Wonder Me!
One of the things I needed to counsel patients on is their alcohol intake. This is very important, esp. in primary care settings. You have to do this screening every day for every NEW patient you see. Therefore, it's very important that you commit this to your memory.



BATES: Ask: “How many times in the past year have you had 4 or more drinks a day (women), or 5 or more drinks a day (men)?”



Resources - I strongly recommend that you print this out guide out and put in your pocket to help you review. Tho I'd say try to commit it to your memory so you don't need to memorize it. However, it's good to carry this if you're not already familiar with the stats and how to conduct it
: http://pubs.niaaa.nih.gov/publications/Practitioner/PocketGuide/pocket.pdf





Epidemiology (who to screen?): adolescent, adult, pregnant women. Stats#: 8.5% US population or 15-20mil. ppl have problem with alcohol abuse for 12-month prevalence


Screening:
Social Clues: h/o pancreatitis, family h/o alcoholism, arrest for intoxicated drinking.

Physical examination clues: hepatosplenomegaly, ascites, caput medusa; others – spider angiomas, palmar erythema & peripheral edema

Interview: Ask about heavy drinking, then Cutting down, Annoyance when criticized, Guilty feelings, & Eye openers (CAGE), then Alcohol Use Disorders Identification Test (AUDIT)

Consequences (Severity): ER, trauma, addiction, fatal car accidents, family disruptions, violence, HTN, cirrhosis, hemorrhagic stroke, upper GI & liver malignancies

1 standard drink = 12 oz regular beer or wine cooler, 8oz malt liquor, 5oz wine, 1.5 oz of 80-proof spirits





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