Preparation for Child Psych PRITE and Boards
Revision as of 20:20, 13 October 2010 by 130.219.207.139 (Talk)
Contents
Introduction and Terms
Alcohol
Diagnosis according to DSM-IV-TR
Managing acute intoxication
Chronic management
Diagnostic pearls
Etiological subtypes (based on Cloninger’s Alcoholism Typology)
- 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 tests
- 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 pearls
Distingwsuish between a "hangover" and withdrawal