43) Which statement about acute alcoholic pancreatitis is FALSE? A) It generally occurs in binge drinkers. B) It is accompanied by nausea, vomiting and severe pain. C) Inflammation of the liver is its primary symptom. D) It can be fatal. 44) Which is associated with cirrhosis? A) loss of digestive enzymes B) accelerated metabolism of alcohol C) increased pancreatic production of insulin D) fibrous scar tissue in the liver 45) An episode of binge drinking is accompanied by an increased risk of ________ within 24 hours of the binge drinking. A) cardiac disintegration B) cardiac atrophy C) cardiac arrhythmia D) cardiac myopathy 46) Which is a sign of a serious alcohol use disorder? A) drinking in the morning B) feeling less awkward in social settings after drinking C) consuming two drinks before dinner daily D) drinking with friends on the weekends 47) Which statement is true regarding alcoholics in the United States? A) The vast majority of alcoholics are poor and homeless. B) Alcoholics are usually college students. C) Over half of alcoholics require some sort of treatment program to help them attain sobriety. D) Most binge drinkers are alcoholics. 48) A regular drinker who used to experience the effect of alcohol after two drinks now requires at least four to get the same desired effect; this is known as ________. A) withdrawal B) tolerance C) antagonism D) inhibition 49) Which symptom associated with alcohol withdrawal is considered a medical emergency? A) elevated pulse and breathing rate B) profound memory gaps (blackouts) C) nightmares D) delirium tremens
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Source: Copstead, L. & Banasik, J. (2006). Pathophysiology (3rd ed.). Mosby. F.C. is a 54-year-old man with a history of chronic heavy alcohol use. He has frequent bouts of gastrointestinal bleeding for which he has been hospitalized on six separate occasions. He continues to drink and exhibits most of the common manifestations of alcoholic cirrhosis. He was recently hit by a car and was hospitalized for a broken leg. He appeared to be under the influence of alcohol at the time of the accident and had a blood alcohol level of 1.8. F.C.'s family reports that his mental functioning has deteriorated significantly over the past few months. Case Questions: 1. What are the common manifestations of alcoholic cirrhosis? Which of these are secondary to hepatocellular failure? Which are secondary to portal hypertension? 2. Why is F.C. at particular risk for GI bleeding? 3. What is the probable cause of F.C.'s progressive mental deterioration? How might his mental deterioration be medically managed? 4. What problems might be precipitated by F.C.'s abrupt cessation of alcohol intake while hospitalized?
A Case of Acute Pancreatitis by David F. Dean Department of Biology, Spring Hill College Case Presentation George Hendrix is a 38-year-old man who has abused alcohol his entire adult life. Recently, following an episode of binge drinking, George experienced a gradual onset of pain in his upper abdomen that radiated to his back. The pain persisted for several hours and worsened each time that he ate. He also felt nauseous and experienced repeated episodes of vomiting. The pain grew more intense and George decided to drive himself to the emergency room of his local hospital. The physician who examined George in the ER noted the following findings when she performed a physical exam: Intense pain upon palpation of the upper left quadrant of the abdominal cavity, gaseous distension of the intestinal tract, and tachycardia. The physical exam findings, together with the history of alcohol abuse and the results of a CBC, serum chemistry panel, and abdominal ultrasound, led the physician to conclude that George was suffering from a case of acute pancreatitis. The doctor immediately initiated the appropriate medical therapy. Questions 1. Describe the anatomic location of the pancreas relative to the other organs in the upper portion of the abdominal cavity. 2. Describe the functional anatomy of the duct system that conveys bile from the liver and digestive juice from the pancreas to the lumen of the duodenum. 3. Briefly outline the endocrine and exocrine functions of the pancreas. 4. Describe the hormonal control of the secretion of bile and pancreatic juice during the digestive process. 5. Explain why proteases are secreted in an inactive state and describe the means by which proteases are activated in the stomach and small intestine. 6. What is pancreatitis and what is the basic mechanism that underlies the condition? 7. List the most common causes of pancreatitis. 8. List the symptoms, signs, and laboratory findings associated with pancreatitis, and state which of these George presents with. 9. Explain what is meant by the phenomenon of referred pain. Is this phenomenon often seen in patients with acute pancreatitis? 10. Describe the treatment of the condition and its prognosis.
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