Behavioral Science and Substance Abuse Flashcards
What has been shown to increase prenatal risk for ADHD?
fetal exposure to alcohol, cocaine and tobacco
What is the most likely diagnosis for pt presenting with GI symptoms, irritability, poor school performance, respiratory depression, cardiac arrhythmia, dilated pupils and eczematiod perio-oral dermatitis?
Inhalant abuse
due to hydrocarbons and nitrates, not detected in standard tox screens
Can synthetic cannabis been detected on standard toxicology screens?
No
what is the likely diagnosis for pt presenting with generalized apathy, lack of concern about personal appearance, loss of productivity, lethargy, moodiness, difficulty concentration, gynecomastia, and psychomotor retardation?
Chronic marijuana use
What is the most likely diagnosis for female pt (18-36 months old) presenting with history of deceleration in head growth at 6 months old, development stagnation followed by regression, stereotypic hand movements, loss of language and purposeful hand movement, and episodes of hyperventilation followed by hypoventilation, and seizures?
Rett syndrome
due to mutation in MECP2 gene on X chromosome
What is the most likely diagnosis of adolescent presenting with persistent acne, irritability, anger/ rage outbursts, decreased testicular size and liver dysfunction?
Anabolic steroids use
stanozolol, nadrolone
What is a possible treatment for night terrors?
preemptive awakening before the usual time of the night terror
what is a common eye finding associated with barbituate intoxications (dizzy/ floating/sleeping feeling, ataxia, poor comprehension, slurred speech, respiratory depression, bradycardia, orthostatic hypotension)?
Nystagmus
can get miosis in high doses
What is the best pharamcologic treatment for children with Autism who have severe aggressive or self-injurious behaviors/ irritability?
- Risperdone (wt gain, prolatin resulting in breast formation)
- Aripiprazole (prolactin)
What is the CRAFFT screening test used for?
Identify risk of drug and alcohol abuse
score of 2 or more is positive
What is the most likely diagnosis for an adolescent who presents after being found passed out, had a generalized seizure, euphoria, enhanced tactile sensation, hyperthermia, hypoglycemia and found to have hyponatremia?
MDMA (3,4 methylenedioxymethamphetamine)
aka Ecstasy, Molly
What are more common adverse side effects of Risperidone? (5)
- Dyslipidemia
- Insulin resistance (hyperglycemia)
- Hypertension
- EKG changes (prolonged GT)
- Prolactin elevation
What is the characteristic age range for breath holding spells?
6 months to 6 years old
What is the most likely diagnosis for adolescent presenting to ER with seizure, diaphoresis, tachycardia, HTN, hyperthermia, mydriasis, paranoid and combative/ violent behavior?
Bath salts (synthetic cathinones) abuse
tx: psychmotor agitiation with benzo
What are potential lethal complications of cocaine abuse? (4)
- Cerebral hemorrhage
- Stroke
- Seizures
- Myocardial infarction
What is the most likely diagnosis for an adolescent presenting with perforated nasal septum and history of chronic congestion and nasal discharge?
Cocaine abuse
vasoconstrictor
What is onychophagia and what is the best treatment?
Nail biting
tx: positive reinforcement and praise when not biting nails
By what age do infants with colic usually have resolution of their symptoms (paroxysms of inconsolable crying for hours for no apparent reason in an otherwise healthy infant)?
3-4 months old
What is the most likely diagnosis for adolescent taking OTC medication to induce euphoria, hallucinations altered time perception, hyperexcitable state, ataxia and slurred speech?
Dextromethorphan abuse
What is a known adverse effect of antidepressants in patients who are predisposed to bipolar disorder?
Manic episode
decreased need for sleep, flight of ideas, pressured speech, grandiosity
What is the window of detection for marijuana in urine drug screens for infrequency users versus frequent users?
infrequent: 2-8 days
Frequent: 4-6 weeks
What OTC medication can cause a false-positive urine drug screen for PCP (phencyclidine)?
Ibuprofen
What is window of detection for PCP (phencyclidine) in urine drug screens?
8-14 days following ingestion
all other drugs besides marijuana are 24-48 hours
What is a potential complication of anabolic steroid use along with hepatic dysfunction/ neoplasm?
Early epiphyseal closure
What is the most likely diagnosis for a pt presenting with losing temper, arguing with authority figures, refuses to comply with adults request/ rules, deliberately annoys adults and peers, blames others for mistakes/ misbehaviors and is angry/ resentful/ vindictive for at least 6 months?
Oppositional Defiant Disorder
Patients with Rett syndrome are at increased risk of sudden death from what?
Cardiac arrhythmia
What is the best treatment for Tic disorder?
Clonidine (alpha 2 agonist)
What medical condition is a contraindication for the use of stimulant medications?
Structural cardiac abnormalities or arrhythmias
increased risk of sudden death
What are the most common pulmonary complications of inhalant abuse?
Pneumothroax and pneumomediastinum
What is the likely diagnosis of an adolescent presenting with disorientation, unable to recognize family/ friends, anxiety, frightened, drooling, hypotensive, and briefly hyperthermic with nystagmus, hyperreflexia with clonus, and muscle rigidity?
Phencyclidine (PCP) abuse
What ADHD treatment has a warning about suicidal ideation as possible advserse effect?
Atomoxetine (norepinephrine reuptake inhibitor)
What mood/ anxiety disorder can be exacerbated by an infection due to Streptococcus pyogenes (group A Strep)?
Obsessive-compulsive disorder (OCD) and Tic Disorders
phenomenon known as PANDAS- pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection
What is the most serious complication of abrupt withdrawal from benzos?
Protracted seizures
What is the most likely diagnosis for patient presenting with acute onset excessive yawning, rhinorrhea, dilated pupils, tachycardia, hypertension, and restlessness?
Opioid withdrawal
What is the first line treatment for obsessive-compulsive disease (OCD)?
SSRIs
What is the most likely diagnosis of a teen presenting with euphoria, weight loss, dry mouth, tooth decay, increased energy and decreased sleep?
Methamphetamine use
What is the best initial step in management of patient who has been sexting?
report to authorities (anywhere the pictures may have been sent)
What is the most likely diagnosis of an unconscious patient presenting with history of agitation, respiratory depression, hypotension, nystagmus, hypotonia and ataxis?
Benzo overdose
What is the most likely diagnosis of unconscious patient presenting with hyperthermia, respiratory depression, rhabdomyolysis, hyponatremia and hypokalemia?
MDMA (ecstasy) use
