With which cancers is alcohol intake associated?

USMLE
#1
  1. With which cancers is alcohol intake associated?
    Cancers of the oral cavity, larynx, pharynx, esophagus, liver, and lung. It also may be
    associated with gastric, colon, pancreatic, and breast cancer.
  2. What is the most common cause of cirrhosis and esophageal varices?
    Alcohol.
  3. Describe the relationship between alcohol and accidental or intentional (i.e.,
    suicide and murder) death?
    Alcohol is involved in roughly 50% of fatal car accidents, 67% of drownings, 67% of
    homicides, 35% of suicides, and 70% to 80% of deaths caused by fire.
  4. What may happen if you give glucose to an alcoholic without giving thiamine first?
    You may precipitate Wernicke encephalopathy. Always give thiamine before glucose to avoid
    this complication.
  5. What is the difference between Wernicke and Korsakoff syndromes? What
    causes each?
    Wernicke syndrome is an acute encephalopathy characterized by ophthalmoplegia,
    nystagmus, ataxia, and/or confusion. It can be fatal but often is reversible with thiamine.
    Korsakoff syndrome is a chronic psychosis characterized by anterograde amnesia (inability
    to form new memories) and confabulation (lying) to cover up the amnesia. Korsakoff
    syndrome is generally irreversible and is thought to be due to damage to the mamillary bodies
    and thalamic nuclei. Both conditions result from thiamine deficiency.
  6. True or false: Alcohol withdrawal can be fatal.
    True. Alcohol withdrawal needs to be treated on an inpatient basis because it can result in
    death (mortality rate of 1% to 5% with delirium tremens).
  7. How is alcohol withdrawal treated?
    With benzodiazepines (or, in rare cases, barbiturates). The dose is tapered gradually over
    several days until symptoms have resolved.
  8. What are the stages of alcohol withdrawal?
    Acute withdrawal syndrome (12 to 48 hours after last drink): tremors, sweating, hyperreflexia,
    and seizures (“rum fits”).
    Alcoholic hallucinosis (24 to 72 hours after last drink): auditory and visual hallucinations
    and illusions without autonomic signs.
    Delirium tremens (2 to 7 days after last drink, possibly longer): hallucinations and illusions,
    confusion, poor sleep, and autonomic lability (sweating, increased pulse and temperature).
    Fatality usually is associated with this stage.
    Of course, these stages may overlap. Delirium tremens may occur several days after the last
    drink. The classic example is a patient who develops delirium on postoperative day 2 but
    was fine before the surgery. He or she could be a closet alcoholic, assuming other causes for
    delirium have been ruled out.
  9. What are the classic physical stigmata of liver disease in alcoholics?
    n Abdominal wall varices (caput medusae)
    n Testicular atrophy
    n Esophageal varices
    n Encephalopathy
    n Hemorrhoids (internal)
    n Asterixis
    n Jaundice
    n Scleral icterus
    n Ascites
    n Edema
    n Palmar erythema
    n Spider angiomas
    n Gynecomastia
    n Terry nails
    n Fetor hepaticus
    n Dupuytren contractures
  10. What are the classic laboratory findings of liver disease in alcoholics?
    n Anemia (classically macrocytic)
    n Prolonged prothrombin time
    n Hyperbilirubinemia
    n Hypoalbuminemia
    n Thrombocytopenia