BEHAVIOURAL HEALTH Flashcards

1
Q

recreational sympathomimmetics (cocaine, amphetamines) inhibits …

A

reuptake from synaptic cleft by MATs
(monoamine transporters)

*terminating stimulation of postsyanptic neurons -> increases NE, serotonin, dopamine in synaptic cleft *

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

tetrahydrocannabinol has what affect on adenyl cyclase

A

inhibits

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

dry mouth
red eyes
impaired reaction time
mydriasis
mild tachycardia
delusion/paranoia

A

cannabis intoxication

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

what receptor does LSD activate

A

5-HT2A in CNS

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

visual illusions
synesthesia
disortered time perception
mild sympathomimetic
anxiety, aggitation, paranoid delusions (bad trip)

A

LSD intoxication
lysergic acid diethylamide

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

formication

A

sensation of insects crawling on/under skin

cocaine, amphetamines

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

negative urine screening

A

bath salts

(stimulant - natural occuring amphetamine) sympathetic stim+ neuropsych

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

amphetamines can be synthesised from

A

over the counter pseudoephedrine

(cold & flu meds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

LSD can be synthesised from

A

ergotamine

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

GHB (gamma-hydroxybutyrate) can be synthesised from

A

sodium oxybate

GHB = direct agonist of GABA receptors

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

cocaine can be used as

A

a local anaesthetic
(or recreationally - induce euphoria)

binds & inhibits MATs - decreased reuptake NE, dop, ser

anaesthetic properties from Na+ channel blockade
indirect symathomimmetic - pupil dilation from blockade a and b receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

? should be used with caution in cocaine users

A

beta blockers
(unopposed a1 stimulation can cause hypertensive crisis)

especially non-selective

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

Overdose with MDMA (3,4-methylenedioxymethamphetamine) can cause …..

2 things

A

serotonin syndrome
MDMA induced SIADH

MDMA stimulates ADH (vasopressin) release, leading to water retention and hyponatremia.
This occurs via serotonin activation of the hypothalamus, which controls ADH secretion.
excess serotonin activity, particularly at 5-HT1A and 5-HT2A receptors.
Leads to neuromuscular excitation, autonomic instability, and altered mental status.

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

thirst, euphoria, confusion, hyperthermia, tachycardia, hypertension, mydriasis, tremor, and hyponatremia

A

MDMA intoxication

Ecstacy

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

mood swings (rapid, brief)
irritability
slurred speech
conjunctial injection
ataxia / dysdiadochokinesia
perioral exematous rash

A

inhalent

MOA similar to nitric oxide - short duration 15-45min

aerosol, glue, show polish, paint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does PCP (phencyclidine) act on receptors

A

inhibition NMDA receptors
activation dopaminergic receptors

usually smoked

16
Q

patients with stimulant intoxication should be treated with

A

benzodiazapines i.e. midazolam

avoid antipsychotics i.e. hapoperidol in stimulant intoxication - decrease seizure threshold

17
Q

runny nose
yawn, irritable
leg muscle cramps
diarrhoea, abdo pain
cool, damp skin, piloerection
sympathetic hyperactivity i.e. reflexes

A

heroin (opiate) withdrawal

To quote John Lennon: “My body is aching, goose-pimple bone, can’t see nobody, leave me alone/ my eyes are wide open, can’t get to sleep, one thing I’m sure of, I’m in at the deep freeze/ cold turkey has got me on the run.”

18
Q

brains reward pathway is called

A

mesocorticolimbic pathway

incldues 3 areas: frontal cortex, nucleus accumbens, ventral tegmental

release of doapmine in these areas caused by drug use (strengthens, motivates use)

19
Q

smoking cessation treatment

A

nicotine replacement therapy
& varenicline & bupropion

20
Q

Acute delirium resulting from thiamine deficiency. Triad of cerebellar dysfunction, confusion, and ocular findings.

A

Wernicke’s encephalopathy

Thiamine cofactor for enzymes in carbohydrate metabolism: α-ketoglutarate dehydrogenase, pyruvate dehydrogenase, and transketolase
*
occular findings - opthalmoplegia, nystagmus, ptosis*

21
Q

what can precipitate wernickes encephalopathy during treatment of i.e. gastroenteritis

A

giving IV with glucose prior to thiamine

can further deplete thiamine levels

must give thiamine before treatment

22
Q

irreversible, late manifestation of confabulations, memory loss/personality change is….

A

Korsakoff psychosis

manifests after Wernickes encephalopathy

23
Q

Drug treatment for alcohol withdrawal

A

benzodiazapines

binding to γ-aminobutyric acid (GABA) type A receptors

conformational change -> increases the frequency of channel opening -> influx of chloride ions.

24
list 6 causes of dilated cardiomyopathy
**ABCCCD: ** chronic Alcohol overuse Beriberi Coxsackie B myocarditis chronic Cocaine use Chagas disease Doxorubicin toxicity
25
wernickes speech area and supply
**left** posterior superior temporal lobe **inferior** division MCA
26
# meg what drug can decrease the seizure threshold in anorexic patients
bupropion | atypical antidepressant - blocks epi & dop reuptake ## Footnote anorexia nervosa associated with major depression
27
signs of cocaine withdrawal
hypersomnia (sleepy) hyperphagia (hungry) depressed low energy
28
timeline for: acute stress disorder post-traumatic stress disorder
ASD: 3d - 1mo PTSD: >1mo
29
reversible acute onset confusional state fluctuating consciousness
delirium ## Footnote more prevelent elderly / PD / dementia / prior stroke (reduced cognitive reserve)
30
patient projects feeling about another onto physician
transference | physician is seen as parent
31
teen persistent rash nose & mouth dry, flakey, eczematous erythromatous nasal nmucosa friable gold stippling grades dropping at school
inhalent abuse