CAGE Score Alcohol Screening — FRCA Final MCQ

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EasyPreoperative AssessmentCAGE Score Alcohol ScreeningFRCA Final

A 30-year-old woman (ASA I) presents for elective breast augmentation as a day case. She takes no medications but drinks 3-4 units of alcohol per night. CAGE questionnaire is positive for 2 out of 4. This suggests:

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Correct answer: E — No concern – CAGE is not validated

A CAGE score of ≥2 has a sensitivity of 77-94% for identifying alcohol dependence and warrants further assessment. CAGE: Cut down (ever felt you should?), Annoyed (by criticism of drinking?), Guilty (about drinking?), Eye-opener (morning drink?). Two positive responses suggest possible alcohol dependence requiring: detailed alcohol history (units/week, pattern, withdrawal symptoms), AUDIT-C or full AUDIT questionnaire, pre-operative liver function tests, and assessment for alcohol withdrawal risk perioperatively. If dependence is confirmed, a planned alcohol withdrawal regimen (chlordiazepoxide) should be available perioperatively.

Reference: NICE – 2015 – NG100 Alcohol-use disorders; RCOA – 2023 – Preoperative assessment: substance misuse