Alcohol symposium

Question 1

top 5 causes of admission to hospital due to alcohol

Answer 1

unintentional injuries eg falls 
mental ill health 
heart conditions and stroke
liver and pancreatitis 
cancer

Question 2

What organ processes alcohol?

Answer 2

liver

Question 3

Main functions of the liver

Answer 3

CHO metabolism = glycogenesis and glycogenolysis
fat metabolism = lipid metabolism, fats –> phospholipids and cholesterol
protein metabolism - deamination, albumin, ammonia
storage - glucose, iron, copper, vitamins
synthesis - fibrinogen, thrombopoetin
Kupffer cells
produce bile
metabolism of drugs and alcohol

Question 4

Alcohol - what breakdown product is carcinogenic?

Answer 4

acetylaldehyde

Question 5

Enzymes involved in alcohol breakdown

Answer 5

ADH and ALDH

Question 6

How many units of alcohol per week keep health risks low?

Answer 6

<14

Question 7

Acetylaldehyde broken down into?

Answer 7

acetate

Question 8

Other important factors with alcohol consumption and health risks

Answer 8

nutrition
genetic differences 
other drugs 
co-existing virus eg Hep C
dependence and progression 
female

Question 9

Causes of cirrhosis

Answer 9

alcohol, fatty liver, Hep C, autoimmune

Question 10

Progression of alcohol related liver disease

Answer 10

normal - steatosis - steatohepatitis - fibrosis - cirrhosis

Question 11

What stage of alcohol related liver disease is reversible?

Answer 11

steatosis

Question 12

How steatosis arises

Answer 12

alcohol - acetylaldehyde - acetate - fatty acids
calorie rich
fat deposited around central vein then parenchyma

Question 13

6 indicators of chronic alcohol use

Answer 13

history 
macrocytosis 
increased ferritin 
low platelets 
elevated gamma GT
enlarged liver on AUSS

Question 14

Alcoholic hepatitis

Answer 14

fatty change and infiltration with leucocytes, hepatic necrosis

Question 15

Signs/symptoms of alcohol hepatitis

Answer 15

abdominal pain, jaundice, fever, hepatomegaly, decompensation

Question 16

Score used to determine 28 day survival rate with alcoholic hepatitis and what it includes

Answer 16

Glasgow alcoholic hepatitis score

age, markers of inflammation and liver function

Question 17

Management of alcoholic hepatitis

Answer 17

abstinence, steroids, treat infection, nutrition

Question 18

Liver fibrosis

Answer 18

chronic inflammation
activation of stellate cells
collagen production and scarring

Question 19

How to identify liver fibrosis

Answer 19

fibroscan

Question 20

Complications of cirrhosis

Answer 20

variceal haemorrhage
encephalopathy
ascites
hepatocellular carcinoma

Question 21

In low doses, alcohol…

Answer 21

euphoria, decrease anxiety, sociability

Question 22

In high doses, alcohol…

Answer 22

intoxication, impaired attention, nystagmus, slurring, disinhibition, mood instability

Question 23

Intoxication

Answer 23

The pathological state produced by a drug, serum, alcohol or any other toxic substance

Question 24

Diagnosing alcohol dependency

Answer 24

acute intoxication
harmful use
dependence
withdrawal state

Question 25

dependence symptoms

Answer 25

cravings, difficult controlling use, primacy, increased tolerance, persistence, physiological withdrawal

Question 26

Withdrawal symptoms

Answer 26

tremor, weakness, nausea, vomit, anxiety, seizures, confusion, agitation, death DELIRIUM TREMENS

Question 27

How alcohol effects life negatively

Answer 27

physical, mental, relationships, work

Question 28

Wernicke's encephalopathy

Answer 28

confusion, ataxia, opthalmoplegia, nystagmus

Question 29

What causes Wernicke's encephalopathy and Korsakoff's psychosis?

Answer 29

thiamine deficiency

Question 30

Screening tools

Answer 30

CAGE - 2 or more | FAST, AUDIT, PAT

Question 31

Managing alcohol dependency

Answer 31

practical advice, holistic approach, CBT/AA, medication, social work

Question 32

Medication for alcohol dependency

Answer 32

chlordiazepoxide | thiamine

Question 33

Licensing act

Answer 33

2005

Question 34

7 messages of the industry

Answer 34

non-drinkers do not exist alcohol is normal, common, healthy and responsible ignore harmful and addictive damage by small group of deviants only solved when all parties work together helping consumer choose education about responsible use is best prevention