Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
25 Cards in this Set
- Front
- Back
|
648. How prevalent is alcoholism?
|
a. 10-15% of people have alcoholism (alcohol abuse or dependence).
b. There is a genetic component to alcoholism!!! i. Close relatives of alcoholics (especially sons) are at increased risk for alcoholism. |
|
|
649. Screening for alcoholism?
|
a. Ask all pts about alcohol use. If alcoholism is suspected, use one of the following screening methods
b. CAGE (any more than 1 positive answer may suggest alcohol abuse) c. MAST (Michigan Alcoholism Screening Test) Questionnaire- 25-item questionnaire that also helps identify alcoholism. |
|
|
650. CAGE questions?
|
a. Cut down? (have you ever felt need to cut down)
b. Annoyed? (Ever felt annoyed by criticisms of your drinking). c. Guilty? Ever felt guilt about drinking d. Eye-opener? Ever taken a morning eye-opener. |
|
|
651. Alcohol and lipid levels?
|
a. Modest alcohol intake (max 1-2 drinks per day) is associated w/an increase in HDL.
b. On the other hand, alcohol increases TG levels. |
|
|
652. 4 symptoms of alcohol withdrawal?
|
a. Tachycardia
b. Sweating c. Anxiety d. Hallucinations. |
|
|
653. Goal in treating alcohol withdrawal?
|
a. To prevent progression to DTs, which is a medical emergency (mortality rate, 20%)
i. DTs occur in 5% of alcoholic withdrawals. |
|
|
654. DT?
|
a. DT is delirium develop-ing w/in a week of last alcoholic intake, usually 2-4 days after the last drink.
b. DT is characterized by: 1. tactile hallucinations 2. Visual hallucinations 3. Confusion 4. Sweating 5. ↑d tachycardia 6. Elevated BP. |
|
|
655. Risk factors for developing DTs w/alcohol withdrawal?
|
1. Pancreatitis
2. Hepatitis 3. Other illness b. DT is rare in healthy people. |
|
|
656. Tx of alcohol withdrawal?
|
a. Give BZDs if withdrawal symptoms are present.
b. Prevention of DT is the best tx. c. Diet is important in tx: 1. High in calorie 2. High in carbs 3. Multivitamins. |
|
|
657. Complications of alcoholism-systems overview?
|
a. GI
b. Cardiac c. CNS d. Pulmonary e. Nutritional deficiencies. f. Peripheral neuropathy g. Sexual dysfunction- impotence, loss of libido h. Psych- depression, anxiety, insomnia. i. ↑d frequency of malignancy- oesophagus, oral, liver, lung j. Frequent falls, minor injuries, motor vehicle accidents!!! |
|
|
657. Complications of alcoholism-systems overview?
|
a. GI
b. Cardiac c. CNS d. Pulmonary e. Nutritional deficiencies. f. Peripheral neuropathy g. Sexual dysfunction- impotence, loss of libido h. Psych- depression, anxiety, insomnia. i. ↑d frequency of malignancy- oesophagus, oral, liver, lung j. Frequent falls, minor injuries, motor vehicle accidents!!! |
|
|
658. GI complications of alcohol?
|
a. Gastritis
b. Oesophagitis c. Peptic ulcer disease d. Alcoholic liver disease (alcoholic hepatitis, cirrhosis, portal HTN) e. Pancreatitis (acute and chronic) f. Mallory-Weiss tears |
|
|
659. Cardiac complications of alcohol?
|
a. Alcoholic cardiomyopathy
b. Essential HTN (more than 3 drinks per day significantly increases BP) |
|
|
660. CNS complications of alcohol?
|
a. Wernicke’s encephalopathy
b. Korsakoff’s encephalopathy |
|
|
661. Wernicke’s encephalopathy-cause?
|
a. Often reversible
b. Caused by thiamine deficiency |
|
|
662. Wernicke’s encephalopathy symptoms?
|
a. Nystagmus
b. Ataxia c. Ophthalmoplegia d. Confusion |
|
|
663. Korsakoff’s encephalopathy cause?
|
a. Thiamine deficiency
b. Irreversible |
|
|
664. Korsakoff’s encephalopathy symptoms?
|
a. Alcohol-induced amnestic disorder
b. Mostly affects short-term memory c. Confabulation is common. |
|
|
665. Pulmonary complications of alcohol?
|
a. Pneumonia
b. Aspiration |
|
|
666. Nutritional complications of alcohol?
|
a. Especially thiamine deficiency
b. Hypomagnesemia c. Folate deficiency |
|
|
667. Pathophys of peripheral neuropathy as a complication of alcohol?
|
a. Due to thiamine deficiency.
|
|
|
668. Lab findings in alcoholics?
|
a. Anaemia
b. Macrocytic (most common)- due to folate deficiency c. Microcytic-due to GI bleeding d. LFTs: ↑ GGT, AST:ALT is 2:1 e. Hypertriglyceridemia f. Hyperuricemia, hypocalcemia g. Thiamine deficiency h. ↓d testosterone level. |
|
|
669. Tx of Alcoholism?
|
a. AA is best tx.
b. Disulfiram (Antabuse) c. Naltrexone (Trexan) d. Drugs for withdrawal: Benzos- best to use long-acting agents (diazepam) e. Correction of fluid imbalance, vitamin supplementation (thiamine, folate, multivitamins). |
|
|
670. Effect of Disulfiram (Antabuse)?
|
a. a few minutes after drinking alcohol, pt experiences SOB, flushing, palpitations, tachycardia.
b. If more alcohol is taken, HA and N/V ensue. c. Symptoms last about 90 minutes. d. It is appropriate for short-term use and should not be taken chronically. e. Routine f/u is important. |
|
|
671. Effect of Naltrexone (Trexan)?
|
a. This has been shown to improve abstinence rates.
b. It reduces the craving for alcohol. |
