Alcohol Use Disorder

Question 1

Criteria for AUD

Answer 1

More than once tried to cut down or stop drinking (or tried) but couldn’t
Spent a lot of time drinking or being sick or getting over the aftereffects/hangover
Wanted a drink so badly you couldn’t think of anything else
Found that drinking, or being sick from it, often interfered with taking care of your home/family, caused job or school issues
Continued to drink even though it was causing trouble with family or friends
Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink
More than once gotten into situations while or after drinking that increased your chances of injury (drunk driving, walking in a dangerous area, unsafe sex)
Continued to drink even though it was making you feel depressed or anxious or adding to another health problem or had a blackout
Had to drink a lot more than you did before to get the effect you want or found that your usual number of drinks had much less effect than before
Found that when the effects of alcohol were wearing off, you had withdrawal symptoms

Question 2

Criteria for mild AUD

Answer 2

2-3 symptoms

Question 3

Criteria for moderate AUD

Answer 3

4-5 symptoms

Question 4

Criteria for severe AUD

Answer 4

6+ symptoms

Question 5

Where does a patient begin to be at risk for withdrawal?

Answer 5

Moderate AUD

Question 6

MoA of ethanol

Answer 6

Facilitates GABAnergic transmission to block glutamate and results in dopamine release in nucleus accumbens

Question 7

GABA is an _____ neurotransmitter system

Answer 7

inhibitory

Question 8

Acute effects of alcohol on GABA

Answer 8

Enhances effectiveness of GABA

Question 9

Chronic effects of alcohol on GABA

Answer 9

Reduces the effectiveness of GABA receptors (downregulation)

Question 10

Glutamate is a ______ neurotransmitter system

Answer 10

stimulatory

Question 11

Acute effects of alcohol on glutamate

Answer 11

Inhibits effectiveness of glutamate and reduces glutamate release

Question 12

Chronic effects of alcohol on glutamate

Answer 12

Increase in NMDA receptors (upregulation) and downregulates the GABAnergic inhibitory neurotransmitters

Question 13

Acute effects of alcohol on dopamine

Answer 13

Increases firing rate of dopamine neurons in VTA, which releases more DA

Question 14

Chronic effects of alcohol on dopamine

Answer 14

During withdrawal, decreases firing rate and DA release

Question 15

What area of the brain is affected by alcohol first?

Answer 15

Frontal cortex

Question 16

What area of the brain is affected by alcohol last?

Answer 16

Brainstem/midbrain

Question 17

Chronic effects of alcohol in CNS

Answer 17

Addiction, Wernicke-Korsakoff Syndrome, Wernicke’s Encephalopathy, cortical atrophy/dementia

Question 18

Symptoms of Wernicke’s Encephalopathy

Answer 18

Confusion, loss of muscle coordination, ataxia, leg tremor, vision changes, nystagmus (chronic quivering of the eye), diplopia (seeing double), eyelid drooping

Question 19

Cause of Wernicke’s Encephalopathy

Answer 19

Thiamine deficiency- supplement patients with this first before glucose!

Question 20

Is Wernicke’s Encephalopathy reversible?

Answer 20

Yes

Question 21

Symptoms of Wernicke-Korsakoff Syndrome

Answer 21

Antegrade amnesia, potentially severe memory loss, confabulation, hallucinations

Question 22

Cause of W-K Syndrome

Answer 22

Longstanding Wernicke’s Encephalopathy

Question 23

Is W-K Syndrome reversible?

Answer 23

No

Question 24

Chronic effects of alcohol on GI tract

Answer 24

Steatosis/fatty liver disease
Alcoholic hepatitis
Cirrhosis
Pancreatitis