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24 Cards in this Set
- Front
- Back
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Name the three pathways for alcohol metabolism and when they are induced |
Alcohol Dehydrogenase - Normal Catalase Pathway - Excess Microsomal Ethanol Oxidising system - Excess |
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What are the products of Alcohol metabolism? |
Acetaldehyde Acetate (in Mitochondria) ROS NADH NADP |
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What are the effects of XS acetaldehyde? |
COLLAGEN - FIBROSIS Binds to proteins Conformational change Immunogenic Stellate cell activated --> collagen deposition |
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What are the effects of XS Acetate? |
INFLAMMATION Inc Acetyl CoA Inflammation Histone Acetylation |
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What are the effects of Inc NADH/NAD ratio? |
FATTY LIVER Inc Fatty Acid oxidation Steatosis |
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Where are ROS mainly produced and what is the end result of their production? |
MEOS NF-kB --> TNF-Alpha --> Mitochondrial Damage Apoptosis |
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What effect does alcohol have on intestinal permeability? |
Increase Endotoxin --> Portal system --> Kupfer cell -->TNF-Alpha --> Hepatocyte --> IL-8 --> Neutrophil activation |
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What is the saving enzyme of apoptosis? Anti-apoptotic factor |
Glutathione |
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What minerals are missing in a malnourished alcoholic that could help protect the liver? |
Thiamine Zn |
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How can you tell the difference between NAFLD and ALD? |
Higher AST:ALT ratio |
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Which portal zones are affected in alcoholic liver disease? |
3 & 2 |
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Histological features of Alcoholic hepatitis? |
Mallory bodies Swollen hepatocytes Giant mitochondria Collagen n Zone 3 |
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Steatosis and Hepatitis can run in the background at the same time. A persisted state of both can lead to cirrhosis. How interesting. Name clinical features of this badboy, from start to death |
Malaise Hepatomegaly Splenomegaly Fever Jaundice Sepsis Encephalopathy Ascites Renal failure Death Good effort ladddd |
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Shall we discuss portal hypertension? How does it result in the following? Hypersplenism Oesophago-gastric varices Encephalopathy Hyperdynamic circulation Ascites Hepato-renal syndrome |
Hypersplenism: Raised portal pressure Oesophago-gastric varices: Porto-systemic shunting Encephalopathy: Porto-systemic shunting Hyperdynamic circulation: Vasodilation--> Reduced effective circulating volume Ascites - Compensatory RAAS --> Na retention Hepato-renal syndrome -->RAAS --> Renal vasoconstriction |
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Safe limit for Men and Women |
<21 <14 |
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Binge drinking limit? |
8 units in one setting |
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Features of dependance? |
Compulsion Control Tolerance Withdrawal Persistence Neglect Repertoire Reinstatement |
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Even more!! DTs Suicide Insomnia Depression Hepatic encephalopathy |
yeah |
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Can the following be reversed? Explain your answer ish Alcohol neurotoxicity Thiamine deficency Both together |
Yes Yes No That's life |
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What can you give to alcohol dependants for management? |
Day/In-patient detox with vitamin replacement
Benzodiazepines Psychological therapies based on goals Antabuse - Block ALDH - disulfiram Treatment of comorbidities |
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Features of FAS |
Flat midface No filtrum Short nose Thin upper lip Minor ear abnormalities |
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Which brain systems does Alcohol give the following effects: Euphoria/Sedation?Amnesia/Ataxia? |
Euphoria: Opioid + DA Sedation/Amnesia/Ataxia: Inc GABA, Dec NMDA |
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What are CNS effects of alcohol |
Wernicke-korsakoff syndrome Peripheral neuropathy Cerebellar degeneration Myopathy Cognitive Decline Seizures/ICH |
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The stages of change From addiction or any behaviour really? |
Pre-contemplation Contemplation Preparation Action Maintenance Relapse/Sustained |
