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Introduction and TermsEdit

AlcoholEdit

Diagnosis according to DSM-IV-TREdit

Managing acute intoxicationEdit

Chronic managementEdit

Diagnostic pearlsEdit

Etiological subtypes (based on Cloninger’s Alcoholism Typology)Edit

  • Type 1 (also type A) alcoholism (75%) is characterized by adult onset and drinking to relieve depression and anxiety; alcoholics often feel guilty about drinking. Patients quickly develop behavioral tolerance
  • Type 2 (also type B) alcoholism (25%) is characteized by early onset and antisocial and risk-taking behavior while intoxicated; it has been termed male-limited alcoholism due to perceived transmission from fathers to sons

Laboratory testsEdit

  • Markers of heay use: GGT (same as GGTP) gamma-glutamyl transferase (or transpeptidase) and CDT (carbohydrate-deficient transferrin). GGT is also elevated in DM, HTN, chronic liver disease (low specificty)
  • Elevated AST and ALT with classic ratio of 2:1
  • Elevated MCV, a finding also seen in macrocytic and Folate/Vitamin B12 anemias
  • Blood alcohol level (BAL)

Clinical pearlsEdit

Distingwsuish between a "hangover" and withdrawal

Further ReadingEdit

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