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Gurpal

Part II ISQ Club - Alcohol

41 posts in this topic

Part II ISQs will be posted regularly. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook/clinical paper/web page you used). Please only deal with one ISQ in each post and include the question as the first line of your post.

Some questions are easier than others. Some questions may be phrased incorrectly - feel free to offer alternative questions.

1. Moderately heavy drinkers are more of a significant public health concern than very heavy drinkers

2. Greater social impairment results from binge alcohol abuse compared with chronic alcohol abuse

3. The public responds more strongly to a rise in moderate drinking habits than heavy drinking

4. The eldest child in a family has a greater chance of becoming dependent on alcohol.

5. Maternal deprivation is significantly associated with alcohol dependence

6. Heritability of alcohol dependence depends on the population prevalence

7. Auditory hallucinations are part of the alcohol withdrawal syndrome

8. Alcohol dependence is a known risk factor for esophageal cancer

9. Alcohol increases the amount of stage 4 sleep [or REM]

10. Minnesota recommendations are to reduce alcohol intake in dependence syndrome rather than abstain

11. Confrontation of a person in precontemplation phase about his substance misuse most readily brings about a change to action phase

12. Visual hallucinations are a common consequence of B12 deficiency

13. Vitamin e deficiency can cause confabulation

14. Pantothenic acid defeciency can cause confabulation

15. B12 deficiency is associated with an amnesic-confabulatory syndrome

16. Vitamin B12 deficiency mostly improves within 5 days

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4. The eldest child in a family has a greater chance of becoming dependent on alcohol.

FALSE

birth order not relevant, but males all more at risk

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14. Pantothenic acid defeciency can cause confabulation

FALSE

not causing pathology - bad english sorry, v v tired :P

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8. Alcohol dependence is a known risk factor for esophageal cancer

TRUE... we've discussed this before

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7. Auditory hallucinations are part of the alcohol withdrawal syndrome

TRUE, fragmentary auditry halls

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11. Confrontation of a person in precontemplation phase about his substance misuse most readily brings about a change to action phase

FALSE

load of bullocks, at the most u manage to alianate patient and they'll never come back 2 see u

Motivational interviewing however would be true

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9. Alcohol increases the amount of stage 4 sleep [or REM

if alcohol intoxication then decrease REM, increase stage 4.

if alcohol withdrawl, then rebound REM, more rem and horrible nightmares (not that i would know.... ::))

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Q.1 -3 TRUE?

Moderate vs. heavy drinkers. 30 million regular drinkers in U.K. 200,000 dependent. Attitudes/legisaltion/money will probably affect moderate drinkers more, cos dependent ones will drink anyway! Am probably gonna say TRUE for all 3. Any takers?

I agree with other above answers posted. Not sure abput REM one.

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12. Visual hallucinations are a common consequence of B12 deficiency. FALSE. (Little evidence of schiz/dep/paranoia. Impairments in memory more common. Ref: TRICKCYCLISTS. Unlikely to be common consequence, but then anything can cause hallucinations).

14. Pantothenic acid defeciency can cause confabulation. FALSE? Deficiency not seen much in humans. Synthesis ACh. Causes burning feet syndrome. No psych sequelae.

15. B12 deficiency is associated with an amnesic-confabulatory syndrome. TRUE?

Causes memory impairment, so probably. More likely with B1 deficiency.

16. Vitamin B12 deficiency mostly improves within 5 days. FALSE? I thought that b12 deficiency took 3 injections over 5 days to slowly increase it.

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1. Moderately heavy drinkers are more of a significant public health concern than very heavy drinkers  

TRUE

Their numbers are much greater

Ref. Memory from some lecture.. I agree with maverick's thinking

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12. 16. Vitamin B12 deficiency mostly improves within 5 days. FALSE? I thought that b12 deficiency took 3 injections over 5 days to slowly increase it.

FALSE

It takes at least 1 week of i.m (or oral apparently..) B12 and then repeated evry month.. most improvement is seen after several weeks

[Kaplan 1146}

Not completely clear cut, though,...

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5. Maternal deprivation is significantly associated with alcohol dependence  

?TRUE

Some animal studies and poor quality older studies suggest this....

1:  Ploj K, Roman E, Nylander I.

Long-term effects of maternal separation on ethanol intake and brain opioid and dopamine receptors in male Wistar rats.

Neuroscience. 2003;121(3):787-99.

1: Psychol Med. 1996 Jan;26(1):79-95.

Childhood parental loss and alcoholism in women: a causal analysis using a twin-family design.

Kendler KS,

Childhood parental loss may be an important risk factor for psychiatric illness in adulthood. . We examined an epidemiological sample of female twin pairs with the same history of continuity or disruption in parent-child relationships (N=1018 pairs; mean age 30 years), using a range of definitions of alcoholism. Childhood parental loss through separation, but not death, substantially increased the risk in adulthood for all definitions of alcoholism.

LS : Have you got references, please for your FALSE? :-[

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6. Heritability of alcohol dependence depends on the population prevalence

TRUE

No refer.. just me guessing that within a more severely affected population the environmental factors will play a greater role....

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10. Minnesota recommendations are to reduce alcohol intake in dependence syndrome rather than abstain

FALSE

It is a 12-step model with a primary therapist. Adolescents are encouraged to admit that SA is problematic and that help is needed in order to eradicate it.

Kaplan 1288

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16. Vitamin B12 deficiency mostly improves within 5 days

false, I remember from kumar and clark

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5. Maternal deprivation is significantly associated with alcohol dependence  

?TRUE

Some animal studies and poor quality older studies suggest this....

1:  Ploj K, Roman E, Nylander I.

Long-term effects of maternal separation on ethanol intake and brain opioid and dopamine receptors in male Wistar rats.

Neuroscience. 2003;121(3):787-99.

1: Psychol Med. 1996 Jan;26(1):79-95.

Childhood parental loss and alcoholism in women: a causal analysis using a twin-family design.

Kendler KS,

Childhood parental loss may be an important risk factor for psychiatric illness in adulthood. . We examined an epidemiological sample of female twin pairs with the same history of continuity or disruption in parent-child relationships (N=1018 pairs; mean age 30 years), using a range of definitions of alcoholism. Childhood parental loss through separation, but not death, substantially increased the risk in adulthood for all definitions of alcoholism.

LS : Have you got references, please for your FALSE?  :-[

Reference Manchester notes.

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No.7 - auditory hallucinations in alcohol withdrawal

I would say FALSE - auditory hallucinations (fragmentary etc) in ALCOHOLIC HALLUCINOSIS, acute withdrawal/DTs characterised by visual hallucinations

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No.7 - auditory hallucinations in alcohol withdrawal

I would say FALSE - auditory hallucinations (fragmentary etc) in ALCOHOLIC HALLUCINOSIS, acute withdrawal/DTs characterised by visual hallucinations

Hallucinations affect about 25% of people undergoing major alcohol withdrawal. Visual hallucinations are the most common type of hallucination experienced during alcohol withdrawal. People will classically 'see' insects or worms crawling on walls or over their skin. Often this is associated with tactile (feeling) hallucinations in which alcoholics think they feel insects crawling on their skin. This phenomenon is called formication. Auditory (hearing) hallucinations can also occur during withdrawal, although less commonly than the other types of hallucinations

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1. Moderately heavy drinkers are more of a significant public health concern than very heavy drinkers ..true(kreitman's Paradox...ref-CPS and Seminar Series)

2. Greater social impairment results from binge alcohol abuse compared with chronic alcohol abuse ...same ref...true

3. The public responds more strongly to a rise in moderate drinking habits than heavy drinking....cldnt find references...but,i think Public likes media and hype...so,false

4. The eldest child in a family has a greater chance of becoming dependent on alcohol. ..false..we know that conduct and truancy more common in large families and younger siblings

5. Maternal deprivation is significantly associated with alcohol dependence ...nowhere any mentioned in any of the major books...false

6. Heritability of alcohol dependence depends on the population prevalence....true coz  Heritability is Simply:

Additive genetic variance / Phenotypic variance

The additive genetic variance is the numerator in the heritability ratio. The denominator is the phenotypic variance. A component of the phenotypic variance is caused by environmental influences.

7. Auditory hallucinations are part of the alcohol withdrawal syndrome..true

8. Alcohol dependence is a known risk factor for esophageal cancer..twofold increase...seminar series

9. Alcohol increases the amount of stage 4 sleep [or REM] ...

acutely,decreases latency,increases SWS.can mildly suppress REM sleep during the first part of the night.during the 2nd half,it can cause sleep diruption and increase REM sleep.

chronic alcoholics show loss of SWS and sleep disruption..they frequently show insomnia

withdrawal..even greater sleep latency,reduction of total sleep,loss of SWS and increased sleep pressure,,,indicated by increased REM sleep  in severe withdrawal

ref-Oxford  textbook

so,acutely...true and if chronic ...false

10. Minnesota recommendations are to reduce alcohol intake in dependence syndrome rather than abstain...false(ref...Seminar series)

11. Confrontation of a person in precontemplation phase about his substance misuse most readily brings about a change to action phase..false(done in preparing for action stage)

12. Visual hallucinations are a common consequence of B12 deficiency..false...not common(depression and memory deficits are..thats why a part of dementia screening)

13. Vitamin e deficiency can cause confabulation..true(ref-any med textbook)

14. Pantothenic acid defeciency can cause confabulation...false(Vit B5 ..water soluble...deficiency if any causes numbness.parasthesia..etc)

15. B12 deficiency is associated with an amnesic-confabulatory syndrome..true

16. Vitamin B12 deficiency mostly improves within 5 days...false(K & S)

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15. B12 deficiency is associated with an amnesic-confabulatory syndrome..true

this one needs a reference...

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No.7 - auditory hallucinations in alcohol withdrawal

I would say FALSE - auditory hallucinations (fragmentary etc) in ALCOHOLIC HALLUCINOSIS, acute withdrawal/DTs characterised by visual hallucinations

Hallucinations affect about 25% of people undergoing major alcohol withdrawal. Visual hallucinations are the most common type of hallucination experienced during alcohol withdrawal. People will classically 'see' insects or worms crawling on walls or over their skin. Often this is associated with tactile (feeling) hallucinations in which alcoholics think they feel insects crawling on their skin. This phenomenon is called formication. Auditory (hearing) hallucinations can also occur during withdrawal, although less commonly than the other types of hallucinations

TRUE

ref:core psych c2000 pgg427

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Social impairments may involve the more basic precursors such as establishing joint attention with a communicative partner,  Basic skills for such acts as requesting objects/actions, giving, calling attention, commenting, and showing may be reduced or absent.

Greater social impairment results from binge alcohol abuse compared with chronic alcohol abuse

true

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