

20+

Question 5

What should you do if a patient has an audit score of 11 and you are worried they have hazardous drinking?

Answer 5

Deliver a brief intervention.

Question 6

What should you do if a person scores 21 on the audit drinking questionaire?

Answer 6

Comprehensive assessment of their drinking

Question 7

What does FRAMES mean in therms of an alcohol brief intervention?

Answer 7

Feedback
Responsibility
Advice
Menu of options
Empathy
Self efficacy

Question 8

What number of units per day is it safe for men to drink?

Answer 8

3 - 4, with 2 alcohol free days (21 units per week)

Question 9

What number of units per day is it safe for women to drink?

Answer 9

2 - 3, with 2 alcohol free days (14 units per week)

Question 10

How many unite counts as a bing drink?

Answer 10

8 units for men

6 units for women

Question 11

What does a comprehensive assessment of someones alcohol use cover?

Answer 11

1. Consumption - pattern and daily unit intake.
2. Dependence
3. Alcohol related problems
4. Treatment history
5. Comorbidity (physical, psychological, social)
6. Other substance use.
7. Cognitive function (MMSE)
8. Readiness and belief in ability to change.

Question 12

How long into alcohol withdrawal might seizures occur?

Answer 12

0 - 48 hours

Question 13

How long into alcohol withdrawal might the DTs occur?

Answer 13

48 - 72 hours.

Question 14

What happens in the delirium tremens?

Answer 14

Course tremor
Confusion
Delusions
Hallucinations

Question 15

What drug is used to in assisted alcohol withdrawal in a fixed dose regime?

Answer 15

Chlordiazepoxide

Question 16

What drug is used in assisted alcohol withdrawal in a flexible dose regimen?

Answer 16

Diazepam

Question 17

A patient who has a significant alcohol dependence problem is staggering and confused. You also notice that his eye movements are very restricted.

Answer 17

Wernicke’s encephalopathy

Question 18

What causes wernicke’s encephalopathy?

Answer 18

Thiamine deficiency (vitamin B1)

Question 19

A patient who has a significant alcohol dependence problem is having short term memory problems, appears to be confabulating and is acting strangely. What is this and what is the cause?

Answer 19

Korsakoff’s syndrome caused by a thiamine deficiency.

Question 20

What is the treatment for Wernicke’s encephalopathy?

Answer 20

Thiamine

Question 21

A patient with a history of alcohol dependence present with nummbess and pain in his hands and feet?

Answer 21

Peripheral neuropathy

Question 22

What causes the peripheral neuropathy seen in alcohol dependency?

Answer 22

Thiamine deficiency

Question 23

What part of the brain starts to degenerate as a result of thiamine deficiency?

Answer 23

Cerebellum

Question 24

What drug do you start FIRST in patientss with overt symptoms of wernicke’s encephalopathy or korsakoff syndrome?

Answer 24

Pabrinex. Patient is on this for 7 days then thiamine is started.

Question 25

What drug, prescribed for those with alcohol dependance reduces glutaminergic activity which reduces alcohol cravings, acting as an adjunct to maintain abstinence?

Answer 25

Acamprosate

Question 26

What drug, prescribed for those with alcohol dependance is an opioid receptor antagonist that reduces the pleasure which reinforces alcohol use meaning there is less chance of a lapse becoming a relapse?

Answer 26

Naltrexone

Question 27

What drug, prescribed for those with alcohol dependance is an opioid receptor agonist which reduces alcohol consumption?

Answer 27

Nalmefene

Question 28

What class of drug is used in medically assisted alcohol withdrawal?

Answer 28

Benzodiapzapine

Question 29

What drugs, used to help with withdrawal are not given in the community due to risk of overdose?

Answer 29

Clomethiazole

Question 30

What benzodiazepine is best to use in alcohol withdrawal if the person have liver impairement?

Answer 30

lorazepam

Question 31

What is the first line treatment for the DTs?

Answer 31

Oral lorazepam

Question 32

A person in the DTS has had some oral lorazepam but there has been no significant improvement. What drug should be given next?

Answer 32

Parenteral lorazepam, haloperidol or olanzapine.

Question 33

What part of the brain is there haemmorhage into in Wernicke's encephalopathy?

Answer 33

Mamillary bodies

Question 34

What is the classic triad of symptoms seen in Werneike's encephalopathy?

Answer 34

Encephalopathy Ataxic gait Oculomotor disfunction

Question 35

What are the symptoms of chronic Werneike;s?

Answer 35

Retrograde and Anterograde amnesia