Diagnosis of Alcoholism
Alcoholism Diagnosis: Book Excerpts
Diagnosis of Alcoholism: medical news summaries:
The following medical news items
are relevant to diagnosis and misdiagnosis issues for Alcoholism:
Diagnostic Tests for Alcoholism: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about diagnostis of Alcoholism.
Alcohol-related disorder:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
For characteristic findings in patients with alcoholism, see Diagnosing substance dependence and related disorders, page 430.
Clinical findings may help support the diagnosis of alcohol-related disorder. For example, laboratory tests can confirm alcohol use and complications and document recent alcohol ingestion. A blood alcohol level ranging from 0.08% to 0.10% weight/volume (200 mg/dl) is accepted as the level of intoxication, depending on the state or country. The blood alcohol level in a physically dependent and tolerant drinker may exceed levels that would cause severe dysfunction or death in a nontolerant drinker. For example, a tolerant drinker might have a blood alcohol level of more than 0.5 mg (the usual lethal level) and still be alive, talking, and moving.
In severe hepatic disease, the blood urea nitrogen level is increased, and the serum glucose level is decreased. Further testing may reveal increased serum ammonia and amylase levels. Urine toxicology studies may help determine if the patient with alcohol withdrawal delirium or another acute complication abuses other drugs as well.
Liver function studies revealing increased levels of serum cholesterol, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, and creatine phosphokinase may point to liver damage, and elevated serum amylase and lipase levels point to acute pancreatitis. A hematologic workup can identify anemia, thrombocytopenia, increased prothrombin time, and increased partial thromboplastin time.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Substance abuse and induced disorders:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
For characteristic findings in patients with this condition, see Diagnosing substance dependence and related disorders, page 430. Various tests can confirm drug use, determine the amount and type of drug taken, and reveal complications. For example, a serum or urine drug screen can detect recently ingested substances.
Characteristic findings in other tests include elevated serum globulin levels, hypoglycemia, leukocytosis, liver function abnormalities, positive Venereal Disease Research Laboratory test results, positive rapid plasma reagin test results due to elevated protein fractions, an elevated mean corpuscular hemoglobin level, elevated uric acid levels, and reduced blood urea nitrogen levels.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cirrhosis and fibrosis:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
CONFIRMING DIAGNOSIS Liver biopsy, the definitive test for cirrhosis, detects destruction and fibrosis of hepatic tissue.
Liver scan shows abnormal thickening and a liver mass. Cholecystography and cholangiography visualize the gallbladder and the biliary duct system, respectively; splenoportal venography visualizes the portal venous system. Percutaneous trans-hepatic cholangiography differentiates extrahepatic from intrahepatic obstructive jaundice and discloses hepatic pathology and the presence of gallstones.
Laboratory findings that are characteristic of cirrhosis include:
❑ decreased white blood cell count, hemoglobin level and hematocrit, albumin, serum electrolyte levels (sodium, potassium, chloride, and magnesium), and cholinesterase
❑ elevated levels of globulin, serum ammonia, total bilirubin, alkaline phosphatase, serum aspartate aminotransferase, serum alanine aminotransferase, and lactate dehydrogenase and increased thymol turbidity
❑ anemia, neutropenia, and thrombocytopenia, characterized by prolonged prothrombin and partial thromboplastin times
❑ deficiencies of folic acid, iron, and vitamins A, B12, C, and K.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Cirrhosis:
Diagnosis
(Handbook of Diseases)
A liver biopsy, the definitive test for cirrhosis, detects destruction and fibrosis of hepatic tissue. A liver scan shows abnormal thickening and, possibly, a liver mass.
Plain films of the abdomen may reveal hepatic or splenic enlargement. Ultrasonography can aid in the assessment of liver size and the detection of ascites or hepatic enlargement. Doppler ultrasonography is used to evaluate patency of the splenic, portal, and hepatic veins. Computed tomography with I.V. contrast or magnetic resonance imaging with serum alpha-fetoprotein levels can help with further assessment of liver nodules. A biopsy of suspicious liver nodules or masses can be performed to check for cancer. Esophagogastroscopy can be used to detect causes of bleeding in the esophagus, stomach, and proximal duodenum and confirm the presence of varices.
The following laboratory findings are characteristic of cirrhosis:
❑ decreased platelet count, decreased hematocrit, and decreased levels of hemoglobin, albumin, electrolytes (sodium, potassium, chloride, and magnesium), and folate
❑ elevated levels of globulin, serum ammonia, total bilirubin, alkaline phosphatase, serum aspartate aminotransferase, serum alanine aminotransferase, and lactate dehydrogenase
❑ increased thymol turbidity
❑ coagulation abnormalities characterized by prolonged prothrombin and partial thromboplastin times.
Clinical tip The best indications of hepatic function are prothrombin time and cholesterol and albumin levels.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Drug abuse and dependence:
Diagnosis
(Handbook of Diseases)
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition – Text Revision, gives characteristic findings for patients with drug dependence. (See Diagnosing substance dependence and related disorders, page 286.)
Various tests can confirm drug use, determine the amount and type of drug taken, and reveal complications. For example, a serum or urine drug screen can detect recently ingested substances.
Characteristic findings in other tests include elevated serum globulin levels, hypoglycemia, leukocytosis, liver function abnormalities, positive rapid plasma reagin test results because of elevated protein fractions, elevated mean corpuscular hemoglobin levels, elevated uric acid levels, and reduced blood urea nitrogen levels.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Alcoholism:
Diagnosis
(Handbook of Diseases)
For characteristic findings in patients with alcoholism, see Diagnosing substance dependence and related disorders, page 286.
Laboratory values may help support the diagnosis of alcoholism — for example, they can confirm alcohol use and complications and indicate recent alcohol ingestion:
Blood alcohol level of 0.10% weight/volume (200 mg/dl) is accepted as the level of intoxication.
Blood urea nitrogen level rises in severe hepatic disease.
Blood glucose level is decreased.
Serum ammonia and amylase levels are increased.
Urine toxicology studies may help detect other types of drug abuse in patients with alcohol withdrawal delirium or another acute complication.
Liver function studies reveal increased levels of serum cholesterol, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, and creatine kinase (which indicate liver damage) and elevated serum amylase and lipase levels (which indicate acute pancreatitis).
Blood studies may identify anemia, thrombocytopenia, increased prothrombin time, and increased partial thromboplastin time.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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