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M&M Test 1 > B6-041 CBCL Fractured Ribs Secondary to Alcohol > Flashcards

B6-041 CBCL Fractured Ribs Secondary to Alcohol Flashcards

1
Q

what is considered at risk drinking for a male

A

> 4 drinks per occasion, >14/week

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2
Q

what is considered at risk drinking for a female

A

> 2 drinks per occasion, >7 per week

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3
Q

[…] grams of ethanol per standard drink

A

14

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4
Q

alcohol is primarily absorbed in the

A

duodenum

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5
Q

characteristic response to alcohol consumption

A

euphoria, impaired thoughts

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6
Q

alcohol increases […] in the mesocorticolimbic system

A

dopamine

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7
Q

alcohol activates the […] peptide system

A

opioid

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8
Q

alcohol facilitates […] transmission and blocks […] receptors

A

GABA
NMDA

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9
Q

increased dopamine and opioids cause

A

euphoria/pleasure

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10
Q

increased GABA signaling causes

A

anxiolysis, ataxia

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11
Q

increased GABA + decreased NMDA signaling causes

A

sedation, amnesia

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12
Q

decreased GABA and increased NMDA signaling causes

A

withdrawal

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13
Q

decreased opioid signaling causes

A

craving

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14
Q

withdrawal symptoms of tremor, anxiety, and insomnia can persist up to […]

A

two weeks

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15
Q

withdrawal symptom of hallucinations can occur for […]

A

one week

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16
Q

seizures occur [….] in the withdrawal period

A

early

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17
Q

alcohol use disorder is more prevalent in [males/females]

A

males

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18
Q

describe the CAGE questionnaire

A

have you ever felt you should Cut down?
have people Annoyed you by criticizing your drinking?
have you ever felt Guilty about your drinking?
Eye-opener (drink first thing in the morning)

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19
Q

[…] yes responses to the CAGE questionnaire indicate risk of AUD

A

two

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20
Q

ALT/AST will be elevated in […] withdrawal/early AUD and […] in chronic AUD

A

acute
lowered

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21
Q

what liver enzymes would you expect to see elevated with AUD (in general)

A

GGTP
AST
ALT

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22
Q

2:1 AST/ALT ratio indicates

A

individual in “at risk” drinking category

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23
Q

why is MCV elevated in AUD?

A

nutritional deficiency

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24
Q

what medication class is used for acute alcohol withdrawal syndrome?

A

benzodiazepines (taper)

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25
Q

what medication classes are used for cardiac management of alcohol withdrawal syndrome? [2]

A

beta blockers
alpha agonists

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26
Q

what medication classes are used for promotion of sobriety? [3]

A

disulfiram
naltrexone
acamprosate

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27
Q

5 As

A

Ask
Advise
Assess
Assist
Arrange

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28
Q

OARS of motivation interviewing

A

Open Ended
Affirming
Reflective
Summarizing

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29
Q

promotes noxious effects of etoh breakdown

A

disulfiram

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30
Q

blocks craving and rewards

A

opioid antagonists

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31
Q

reduces drinking; modulates GABA and NMDA activity [2]

A

acamprosate
anticonvulsants

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32
Q

Wernicke-Korsakoff is caused by lack of vitamin

A

B1

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33
Q

confusion, ataxia, abnormal eye movement seen in the context of AWS

A

Wernicke encephalopathy (acute)

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34
Q

confabulation, memory loss, inability to form new memories, hallucinations

A

Korsakoff syndrome (chronic)

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35
Q

caused by changes to the thalmus and hypothalmus

A

Wernicke-Korsakoff

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36
Q

2nd line option for AUD

A

disulfiram

37
Q

1st line options for AUD [2]

A

naltrexone
acamprosate

38
Q

inhibits ALDH preventing the conversion for acetaldehyde to acetate

A

disulfiram

39
Q

patients must abstain for alcohol for at lead […] prior to dosing with disulfiram

A

12 hours

40
Q

disulfiram is absolutely contraindicated in patients with

A

myocardial disease (causes cardio toxicity)

41
Q

[…] is available the form of injectable IM suspension given every 4 weeks

A

naltrexone (vivitriol)

42
Q

most concerning side effect of naltrexone

A

hepatotoxicity

**should be avoided in patients with active liver disease

43
Q

[…] has the side effect of opioid overdose

A

naltrexone

44
Q

not metabolized by the liver, and therefore safe for patients with liver disease

A

acamprosate

45
Q

can be used in patients receiving opioid maintenance or pain therapy

A

acamprosate

46
Q

[…] standard drinks per day is considered hazardous for men

A

4

47
Q

[…] standard drinks per day is considered hazardous for women

A

2

48
Q

[males/females] demonstrate the highest incidence of AUD

A

males

49
Q

increased […] and […] activity is associated with euphoria and pleasure

A

dopamine and opioid

50
Q

inhibitory neurotransmitter associated with anti-anxiety effects produced by alcohol

A

GABA

51
Q

amino acid that binds to glutamate receptors involved in memory and learning

A

NMDA

52
Q

how does alcohol induce “blackouts”?

A

acute decreased NMDA activity causes memory lapses

53
Q

indirectly increased in the mesocorticolimbic system by alcohol

A

dopamine

54
Q

during withdrawal NMDA activity is […]

A

increased

55
Q

during withdrawal opioid activity is […]

A

decreased

56
Q

opioid activity is acutely […] by alcohol use

A

increased

57
Q

what causes craving?

A

decreased opioid activity during withdrawal

58
Q

increased […] and […] activity is associated with euphoria and pleasure

A

dopamine and opioid

59
Q

elevation of MCV and mild anemia are consistent with

A

folate deficiency

60
Q

shown to reduce craving and relapse drinking and promotes sustained abstinence from chronic, severe drinking

A

acamprosate

61
Q

psychological symptoms of AWS

A

anxiety
psychomotor agitiation
hallucinations
insomnia

62
Q

physiological symptoms of AWS

A

tremor
autonomic hyperactivity (sweating, tachycardic)
nause
vomiting
seizures

63
Q

first line treatment to decreases severity of AWS

A

benzodiazepines

64
Q

why is disulfiram contraindicated in acute withdrawal?

A

it interferes with the metabolism of alcohol leading to accumulation of acetylaldehyde

**need to abstain for at least 12 hrs

65
Q

supplemental thiamine can be administered to alleviate risk of

A

Wernicke’s encephalopathy

66
Q

alcoholism is commonly associated with deficiency of […] vitamins

A

B

67
Q

[…] deficiency can precipitates central and peripheral neurodegeneration

A

thiamine

68
Q

associated with CNS symptoms such as confusion, visual and tactile hallucinations, and tremors but not peripheral and optical disturbances

A

delirium tremens

69
Q

indirectly elevates dopamine levels in the nucleus accumbens

A

alcohol

70
Q

[…] is associated with microencephaly and intellectual disability

A

fetal alcohol exposure

71
Q

what percentage of death from external causes is due to alcohol?

A

45%

72
Q

standard drinks are […] grams of pure alcohol

A

14

73
Q

screening instrument designed to be developmentally appropriate for teens

A

CRAFFT

74
Q

has high sensitivity in detecting both alcohol and substance abuse disorders in teens

A

CRAFFT

75
Q

general alcohol screening questionnaire designed for adults

A

CAGE

76
Q

used to screen for risk drinking in pregnancy

A

TWEAK

77
Q

risk drinking in pregnancy is defined as

A

1 oz or more of alcohol per day

78
Q

synthetic compound shown to reduce craving and encourage abstinence

A

acamprosate

79
Q

used to mitigate AWS but has no effect on craving

A

diazepam

80
Q

creates aversive reaction to alcohol but has no direct effect on craving

A

disulfiram

81
Q

mu opioid receptor antagonist used to help reduce relapse in the treatment of AWS

A

naltrexone

82
Q

what form is naltrexone (reVia) administered in?

A

pill once per day

83
Q

what form is naltrexone (vivitrol) administered in?

A

IM injection 1x per month

84
Q

taurine analog

A

acamprosate

85
Q

what class of medications are first line for AWS?

A

sedative hypnotics

86
Q

reduced […] in women concentrates alcohol within the blood relative of men the same size

A

body water

87
Q

what neural system mediates the rewarding properties of abused drugs?

A

mesocorticolimbic pathway

88
Q

toxic metabolite of alcohol

A

acetylaldehyde

89
Q

reinforcing effects of alcohol occur through action on opiate receptors in the

A

ventral tegmental area

M&M Test 1 (15 decks)

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