1. What happens if you give glucose to an alcoholic without thiamine?
    Thiamine is a cofactor in carb metabolism.  If you give glucose you trigger carb metabolism, which depletes thiamine stores.  This can precipitate Wernicke's encephalopathy
  2. Wernicke encephalopathy
    • Acute encephalopathy
    • Nystagmus
    • Ophthalmoplegia
    • Ataxia
  3. Korsakoff syndrome
    • Chronic psychosis seen in alcoholics
    • Retrograde amnesia, confabulation
    • Irreversible!!
    • Caused by damage to mammary bodies and thalamic nuclei
  4. Stages of alcohol withdrawal:
    • 1. Acute--12--48 hours--tremors, sweating, hyperreflexia, seizures
    • 2. Alcoholic hallucinations--24--72 hours--auditory and visual hallucinations
    • 3. DT--2--7 days--hallucinations, confusion, autonic instability (sweating, tachycardia, fever), can be fatal
  5. Why is peripheral neuropathy seen in alcoholics?
    Thiamine deficiency
  6. Mechanism of Disulfiram
    • Inhibits aldehyde dehydrogenase, causes nausea and vomiting with drinking
    • (cephalosporins and metronidazole have a similar effect when taken with alcohol)
  7. Fetal alcohol syndrome
    • Mental retardation
    • Microcephaly
    • Microphthalmia
    • Short palpebral fissures
    • Midfacial hypoplasia
    • Cardiac defects
  8. Most common cause of hypoglycemia
    Alcohol abuse
  9. Management of non-bleeding varices
    Non-selective beta blockers (propranolol, nadolol, timolol)
Card Set
step II