Alcohol use disorder

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Alcohol use disorder

Psychological disorders

Mood disorders

Major depressive disorder

Suicide

Bipolar disorder

Seasonal affective disorder

Premenstrual dysphoric disorder

Anxiety disorders

Generalized anxiety disorder

Social anxiety disorder

Panic disorder

Agoraphobia

Phobias

Obsessive-compulsive disorders

Obsessive-compulsive disorder

Body focused repetitive disorders

Body dysmorphic disorder

Stress-related disorders and abuse

Post-traumatic stress disorder

Physical and sexual abuse

Psychotic disorders

Schizoaffective disorder

Schizophreniform disorder

Delusional disorder

Schizophrenia

Cognitive and dissociative disorders

Delirium

Amnesia

Dissociative disorders

Eating disorders

Anorexia nervosa

Bulimia nervosa

Personality disorders

Cluster A personality disorders

Cluster B personality disorders

Cluster C personality disorders

Somatoform and factitious disorders

Somatic symptom disorder

Factitious disorder

Substance use disorders and drugs of abuse

Tobacco dependence

Opioid dependence

Cannabis dependence

Cocaine dependence

Alcohol use disorder

Sleep disorders

Bruxism

Nocturnal enuresis

Insomnia

Night terrors

Narcolepsy (NORD)

Sexual dysfunction disorders

Erectile dysfunction

Male hypoactive sexual desire disorder

Orgasmic dysfunction

Female sexual interest and arousal disorder

Genito-pelvic pain and penetration disorder

Pediatric disorders

Attention deficit hyperactivity disorder

Disruptive, impulse control, and conduct disorders

Learning disability

Fetal alcohol syndrome

Tourette syndrome

Autism spectrum disorder

Rett syndrome

Shaken baby syndrome

Enuresis

Encopresis

Psychiatric emergencies

Suicide

Serotonin syndrome

Neuroleptic malignant syndrome

Psychological disorders review

Mood disorders: Pathology review

Amnesia, dissociative disorders and delirium: Pathology review

Personality disorders: Pathology review

Eating disorders: Pathology review

Psychological sleep disorders: Pathology review

Psychiatric emergencies: Pathology review

Drug misuse, intoxication and withdrawal: Hallucinogens: Pathology review

Malingering, factitious disorders and somatoform disorders: Pathology review

Anxiety disorders, phobias and stress-related disorders: Pathology Review

Trauma- and stress-related disorders: Pathology review

Schizophrenia spectrum disorders: Pathology review

Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Drug misuse, intoxication and withdrawal: Alcohol: Pathology review

Developmental and learning disorders: Pathology review

Childhood and early-onset psychological disorders: Pathology review

Assessments

Alcohol use disorder

Flashcards

0 / 12 complete

USMLE® Step 1 questions

0 / 9 complete

High Yield Notes

11 pages

Flashcards

Alcohol use disorder

of complete

Questions

USMLE® Step 1 style questions USMLE

of complete

A 40-year-old man is brought to the emergency department following a head-on motor vehicle collision. Trauma workup demonstrates a fracture of the right femur and tibia for which the patient is admitted and scheduled for surgical repair the next day. Twelve hours after admission, the patient becomes agitated, hypervigilant, and paranoid. He repeatedly tells the nurse that he hears voices calling out his name and someone is planning to kill him. He frequently attempts to remove his morphine PCA pump. Past medical history is significant for alcohol use disorder, opioid use disorder, and moderate marijuana use. Temperature is 37.5°C (99.5°F), a pulse is 88/min, respirations are 17/min, and blood pressure is 135/87 mmHg. Physical examination shows an alert and oriented male with tremulousness and diaphoresis. Which of the following is the most likely etiology of this patient’s condition?  

External References

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Acamprosate

alcoholism p. 595, 726

Alcoholism p. 595

anemia p. 428

in anemia taxonomy p. 425

cardiomyopathy p. 317

cataracts and p. 554

cirrhosis and p. 398

common organisms affecting p. 176

esophageal cancer p. 387

ethanol metabolism and p. 70

folate deficiency p. 428

gastritis in p. 388

hepatitis p. 376

hypertension and p. 306

ketone bodies in p. 88

Klebsiella in p. 143

Korsakoff syndrome p. 581

liver serum markers in p. 399

lung abscesses and p. 710

magnesium levels in p. 336

Mallory-Weiss syndrome in p. 386

osteonecrosis in p. 473

osteoporosis and p. 472

pancreatitis p. 250, 406

porphyria p. 432

sideroblastic anemia p. 427

subdural hematomas p. 532

treatment p. 726

vitamin B1 deficiency p. 64

vitamin BNaN deficiency p. 66

wet beriberi p. 714

Alcohol-related disorders

readmissions with p. 277

Aspiration pneumonia

alcoholics p. 176

Bacteroides spp.

alcoholism p. 176

Disulfiram

alcoholism p. 726

alcoholism treatment p. 595

Fusobacterium spp.

alcoholism p. 176

Hepatitis

alcoholism p. 595

Klebsiella spp. p. 143

alcoholism p. 176

Naltrexone

alcoholism p. 595, 726

Pancreatitis p. 406

alcoholism p. 595

Peptostreptococcus spp.

alcoholism p. 176

Peripheral neuropathy

alcoholism p. 595

Testicular atrophy

alcoholism p. 595

Transcript

Content Reviewers

Rishi Desai, MD, MPH

Contributors

Tanner Marshall, MS

Vincent Waldman, PhD

Kelly Mackenzie, MA

Alcohol is one of the most widely used psychoactive substances in the world, and has been a part of different cultures for hundreds of years.

Drinking alcohol can have serious harmful consequences, it’s been linked to various cancers, gastrointestinal diseases, and metabolic problems.

Over time, regular use of alcohol can lead to alcohol dependence and bouts of withdrawal, and this can take a serious physical and emotional toll on a person’s life.

Alcoholic drinks contain the chemical ethanol, which is a tiny molecule that reduces the activity of various inhibitory and excitatory neurotransmitter pathways in the brain.

Inhibitory neurotransmitters make neurons in the central nervous system less likely to fire an action potential, and the brain’s major inhibitory neurotransmitter—gamma-aminobutyric acid or GABA—acts as an “off” switch and restricts brain activity.

Ethanol is a GABA agonist, so when it binds to GABA receptors it makes that inhibitory signal even stronger.

Ethanol also activates opioid receptors and induces the release of endogenous morphine—known as endorphins.

The opioids then bind to receptors on dopaminergic neurons in the nucleus accumbens, which trigger the release of dopamine and serotonin in that part of the brain.

Ethanol also acts as a glutamate antagonist.

In other words, ethanol blocks glutamate, which is an excitatory neurotransmitter, from binding to glutamate receptors, making it less likely that those neurons will fire.

The combined effect that ethanol has on these neurotransmitters varies by the location in the brain.

For example, in the nucleus accumbens and the amygdala, which are the reward centers of the brain, ethanol produces pleasant or rewarding feelings like euphoria.

This is important because if a person believes that drinking leads to euphoria, they are more likely to drink again.

In the cerebral cortex, the thought-processing center of the brain, ethanol slows everything down, making it difficult to think and speak clearly.

Elsevier

Copyright © 2023 Elsevier, except certain content provided by third parties

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