Psychiatry: Alcohol Use Disorder

Question 1

What are the stages of change

Answer 1

Precontemplation
Contemplation
Preparation
Action
Maintenance

Question 2

What is Alcohol

Answer 2

Ethyl Alcohol (Ethanol)

Question 3

How is Alcohol Metabolized

Answer 3

by the liver

Question 4

What is the biochemical effect of Alcohol

Answer 4

Activates GABA receptors

Question 5

What are common symptoms of Alcohol Intoxication

Answer 5

CNS Depressant
Slurred Speech
Incoordination
Unsteady Gait
Stupor
Coma

Question 6

Biomarkers of Liver Damage In Alcohol Use Disorder

Answer 6

GGT
AST

Question 7

How long does it take GGT to return to normal

Answer 7

2-6 weeks

Question 8

How long does it take AST to return to normal

Answer 8

7 days

Question 9

What triggers alcohol withdrawl

Answer 9

Heavy drinkers after abrupt cessation

6-24 hours after last drink

Question 10

What are common symptoms of alcohol withdrawal

Answer 10

Tremors
Anxiety
GI upset
Headache
Sweating
Palpitations
Mental status intact

Question 11

When do alcohol seizures occur

Answer 11

24 to 48 hours after last drink

Question 12

What type of seizures occur in alcohol withdrawal

Answer 12

Generalized tonic-clonic seizures

single or clusters of 2-3

Question 13

When do alcohol hallucinations occur

Answer 13

24 to 48 hours after last drink

Question 14

What type of Hallucinations are most common in alcohol withdrawal

Answer 14

Visual

Question 15

What is the most severe manifestation of alcohol withdrawl

Answer 15

Delirium Tremens

Question 16

When does Delirium Tremens occur

Answer 16

48 to 96 hours after last drink

Question 17

What are features of Delirium Tremens

Answer 17

Delirium
Agitation
Fever
Drenching sweats
Autonomic Hyperactivity

Question 18

What Does Autonomic Hyperactivity cause in Delirium Tremens

Answer 18

Tachycardia

Hypertension

Question 19

What are common causes of death in Delirium Tremens

Answer 19

Hyperthermia

Cardiovascular collapse

Arrhythmias

Fluid/electrolyte abnormalities

Question 20

What is used to treat alcohol withdrawl

Answer 20

Benozdiazepines

Question 21

What Benodiazepines are used for alcohol withdrawal with a functional liver

Answer 21

Long-acting
-diazepam
-chlordiazepoxide

Question 22

What benzodiazepines are used for alcohol withdrawal with cirrhosis or alcoholic hepatitis

Answer 22

Short acting
-Lorazepam

Question 23

What Scale is used to assess therapy in Alcohol Withdrawl

Answer 23

CIWA Scale

Question 24

What are GI Complications of Alcohol Use Disorder

Answer 24

Gastritis

Hepatitis

Cirrhosis

Pancreatitis

Question 25

What are Cardiac Complications of Alcohol Use Disorder

Answer 25

Dilated Cardiomyopathy Refractory Hypertension

Question 26

What are malignant complications of Alcohol use disorder

Answer 26

Esophageal cancer oropharyngeal cancer

Question 27

What is a neurological complication of Alcohol Use Disorder

Answer 27

Wernicke-Korsakoff

Question 28

How does Wernicke Encephalopathy present

Answer 28

Visual disturbances/nystagmus Gait ataxia Confusion

Question 29

How does Korsakoff Amnesia Present

Answer 29

Affects recent memory more confabulation lack of interest or concern (apathy)

Question 30

What is Confabulation

Answer 30

Can't remember things so you make them up

Question 31

What nutritional deficiences are associated with alcohol use disorder

Answer 31

Thiamine (B1) Pyridoxine (B6) Folate (B9) Mg Ca PO4

Question 32

What is vitamin B1

Answer 32

Thiamine

Question 33

What is Vitamin B6

Answer 33

Pyridoxine

Question 34

What is vitamin B9

Answer 34

Folate

Question 35

What deficiency are Wernicke and Korsakoff associated with

Answer 35

B1 Thiamine

Question 36

What is a common finding on imaging in Wernicke-Korsakoff

Answer 36

Atrophy of mammillary bodies

Question 37

What is Wernicke precipitated by

Answer 37

Glucose without thiamine -thiamine is a co-factor for glucose metabolism

Question 38

What is in a banana bag

Answer 38

Thiamine (b1) Folate (b9) Mg

Question 39

What are treatment options for Alcohol Use disorder

Answer 39

Support groups (AA) 3 FDA approved drugs

Question 40

What are the 3 FDA approved drugs for Alcohol Use Disorder

Answer 40

Disulfiram (Antebuse) Naltrexone Acamprosate

Question 41

What is the Mechanism of Disulfiram (Antebuse)

Answer 41

Inhibits aldehyde Dehydrogenase causing an accumulation of Acetaldehyde triggering a catecholamine release

Question 42

What Happens as a result of using Disulfiram (Antabuse)

Answer 42

Sweating Flushing Palpitations Nausea Vomiting

Question 43

What is the Mechanism of Naltrexone

Answer 43

Long-acting opioid antagonist

Question 44

How is naltrexone given

Answer 44

PO

Question 45

What is the role of opioids in alcohol use disorder

Answer 45

endogenous opioids reinforce the effects of alcohol

Question 46

How does Acamprosate work

Answer 46

Modulates NMDA receptors

Question 47

What is a common side effect of Acamprosate

Answer 47

Diarrhea

Question 48

What is a common screening tool for alcohol use disorder

Answer 48

CAGE questionnaire

Question 49

What is the C in CAGE for

Answer 49

Cut down ever felt you should cut down on drinking

Question 50

What is the A in CAGE for

Answer 50

Annoyed have people annoyed you by criticizing your drinking

Question 51

What is the G in CAGE for

Answer 51

Guilty have you ever felt guilty about your drinking

Question 52

What is the E in CAGE for

Answer 52

Eye opener have you ever had a drink first think in the morning as an eye opener

Question 53

What score on the CAGE is clinically significant

Answer 53

2 or greater