Chapter_7_ 1_ AUD Flashcards
According to DSM-5, how many criteria must be met within 12 months to diagnose Alcohol Use Disorder (AUD)?
A) 1
B) 2
C) 4
D) 6
B) 2
Which of the following is NOT included in the DSM-5 criteria for AUD?
A) Cravings
B) Withdrawal symptoms
C) Blackouts
D) Social/interpersonal problems
C) Blackouts
What percentage of U.S. adults meet criteria for AUD at some point in their lifetime?
A) 2–5%
B) 10–15%
C) 20–25%
D) 30–40%
B) 10–15%
Which neurotransmitter system is most affected by alcohol, leading to sedation and disinhibition?
A) GABA
B) Glutamate
C) Dopamine
D) Serotonin
A) GABA
What is the mechanism of alcohol withdrawal symptoms?
A) Increased serotonin activity
B) Upregulation of dopamine receptors
C) Glutamate overactivity due to GABA downregulation
D) Decreased norepinephrine release
C) Glutamate overactivity due to GABA downregulation
A BAC of 200–300 mg/dL is most likely to cause:
A) Euphoria
B) Blackouts
C) Coma
D) Respiratory depression
B) Blackouts
What is the earliest symptom of alcohol intoxication?
A) Slurred speech
B) Nystagmus
C) Mood lability
D) Respiratory depression
C) Mood lability
What is the most serious complication of acute alcohol intoxication?
A) Hallucinations
B) Coma
C) Respiratory depression
D) Seizures
C) Respiratory depression
Alcoholic ketoacidosis occurs due to:
A) Liver failure
B) Excess insulin release
C) Dehydration and starvation
D) Alcohol-induced pancreatitis
C) Dehydration and starvation
A breathalyzer detects alcohol up to:
A) 2 hours
B) 6 hours
C) 12 hours
D) 24 hours
C) 12 hours
Alcohol withdrawal symptoms typically begin:
A) 1 hour after last drink
B) 6–24 hours after last drink
C) 48 hours after last drink
D) 72 hours after last drink
B) 6–24 hours
Which withdrawal symptom peaks at 48 hours?
A) Seizures
B) Tremors
C) Hallucinations
D) Delirium tremens
A) Seizures
Which feature distinguishes alcoholic hallucinosis from delirium tremens (DTs)?
A) Presence of tremors
B) Presence of visual hallucinations
C) Intact orientation
D) Autonomic instability
C) Intact orientation
What is the first-line treatment for alcohol withdrawal?
A) Haloperidol
B) Lorazepam
C) Carbamazepine
D) Valproate
B) Lorazepam
Which lab abnormality is commonly seen in chronic alcoholics?
A) Hypokalemia
B) Hypermagnesemia
C) Thrombocytosis
D) Hyperglycemia
A) Hypokalemia
Which medication reduces cravings in alcohol use disorder?
A) Disulfiram
B) Naltrexone
C) Bupropion
D) Risperidone
B) Naltrexone
Acamprosate works by:
A) Blocking opioid receptors
B) Enhancing GABA activity
C) Modulating NMDA receptors
D) Inhibiting dopamine release
C) Modulating NMDA receptors
Which medication is contraindicated in patients with liver disease?
A) Disulfiram
B) Acamprosate
C) Naltrexone
D) Lorazepam
C) Naltrexone
Which drug causes severe nausea, vomiting, and hypotension if alcohol is consumed?
A) Naltrexone
B) Disulfiram
C) Acamprosate
D) Topiramate
B) Disulfiram
The best treatment for a motivated patient with alcohol dependence is:
A) AA + Disulfiram
B) AA + Acamprosate
C) CBT + Naltrexone
D) Motivational interviewing only
A) AA + Disulfiram
Which vitamin deficiency leads to Wernicke’s encephalopathy?
A) Vitamin B6
B) Vitamin B12
C) Thiamine (B1)
D) Niacin (B3)
C) Thiamine (B1)
The triad of Wernicke’s encephalopathy includes:
A) Confusion, ataxia, ophthalmoplegia
B) Amnesia, confabulation, nystagmus
C) Seizures, tremors, delirium
D) Hypotension, bradycardia, hyperreflexia
A) Confusion, ataxia, ophthalmoplegia
Which alcohol-related disorder involves confabulation and permanent memory loss?
A) Alcoholic hallucinosis
B) Wernicke’s encephalopathy
C) Korsakoff syndrome
D) Hepatic encephalopathy
C) Korsakoff syndrome
Which questionnaire is used to screen for alcohol misuse?
C) CAGE
Which pathway is disrupted in addiction?
A) Mesolimbic dopamine system
What are the DSM-5 criteria for Alcohol Use Disorder (AUD)?
At least 2 out of 11 criteria within 12 months
WILD PATTERNS mnemonic
What mnemonic helps remember DSM-5 SUBSTANCE USE criteria?
WILD PATTERNS
W 💀 Withdrawal
I ⏳ Increased use
L 🔒 Loss of control
D 🤯 Desire/Craving
P 🚑 Physical Danger
A 🎭 Activities Reduced
T ⏲ Time Spent
T 🔺 Tolerance
E 🏥 Endangering Health
R 📜 Role Failure
N 💔 Neglecting Relationships
S 🌀 Social Issues
How is AUD severity classified?
Mild: 2-3 symptoms | Moderate: 4-5 symptoms | Severe: 6+ symptoms
What are the BAC levels and their effects?
50-100 mg/dL: Euphoria |
100-200 mg/dL: Slurred speech, ataxia |
200-300 mg/dL: Vomiting, blackouts |
>400 mg/dL: Coma, death
What is the alcohol withdrawal timeline?
6-24 hrs: Tremors, anxiety | 12-48 hrs: Seizures | 48-96 hrs: Delirium Tremens (DTs)
What is Delirium Tremens (DTs)?
Life-threatening withdrawal state with confusion, hallucinations, tachycardia, hyperthermia | Peaks at 48-96 hrs | Treat with IV benzodiazepines
What are first-line treatments for alcohol withdrawal?
IV benzodiazepines (Lorazepam, Diazepam), IV fluids, thiamine, magnesium
What medications are used for AUD?
Naltrexone (cravings), Acamprosate (abstinence), Disulfiram (deterrence)
What is the mnemonic for AUD medications?
NAD Therapy: Naltrexone (Cravings), Acamprosate (Abstinence), Disulfiram (Deterrence)
What are the Stages of Change for AUD treatment?
Precontemplation → Contemplation → Preparation → Action → Maintenance
What is Wernicke’s encephalopathy triad?
Confusion, ataxia, ophthalmoplegia (caused by thiamine deficiency)
What is Korsakoff syndrome?
Anterograde amnesia + Confabulation (due to untreated Wernicke’s encephalopathy)
What is the first step in treating Wernicke-Korsakoff syndrome?
IV Thiamine BEFORE glucose (to prevent worsening)
What is the best screening tool for AUD?
CAGE Questionnaire (Cut down, Annoyed, Guilty, Eye-opener)
What pathway is disrupted in addiction?
Mesolimbic dopamine system (reward circuit)
What does the CAGE questionnaire stand for?
C - Cut down, A - Annoyed, G - Guilty, E - Eye-opener
What does a score of 2 or more on the CAGE questionnaire indicate?
Suggests problematic alcohol use; further assessment is needed but does not confirm Alcohol Use Disorder (AUD).
Why is the CAGE questionnaire not a definitive diagnostic tool?
CAGE screens for problematic use but does not assess quantity, frequency, or DSM-5 criteria for AUD. Additional evaluation is required.
What is the purpose of the CAGE questionnaire?
It is a quick screening tool to identify potential alcohol use problems but does not diagnose AUD.
What is considered a positive CAGE score?
2 or more ‘Yes’ responses suggest possible problematic alcohol use, requiring further assessment.
Why is a CAGE score of 1 still important?
A single ‘Yes’ answer may indicate early problematic drinking and warrants additional questioning.
What should be done if a patient scores 2 or more on the CAGE questionnaire?
Further assessment using DSM-5 criteria for AUD, history, and lab testing.
Why doesn’t CAGE assess quantity or frequency of alcohol use?
It focuses on the impact of drinking rather than the amount consumed, making it useful for detecting problematic patterns.
What screening tool is better for detecting mild alcohol problems than CAGE?
AUDIT (Alcohol Use Disorders Identification Test) is more sensitive for early detection.
How is CAGE different from AUDIT?
CAGE focuses on consequences of drinking, while AUDIT assesses quantity, frequency, and impact on function.
