Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CLINICAL YR: Psych > 14% Substance-related Disorders > Flashcards

14% Substance-related Disorders Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

(PPP 600)

three pharm management possibilities for tobacco use disorder

A

NRT
bupropion
varenicline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

(PPP 600)

what is the MOA of the antidepressant drug used for tobacco use disorder?

A

bupropion: dopamine & NE reuptake inhibitor that reduces nicotine cravings and withdrawal symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

(PPP 600)

what is a major adverse effect of the drug that blocks nicotine receptors for tobacco use disorder?

A 
increased suicidality (varenicline)
(other AEs:  HA, nausea, insomnia, other neuropsychiatric conditions)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

(PPP 600)

major contraindication for bupropion use

A

epilepsy
conditions with increased sz risk (eg eating disorders such as bulimia and anorexia nervosa)

(avoid in pts with recent MAOI use)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

(PPP 600)

can bupropion be stopped suddenly?

A

no - “avoid abrupt withdrawal”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

RoshReview

what are the five A’s of tobacco cessation counseling?

A

Ask - Identify and document tobacco use status for every patient at every visit. (You may wish to develop your own vital signs sticker, based on the sample below).
Advise - In a clear, strong, and personalized manner, urge every tobacco user to quit.
Assess - Is the tobacco user willing to make a quit attempt at this time?
Assist - For the patient willing to make a quit attempt, use counseling and pharmacotherapy to help him or her quit.
Arrange - Schedule followup contact, in person or by telephone, preferably within the first week after the quit date.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

(RoshReview)
a pt comes to ER reporting ingesting angel dust - which of the following is most likely found on PE?

a) Argyll Robertson pupil
b) miosis
c) mydriasis
d) rotary nystagmus

A

d) ROTARY NYSTAGMUS

phencyclidine (PCP) noncompetitively binds NMDA receptors, stimulates sigma receptors, blocks reuptake of biogenic amines

exhibits nystagmus which can be horizontal, vertical or rotary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

(RoshReview)

“Which modern anesthetic is derived from phencyclidine?”

A

ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q 
(RoshReview)
"A 27-year-old man presents to the emergency department in a coma after being found on the side of a street in a parked car. Vital signs are significant for a respiratory rate of 10 breaths per minute. You examine him and notice pinpoint pupils. A standard urine drug test is performed. Which of the following drugs is most likely to return a positive result for the drug class that is suspected to have caused this patient’s presentation?"
a) fentanyl
b) methadone
c) morphine
d) oxycodone
A

c) MORPHINE
Urine toxicology is not indicated in patients with suspected opioid overdose because it lacks sensitivity. The standard urine drug tests can detect cocaine, amphetamines, benzodiazepines, barbiturates, natural opioids (morphine and codeine), cannabis, and phencyclidine, but they often cannot identify synthetic opioids (such as fentanyl and methadone) and some semisynthetic opioids (such as oxycodone).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

(RoshReview)

“What are the causes of false positives for opioids on a urine drug test?”

A

Ingestion of poppy seeds, rifampin, and fluoroquinolones (ciprofloxacin, moxifloxacin, and levofloxacin).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q 
(RoshReview)
"Which of the following is the most commonly abused substance by schizophrenic patients?
a) alcohol
b) cannabis
c) cocaine
d) tobacco"
A

d) tobacco

“Those at a higher risk of substance abuse include comorbidities of depressive, anxiety, or bipolar disorders, posttraumatic stress disorder, eating disorder, attention deficit hyperactivity disorder, or schizophrenia. In an epidemiologic study, researchers found 90% of schizophrenic patients use nicotine.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

(RoshReview)

“What medication is contraindicated in treating cocaine-induced hypertension?”

A

“Propranolol due to unopposed alpha-constriction.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

(RoshReview)
19 y/o pt who ate a brownie with an unknown substance 1 hr ago; he presents w/ slurred speech, mild paranoia, tachycardia, slightly elevated bp, conjunctival injection, horizontal gaze nystagmus. What component of this unknown substance is primarily responsible for its psychoactive response, given most likely cause for this presentation?

A

delta-9-tetrahydrocanniabinol

pts w/ acute cannabis intox may have tachycardia, elevated bp, elevated RR, conjunctival injection, nystagmus. Pupils are not affected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

(RoshReview)

what is the clinical scale used to guide treatment once diagnosis of alcohol withdrawal syndrome has been made?

A 
CIWA-Ar
Clinical
Institute
Withdrawal
Assessment for 
Alcohol - 
revised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

(RoshReview)

how does the scoring work for CIWA-Ar?

A

mild == <8
moderate = 9 - 15
severe withdrawal = >15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

(RoshReview)

what’s the point of scoring alcohol withdrawal with CIWA-Ar?

A

the scoring system provides timing recommendations for the next dose of medication

mild - no meds necessary
moderate - q 2 hrs
severe - q 1 hr

17
Q

(RoshReview)

mild s/s of alcohol withdrawal syndrome

A 
tachycardia
diaphoresis
tremors
n/v
anxiety/mild agitation
insomnia
alcohol craving
HA
18
Q

(RoshReview)

moderate to severe symptoms for alcohol withdrawal syndrome

A

hallucinations
DTs
szs which may be fatal

19
Q

(RoshReview)

clinical s/s of phencyclidine OD

A 
behavior problems
anger, aggression, irritability
impaired judgement
vertical OR rotary nystagmus
bp elevated, HR elevated
20
Q

(RoshReview)

PCP MOA

A

glutamate receptor (NMDA) antagonist

21
Q

(RoshReview)

cocaine intoxication s/s (possibly early ones)

A 
mydriasis
bruxism (grinding/clenching teeth)
HA
n/v
tremors
hallucinations
pallor
22
Q

(RoshReview)

cocaine intoxication does what to BP, temp, RR?

A

all of ‘em get elevated

23
Q

(RoshReview)

three pathophys mechanisms of cocaine intoxication

A

biogenic amines - blockade of reuptake

sodium channels - blockade of sodium channels

AA stim - excitatory amino acid stimulation

24
Q

(RoshReview)

what should be avoided when a pt presents with cocaine intoxication?

A

BETA BLOCKERS

due to concern for HTN and coronary artery vasoconstriction which occur due to UNOPPOSED ALPHA-ADRENERGIC STIMULATION

25
Q

(RoshReview)

what do BBs do in situations with cocaine intoxication?

A

they have been shown to WORSEN CORONARY ARTERY VASOCONSTRICTION
and are associated w/ poor clinical outcomes

26
Q

(RoshReview)

what is the difference b/w Ach toxidrome and sympathomimetic toxidrome (cocaine and amphetamines)?

A

Ach toxidrome differs by DRY SKIN and DECREASED BOWEL SOUNDS

27
Q

(RoshReview)
T/F: people who use cocaine and experience acute coronary syndrome have a higher troponin level than people who do not use cocaine.

A

TRUE

28
Q

(RoshReview)

“T/F: bupropion is recommended for tobacco cessation in pregnant patients”

A

FALSE.

“behavioral interventions should be the cornerstone of tobacco cessation efforts in pregnant women.”

29
Q

(RoshReview)
“which of the following clinical scenarios in a pt with chronic ethanol use should prompt admission to the hospital?”

a) fever, tachycardia, HTN
b) intoxication w/ vomiting
c) mild tachycardia, tongue fasciculations
d) normal vital signs, one sz six hours ago

A

A) FEVER, TACYCARDIA, HTN

abnormal v/s = major alcohol withdrawal
major ETOH withdrawal = anxiety, irritability, tremors, tachycardia, fever, HTN, decreased sz threshold, A/VH
condition is life-threatening, requires benzos, possibly antipsychotics

(if a pt had an isolated sz and is sz-free for a period of 6 hrs w/o signs of ongoing withdrawal, they are eligible for discharge from ER)

30
Q

(RoshReview)

what is the time frame in which DTs typically develop?

A

> 72 hrs

31
Q

(RoshReview)

“what are the three clinical findings that comprise the triad associated with Wernicke encephalopathy?”

A

encephalopathy
oculomotor dysfunction
gait ataxia

32
Q

(RoshReview)
a guy comes into the ER after a bar fight, wound up, agitated, bp 208/115, having OD’d on amphetamines. What is first-line tx for his elevated bp?

A

“hypertension related to amphetamines is usually controlled with benzodiazepines, such as lorazepam”

“However, nitroprusside or phentolamine can be used as second-line agents in patients whos bp is refractory to benzos”

33
Q

(RoshReview)

“which antidepressant medication can cause a false positive for amphetamines on a urine drug assay?”

A

bupropion

CLINICAL YR: Psych (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions