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GEN PEDS > BEHAVIORAL MEDICINE & SUBSTANCE USE > Flashcards

BEHAVIORAL MEDICINE & SUBSTANCE USE Flashcards

1
Q

What are 2 first-line stimulant types for treatment of ADHD?

A

1 - Methylphenidate
2 - Dextroamphetamine

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2
Q

What to use in ADHD when patient cannot tolerate either stimulant class? (2 options)
What class is this medication?

A

Guanfacine or Clonidine
(alpha-agonist)

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3
Q

What are the adverse effects of guanfacine or clonidine in treatment of ADHD? (3)

A

1 - Sedation
2 - Bradycardia
3 - Hypotension

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4
Q

What are the adverse effects of stimulants for ADHD? (6)
Which one is most common ?

A

1 - Sleep disturbances (most common)
2 - Decreased appetite / weight loss
3 - Headache
4 - Insomnia
5 - Tics
6 - Emotional lability

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5
Q

Anxious, diaphoretics, confused, extreme agitation

Withdrawal from what types of drugs? What is the significant complication associated with this withdrawal?

A

Benzodiazepine

Withdrawal can cause seizures

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6
Q

What are the only 2 psychotropic medications approved for ASD ?

A

1 - Risperidone
2 - Aripiprazole

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7
Q

Which psych med can cause increase prolactin level?

A

Risperidone

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8
Q

Which mental health disorder is associated with contact dermatitis?

A

OCD

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9
Q

What is an essential component of Rett syndrome?

A

Expressive dysfunction with diminished language and social skills

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10
Q

When is the typical onset of Rett syndrome?

A

6 - 18 months of age

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11
Q

Young girl with loss of hand skills, loss of acquired language skills, gait abnormalities, stereotypic hand movements

What is the condition?

A

Rett syndrome

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12
Q

What causes higher risk of death in patients with Rett syndrome?

A

Cardiac arrhythmia

(consequence of abnormal regulation of autonomic nervous system)

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13
Q

Distortions of sensory perceptions, “seeing smells”, euphoria or dysphoria

What is the drug?

A

LSD

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14
Q

Slurred speech, lacrimation, salivation, stupor

What is the drug?

A

Inhalant use (huffing)

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15
Q

Ataxia, diplopia, lateral nystagmus, euphoria

What is the drug?

A

Barbiturates

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16
Q

Clenching/grinding of teeth, hyperthermia, muscle rigidity

What is the drug?

A

MDMA / Ecstasy

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17
Q

Excessive salivation, involuntary tongue and limb movement, anxiety, laryngospasm

What is the drug?

A

Ketamine

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18
Q

Development of tics while on treatment of ADHD

What is going on? Management

A

Stimulant medication may unmask/wrosen the underlying tic disorder that co-exists with ADHD

Treat by adding alpha-agonist (clonidine)

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19
Q

Ataxia, nystagmus, increased appetite, slurred speech, decrease in alertness, anxiety

What is the drug?

A

Marijuana

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20
Q

What lab finding is associated with synthetic steroid use?

A

Elevated serum transaminases

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21
Q

Skin finding associated with inhalant use?

A

Perioral / perinasal dermatitis

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22
Q

Decrease school performance, irritability, conjunctival injection/irritation

What is the drug?

A

Marijuana

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23
Q

Hyponatremia and seizure after taking a drug

What is the drug? How to explain hyponatremia

A

MDMA

cause hyperthermia leading to consuming large amounts of water

24
Q

Impaired short-term memory, nystagmus, ataxia, confusion in an alcoholic

What is going on?

A

Wernicke-Korsakoff syndrome
aka Vitamin B1 (thiamine) deficiency

25
Q

How to distinguish folate vs B12 deficiency?

A

B12 deficiency -> neurologic abnormalities (peripheral neuropathy, reversible dementia)

(i.e. neuroexam normal -> more likely folate deficiency)

26
Q

Dry mouth is associated with which drug?

A

Methamphetamine

27
Q

Clenching/grinding of teeth associated with which drug?

A

MDMA

28
Q

Most common physical finding of barbiturate use?

A

Nystagmus

29
Q

What is the first step after diagnosis of ADHD ?

A

Screen for co-morbidities

30
Q

What are co-morbidities of ADHD that should be screened after ADHD is diagnosed? (3)

A

1 - Learning disabilities
2 - Anxiety
3 - Depression

31
Q

Diagnostic criteria for Tourette syndrome (4)

A

1 - >= 2 motor tics and >= 1 vocal tic (not necessarily at same time)
2 - Tics occurred > 1 year
3 - Tics started before 18 yo
4 - Tics not caused by use of substance or other medical condition

32
Q

Most common pulmonary complications of inhalant use (2)

A

1 - Pneumothorax
2 - Pneumomediastinum

33
Q

Visual and auditory hallucination, euphoria, altered time perception

Which OTC med might be abused to have this effect?

A

Dextromethorphan

34
Q

What is purpose of CRAFFT questions? What are components made up the acronyms? (6)

A

Risk for drug & substance abuse

  • Car with drug
  • Relax with drug / peeR pressure
  • Alone with drug
  • Forget with drug
  • Friends / family concerns
  • Trouble because of drug
35
Q

What is the threshold for a positive CRAFFT screen?

A

Score >= 2

36
Q

What are criteria for positive depression screening? (8)

A

SIEGECAPS >= 5 symptoms for at least 2 weeks

  • Sleep
  • Interest loss
  • Guilt
  • Energy
  • Concentrating
  • Appetite
  • Psychomotor activity change
  • Suicidal ideation
37
Q

Which drug can precipitate acute manic episode?

A

SSRI

38
Q

Episodes of hyperventilation followed by hypoventilation, apnea during weakfulness

What is the associated syndrome?

A

Rett syndrome

39
Q

Which is a feature that distinguish conduct disorder from ODD?

A

Initiating physical fights (usually not in ODD)

40
Q

Yawning, restlessness, dilated pupil, tachycardia, hypertension

What is going on?

A

Opioid withdrawal

41
Q

What increase prenatal risk for ADHD? (4)

A

Fetal exposure to alcohol, lead, tobacco or cocaine

42
Q

What are potential fatal complications of cocaine use? How? (3)

A

Vasoconstriction lead to:
1 - Cerebral stroke or hemorrhage
2 - Seizures
3 - MI

43
Q

Most commonly used substance by adolescents

A

Alcohol

43
Q

Most commonly used substance by adolescents

A

Alcohol

44
Q

What are side effects of risperidone in treatment of ASD? (6)

A
  1. Dyslipidemia (common)
  2. Liver dysfunction
  3. Insulin resistance
  4. Hypertension
  5. Long QT
  6. Increase prolactin level
44
Q

What are side effects of risperidone in treatment of ASD? (6)

A
  1. Dyslipidemia (common)
  2. Liver dysfunction
  3. Insulin resistance
  4. Hypertension
  5. Long QT
  6. Increase prolactin level
45
Q

What are Spice and K2?

A

Synthetic cannabinoids

46
Q

What is the orthopedic complications of androgenic steroids in adolescent?

A

Early epiphyseal closure

47
Q

Hyperreflexia, muscle rigidity, drooling, nystagmus

What is the drug?

A

Phencyclidine (PCP)

(a hallucinogen)

48
Q

Hypotension, generalized hypotonia, nystagmus, altered mental status

If this is related to a substance, what it is?

A

Benzodiazepine overdose

49
Q

Overdose of which drug can lead to dysrhythmias and cardiac arrest?

A

Cocaine

50
Q

Tooth decay, gingival hypertrophy

What drug causes this?

A

Meth

51
Q

Heightened sensory awareness, tachycardia, teeth grinding

What drug?

A

MDMA

52
Q

Hallucinations, paranoia, seizures

What drug?

A

Bath Salt

53
Q

Euphoria, alertness, decreased need for sleep

What drug?

A

Cocaine

GEN PEDS (16 decks)

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