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Topic 2
Acute & Chronic Alcoholism
80
Other
Undergraduate 4
01/10/2017

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Term
What is the third leading health cause of death in the United States?
Definition
alcohol (behind heart disease & cancer)
Term
_____ percent of the US population has an issue with alcohol dependency, & worldwide, it is the most abused drug
Definition
13%
Term
Alcohol abuse and/or dependency has been found to reduce life expectancy by up to _____ years
Definition
10
Term
Alcohol is involved in _____% of all traffic fatalities, _____% of all homicides, & _____% of all suicides
Definition
50% traffic, 50% homicides, 25% suicides
Term
four symptoms of alcoholism
Definition
1. craving (a strong need or urge to drink)
2. loss of control (not being able to stop drinking once you start)
3. physical dependence (withdrawal symptoms)
4. tolerance (the need to drink more alcohol to get drunk)
Term
How does alcohol affect the central nervous system (the part of the body most affected by alcohol)?
Definition
it is a depressant
Term
The degree to which the central nervous system is affected by alcohol is directly proportional to the _____
Definition
concentration of alcohol in the blood
Term
What is alcohol's path once ingested?
Definition
from the stomach to the small intestine, where it is rapidly absorbed into the blood & distributed throughout the body
Term
The ______ is by far the most efficient region of the GI tract for alcohol absorption because of its very large surface area
Definition
small intestine
Term
In a fasting individual, what percentage of alcohol is absorbed in the stomach versus the small intestine?
Definition
20-25% = stomach

75-80% = small intestine
Term
What is the difference in timing between peak alcohol ingestion in a fasting person & a non-fasting person?
Definition
fasting = 0.5 - 2 hours

non-fasting = 1 - 6 hours
Term
Does alcohol have a high or low affinity for water?
Definition
high!
Term
What happens to alcohol in the blood once absorption is complete?
Definition
equilibrium occurs such that blood at all points in the system contain approximately the same concentration of alcohol
Term
What does the body oxidize alcohol into?
Definition
acetic acid
Term
How does body weight affect your likelihood of getting affected by alcohol?
Definition
the less you weigh, the more alcohol will affect you
Term
Alcohol is a multiple-action depressor of the ______, and the depression caused by it is dose-dependent
Definition
central nervous system
Term
Despite people using alcohol for its stimulating action, this stimulation is only apparent & happens only with ______?
Definition
moderate doses
Term
How does alcohol act in a stimulating way?
Definition
it depresses inhibitory tone
Term
2 results of alcohol removing the cortex from its integrative role
Definition
1. confused/disorganized thinking
2. disruption of adequate motor control
Term
______ diffuses through lipids, modifying protein fluidity & function
Definition
ethanol
Term
How do high levels of ethanol affect the sodium/potassium pump?
Definition
decreases its electron-transporting functions, thus impairing electrical conduction of the nerve cells
Term
Does ethanol affect various or only a few cerebral transmitters?
Definition
various
Term
Does ethanol affect the inhibitory GABA transmitter?
Definition
yes!
Term
What happens when GABA binds to a receptor?
Definition
it promotes an increase in the frequency of opening of chloride channels, thus hyperpolarizing the cell
Term
How does ethanol affect NMDARs?
Definition
it inhibits NMDAR current & therefore affects synaptic plasticity
Term
In the early stages of alcohol intake, there is an increase in ______, which provides anxiety relief
Definition
GABAergic tone
Term
As the concentrations of alcohol increase in the brain, what happens?
Definition
GABAergic tone on the inhibitory interneurons which prevents there inhibition which causes excitation
Term
two reasons why women are worse with handling their alcohol then men
Definition
1. a smaller blood volume & a higher proportion of body fat
2. ADH is 70-80% more present in men
Term
4 things in the diencephalon
Definition
1. thalamus
2. hypothalamus
3. epithalamus
4. subthalamus
Term
What ventricle is shared with the diencephalon?
Definition
telencephalon
Term
the fornix
Definition
a c-shaped bundle of fibers (axons) in the brain that carries signals from the hippocampus to the mammillary bodies & septal nuclei
Term
7 steps of the Papez circuit
Definition
1. subiculum --> fornix
2. fornix --> mammillary nuclei
3. mammillary nuclei --> MTT & anterior thalamus
4. anterior thalamus --> internal capsule
5. internal capsule --> cingulate gyrus
6. cingulate gyrus --> parahippocampal gyrus
7. parahippocampal gyrus --> subiculum
Term
2 types of alcohol impairment
Definition
1. acute
2. chronic
Term
2 parts of the sensory store most affected by acute alcohol impairment
Definition
1. visual
2. verbal
Term
acute alcohol impairment on STM
Definition
small loss of visual & verbal STM
Term
acute alcohol impairment on recency effect
Definition
depresses the recency effect
Term
acute alcohol impairment on retrieval deficits
Definition
none
Term
state-dependent learning (SDL)
Definition
you will remember information best in the state in which you learned it
Term
alcohol blackout
Definition
the inability of a person to recall, while sober, the information learned while intoxicated
Term
2 signs of early stage alcoholism
Definition
1. increased tolerance
2. increased blackouts
Term
Do we know exactly why or how blackouts occur?
Definition
no!
Term
Blackouts usually occur during the _____ phase
Definition
short-term
Term
Alcohol acts as an agonist of the _____ receptor, disrupting memory
Definition
GABA "A"
Term
Is Wernicke-Korsakoff syndrome linked with chronic or acute alcoholism?
Definition
chronic
Term
3 symptoms discussed by Carl Wernicke in the Wernicke-Korsakoff syndrome
Definition
1. paralysis of eye movements
2. ataxia
3. confusion
Term
What ended up happening to the alcoholic patients (and the woman who ingested acid) researched by Wernicke?
Definition
coma & death
Term
Did SS Korsakoff describe disruptions of memory in patients with short-term or long-term alcoholism?
Definition
long-term
Term
What name did Korsakoff give to the syndrome he found in his alcoholic patients?
Definition
psychosis polyneuritica
Term
What was the first amnesic syndrome?
Definition
psychosis polyneuritica discovered by Korsakoff
Term
A deficiency in _____ seems to be evident in patients suffering from Wernicke-Korsakoff syndrome
Definition
thiamine
Term
How does alcohol affecting the GI system (particularly the liver) lead to a deficiency in thiamine?
Definition
decreased activation of thiamine pyrophosphate from thiamine, as well as a decreased capacity for the liver to store thiamine
Term
Thiamine is converted into _____, which serves as a co-factor for several enzymes necessary for glucose utilization
Definition
thiamine pyrophosphate
Term
3 enzymes that require thiamine pyrophosphate as a co-enzyme
Definition
1. transketolase
2. pyruvate dehydrogenase
3. alpha ketoglutarate
Term
Is the Korsakoff amnesic state observed in a large or small number of patients?
Definition
small
Term
How do individuals in the Korsakoff amnesic state present themselves?
Definition
alert & responsive
Term
How do Korsakoff amnesic state patients become apparent upon examination?
Definition
by demonstrating confusion
Term
2 types of amnesia present in those with Korsakoff amnesic state
Definition
1. retrograde
2. anterograde
Term
2 characteristics of the anterograde amnesia in the Korsakoff amnesic state
Definition
1. severe
2. incomplete
Term
How is the anterograde amnesia in the Korsakoff amnesic state demonstrated?
Definition
the patients can recall numbers/shapes as they're stated but not after a period of time has passed
Term
How is the retrograde amnesia in the Korsakoff amnesic state demonstrated?
Definition
gaps in patients' memories recent & remote past events
Term
confabulation
Definition
filling in gaps in the patient's memory with stories
Term
anosognosia
Definition
a condition in which a person suffers disability seems unaware of his/her existing condition
Term
6 critical lesion sites for the memory disorder of Wernicke-Korsakoff syndrome
Definition
1. the medial dorsal nucleus of the thalamus
2. mammillary bodies & anterior/midline portion of the thalamus
3. bilateral fornix
4. MTT & anterior thalamus
5. midline of the thalamus
6. anterior thalamic nuclei
Term
Patient NA demonstrated what type of amnesia?
Definition
thalamic
Term
How did NA's amnesia manifest itself?
Definition
verbal amnesia with no other cognitive deficits
Term
6 parts of the brain that were messed up to cause NA's amnesia
Definition
1. left mediodorsal nucleus of the thalamus
2. rostral & caudal intralaminar nuclei
3. ventral mediodorsal nucleus
4. ventral lateral & ventral anterior thalamic nuclei
5. mammillothalamic tract
6. mammillary bodies
Term
Zola-Morgan & Squire demonstrated that circumscribed lesions in the _____ could produce amnesia in monkeys
Definition
mediodorsal thalamic nuclei
Term
4 characteristics of the amnesia studied by Graff-Radford with bilateral thalamic lesions
Definition
1. deficits in anterograde verbal learning
2. deficits in anterograde visual learning
3. retrograde amnesia
4. no motor deficiencies
Term
Who was the first patient with non-alcoholic diencephalic amnesia?
Definition
patient NA
Term
describe the nature of NA's amnesia
Definition
it affects primarily verbal material without other apparent cognitive deficits
Term
What was the trajectory of the injury to patient NA?
Definition
right nostril to left thalamus (contralateral)
Term
What was the trajectory of the injury to patient BJ?
Definition
left nostril to basal regions of the brain
Term
What type of memory impairment was the worst with patient BJ?
Definition
verbal
Term
Where was the location of patient BJ's lesion?
Definition
hypothalamus in the region of the mammillary bodies
Term
What lesions produced patient BY's amnesia?
Definition
bilateral lesions to the thalamus
Term
4 areas that were normal in patient BY
Definition
1. speech
2. reading
3. writing
4. calculation
Term
2 types of severe amnesia in patient BY
Definition
1. retrograde
2. anterograde
Term
At first, how was patient BY's retrograde amnesia?
Definition
very severe, going back a few years
Term
Did patient BY's retrograde amnesia improve over time?
Definition
yes!
Term
Did patient BY's anterograde amnesia improve over time?
Definition
sort of, but not like the retrograde improvements
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