Produced by
the Royal New Zealand College of General Practitioners
Alcohol workshop:  screening, assessment and      
management in general practice      
home topic information CME remaining work

Case Study
Phil: Physical effects of alcohol

Introduction and Aims
Alcohol related problems
Contributing factor
Physical complications of alcohol use
Physical consequences
Physical signs of alcohol abuse
Suggestive sign
GGT
GGT results
Other causes of abnormal liver enzymes
Elevated GGT
AST/ALT
Elevated AST/ALT
Giving feedback
About abnormal tests
Improvement in liver function tests
Rate of change
Other blood tests
MCV and other tests
GGT as a screening test
Sensitivity of GGT screening
Quick quiz
Quiz answers

Quick quiz

AST and ALT return to normal more slowly than GGT.
 True  False
 

Macrocystosis in heavy drinkers is usually related to B12 or folate deficiency.
 True  False
 

Reduction in heavy alcohol consumption is likely to improve gout symptoms.
 True  False
 

GGT should be widely used as a screening test for heavy alcohol use.
 True  False
 

GGT has been associated with increased morbidity and mortality.
 True  False
 

An elevated GGT in association with regular drinking is likely to be alcohol related.
 True  False
 

Improvement in GGT levels should be evident within a week of reduction in heavy drinking.
 True  False
 

Alcohol screening questions are more likely to detect heavy drinking and alcohol problems than liver function tests.
 True  False
 

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