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22 Cards in this Set

  • Front
  • Back
With which CA is ETOH intake associated?
Oral cavity, larynx, pharynx, esophagus, liver, lung.
Can also be gastric, colon, pancreatic, and breast
What is the most common cause of cirrhosis and esophageal varices?
Relationship between ETOH and accidental or intentional death?
ETOH involved in ~50% of fatal car accidents, 67% of drownings, 67% of homicides, 35% of suicides, and 70-80% of deaths caused by fire
What may happen if you give glucose to an alcoholic without giving thiamine first?
May precipitate Wernicke's encephalopathy
What's Wernicke syndrome?
Acute encephalopathy char. by ophthalmoplegia, nystagmus, ataxia, and/or confusion. Can be fatal, but is reversible with thiamine
What is Korsakoff syndrome?
Chronic psychosis char. by anterograde amnesia and confabulation to cover up amnesia. Generally irreversible and is thought to be d/t damage to mamillary bodies and thalamic nuclei
T/F, ETOH withdrawal can be fatal?
Tx for ETOH withdrawal?
Benzos, tapered gradually
First stage of ETOH withdrawal?
Acute withdrawal (12-48 hrs after last drink; tremors, sweating, hyperreflexia, seizures) "rum fits"
Second stage of ETOH withdrawal?
Alcoholic hallucinosis (24-72 hrs after last drink) auditory and visual hallucinations, and illusions with autonomic signs
What is the third stage of ETOH withdrawal?
Delirium tremens (2-7 days after last drink, possibly longer); hallucinations and illusions, confusion, poor sleep, and autonomic lability. Fatality is usually associated with this stage
What are the classic physical stigmata of liver dz in alcoholics?
Caput medusae, esophageal varices, testicular atrophy, encephalopathy, Hemorrhoids (internal), Jaundice, Ascites, palmar erythema, spider angiomas, gynecomastia, asterixis, prolonged PT, hyperbilirubinemia, hypoalbuminemia, anemia (macrocytic)
What dzs and conditions may be caused by chronic ETOH intake?
Gastritis, Mallory-Weiss tears, Pancreatitis, Peripheral neuropathy, dilated cardiomyopathy, rhabdo, fatty change in liver, hepatitis, cirrhosis, wernicke or korsakoffs, cerebellar degeneration
What's the classic derangement of AST (SGOT) and ALT (SGPT) in alcoholic hepatitis?
The ratio of AST to ALT is at least 2:1, although both may be elevated. Other causes of hepatitis are usually associated with the opposite ratio or equal elevation of both
What's the best Tx for alcoholism?
AA or other peer-based support groups have had the best success.
Describe the effects of ETOH on pregnancy?
It's the most common cause of preventable mental retardation in the US. Classic presentation of FAS: mental retardation, microcephaly, microphthalmia, short palpebral fissures, midfacial hypoplasia, and cardiac defects.
Epidemiology of ETOH abuse?
~10-15% of population abuses ETOH. More common in men. Genetic component passed most easily from father to son
What kind of pneumonia should you suspect in a "skid-row" alcoholic?
Aspiration. Look for enteric organisms (anaerobes, E.coli, streptococci, staphylococci). Especially think Klebsiella if sputum resembles currant jelly, or thick, mucoid capsules are mentioned
T/F, ETOH can precipitate hypoglycemia?
True, but give thiamine first, then glucose in an alcoholic
What are the classic electrolyte abnormalities in alcoholics?
Low magnesium, low potassium, low sodium, elevated uric acid/gout
What are the classic vitamin/mineral abnormalities in alcoholics?
Folate and thiamine
How are bleeding esophageal varices treated?
First ABC's, IV and blood if necessary. Next endoscopy to determine cause of UGI bleed and then sclerotherapy. Mortality rate is high