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Year 2- GIT > Alcohol Related Disease > Flashcards

Alcohol Related Disease Flashcards

(51 cards)

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1
Q

Does everyone metabolise alcohol the same?

A

No, there are genetic differences in how individual’s metabolise alcohol

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2
Q

What does alcohol dehydrogenase do?

A

Breaks alcohol down into a toxic metabolite acetaldehyde.

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3
Q

What can acetaldehyde cause to happen?

A

Unpleasant side effects like flushing and nausea, which can limit how much people drink

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4
Q

What happens if the pathway of breaking ethanol into acetaldehyde becomes saturated?

A

Alcohol has to get broken down using other pathways

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5
Q

What happens if the alternative breakdown pathways become saturated?

A

Toxic metabolites build up

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6
Q

Which other metabolites may start to build up?

A

Excess lipids as the alcohol goes down the fatty acid pathway.

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7
Q

What does the build up of lipids lead to?

A

Build up of lactic acid and ketones which leads to acidosis and a breakdown in the gluconeogenesis glycolysis pathway,

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8
Q

What may happen after acidosis?

A

Hyperglycaemia as you can no longer metabolise stores of glucose

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9
Q

What is meant by steatosis?

A

Fatty liver

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10
Q

What is meant by steatohepatitis?

A

Inflammation of the liver with background fat

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11
Q

What can steatohepatitis lead to or cause?

A

Scarring or fibrosis of the liver and ultimately cirrhosis

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12
Q

Which questionnaire can be taken in order to determine someone’s alcohol intake?

A

CAGE

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13
Q

What are the questions asked in CAGE?

A

Just for a general idea :)

  1. Have you ever felt the need to cut down?
  2. Have you ever been annoyed by criticism of you drinking?
  3. Have you felt guilty about drinking?
  4. Do you need an eye opener?
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14
Q

What is the alcohol screening tool called?

A

FAST

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15
Q

Give some proportions of drinks which add up to a unit of alcohol.

A

125ml glass of wine
25ml spirit
Half a pint

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16
Q

How much do you need to score in FAST scoring to be deemed a heavier drinker?

A

> 3

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17
Q

When someone prevents with alcohol related liver disease, what is normally seen?

A

Normally nothing, it may not be found until advanced liver disease

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18
Q

Which symptoms may you get with advanced liver disease, not just because of alcohol?

A

Spider naevi
Parenchymal
Gynecomastia
Ascites
Jaundice
Muscle wasting

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19
Q

While blood tests are non-specific, which finding would be suggestive of alcohol?

A

If AAT is more than double ALT

AAT= Alpha-1 Antitrypsin
ALT Alanine Transaminase

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20
Q

When may hepatic encephalopathy occur?

A

At any point in end-stage liver disease but can be suggestive of liver failure

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21
Q

What are some causes of hepatic encephalopathy?

Study These Flashcards
A

Infections
Drugs
Constipation
GI bleed

22
Q

RECAP- what is hepatic encephalopathy?

23
Q

Why may constipation be a cause of hepatic encephalopathy?

Study These Flashcards
A

If bowels are not clearing, there can be a build-up of toxic metabolites such as ammonia which can cause hepatic encephalopathy

24
Q

What must you exclude before diagnosis of hepatic encephalopathy?

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A

Infection
Hypoglycaemia
Brain bleed

25
How can bowels be cleared if someone has constipation?
Laxatives Enemas
26
What is spontaneous bacterial peritonitis?
Infection of ascites (excess fluid in abdomen)
27
What will patients with spontaneous bacterial peritonitis present with?
Abdominal pain Rigours (swinging fever) Renal impairment
28
How is spontaneous bacterial peritonitis diagnosed?
Ascitic tap to test fluid
29
What do you test the ascites fluid for?
Protein and glucose levels Cultures to find out which bacteria has caused the infection WBC content
30
What WBC count would suggest spontaneous bacterial peritonitis?
>0.25
31
Do protein levels tend to be high or low in those with spontaneous bacterial peritonitis?
Low
32
What is the treatment for spontaneous bacterial peritonitis?
High dose broad spectrum antibiotic
33
How may the high dose broad spectrum antibiotic be given to those with spontaneous bacterial peritonitis?
Intra-venously
34
What can be given to those with spontaneous bacterial peritonitis to increase vascular volume?
Albumin as this reduces chances of reoccurrence of ascitic fluid
35
What will patients with alcoholic hepatitis present with?
Jaundice Encephalopathy Infection is common
36
What would blood tests of someone with alcoholic hepatitis show?
Raised bilirubin Raised GGT (Gamma Gt) Raised ALKPHOS
37
When taking a history, what part is important to confirm the diagnosis of alcoholic hepatitis?
Must have a history of drinking, cannot diagnose alcoholic hepatitis if patient does not drink
38
What are some differential diagnoses for someone with jaundice?
Bile duct obstruction Gall stones Pancreatic cancer Viral hepatitis Drug induced liver disease
39
What are some of the treatment options for alcoholic hepatitis?
Mostly supportive- Treat infection Treat encephalopathy Treat alcohol withdrawal
40
Which drug can be given to minimise alcohol withdrawal?
Benzodiazepines
41
What are those with alcoholic hepatitis at a higher risk of?
GI bleed
42
What is the usual alcoholic hepatitis scoring system usually used?
Glasgow Alcoholic Hepatitis Score ->classical use of Glasgow
43
What happens if you have a Glasgow Alcoholic Hepatitis score >9?
Graded as having severe alcoholic hepatitis
44
What is the treatment for those with severe alcoholic hepatitis?
Steroids- prednisolone
45
What are the risks of taking prednisolone?
Increased risks of GI bleeding and infection
46
Which other test can be used to grade alcoholic hepatitis as well as Glasgow Alcoholic Hepatitis Score?
Maddrey's discriminant function.
47
Which score of the Maddrey's discriminant function would indicate severe alcoholic hepatitis?
>32
48
How are those with alcoholic hepatitis affected nutrioanlly?
100% are malnourished!!!
49
Which vitamin is most deficient in individuals with alcoholic hepatitis?
Vitamin B (thiamine)
50
What happens if the thiamine (vit.B) is not replenished?
Permanent brain damage
51

Year 2- GIT (37 decks)

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