so lets think about this folks key binding ain't rocket science windows uses alt f4 to close programs that have developed a mind of there own. windows will not allow you to reassign this combo so why do we have a key bind that uses that combo. that being said I assigned an item in the game to f4 and it took me 2 times getting booted to realize that by using that key combo I was shooting my self in the foot when I used it just saying they program for a living not a mistake they should make

I did not know that Alt F4 did anything in this game :p

Alt brings up a menu (as well as ESC) and F4 allows you to use a consumable. But there is no need to use both ALT and F4 (or ALT+F4) at the same time... unless you are trying to close the game.