psych Flashcards

1
Q

How should you confirm positive urine drug screens?

A

Gas chromatography and mass spectrometry

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2
Q

What is the most common fatal complication with use of inhalants in teenagers ?

A

Cardiac arrhythmias

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3
Q

What diagnosis should you consider in a patient with agitation and ataxia who has hydrocarbon smell on breath, but urine tox screen is negative?

A

Inhalant use

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4
Q

What can occur with chronic use of inhalants?

A

Encephalopathy

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5
Q

What type of drug use should you consider in a patient who is combative with muscle rigidity, vertical & horizontal nystagmus? What would you expect the pupils to be like?

A

PCP - normal pupils

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6
Q

What type of drug use should you expect in a combative patient with tachycardia, tremors, HTN and dilated pupils? (2 answers)

A

Cocaine

Amphetamines

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7
Q

What type of drug use should you consider in a combative and agitated patient without tremors and with a normal heart rate? (2 answers)

A

Opiates

Alcohol

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8
Q

What are 4 psychological consequences with marijuana use?

A

Learning problems
Poor problem solving skills
Memory impairment
Worsening anxiety/depression

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9
Q

what are 4 acute physical signs of marijuana use?

A

Dry mouth
Dilated pupils
Drowsiness
Distortion of time

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10
Q

What are 3 chronic effects of marijuana use?

A

Pulmonary compromise
Tachycardia
Gynecomastia

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11
Q

What are 4 additional signs you may find in a teenage patient who presents with ataxia, slurred speech, visual disturbance and vomiting ? What is the likely diagnosis ?

A
Sluggish pupils
Excessive sweating
Flushed skin
Hypoglycemia 
*alcohol toxicity*
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12
Q

What symptoms occur with opiate overdose in regards to 1. Breathing, 2. Blood pressure, 3. Temperature, 4. Stooling/urination, 5. Pupils?

A
  1. Respiration depression/arrest
  2. Hypotension
  3. Hypothermia
  4. Constipation/urinary retention
  5. Miosis
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13
Q

What are the possible causes of death in patients with severe opioid overdose? (3 answers)

A

Respiratory arrest
Circulatory collapse
Seizures

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14
Q

What should you suspect in a patient with anxiety, rhinorrhea, insomnia and stomach cramps?

A

Opioid withdrawal

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15
Q

What are the signs of amphetamine abuse in regards to vitals and pupils? What psych finding is specific to amphetamine use?

A
Tachycardia 
Hypertension 
Hyperthermia
Sluggish dilated pupils 
*feeling insects crawling on skin
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16
Q

What are the signs of barbituate overdose in regards to vital signs, bowel sounds and pupils?

A
Bradycardia
Bradypnea 
Hypotension 
Hypothermia 
Hypoactive bowel sounds 
Normal pupils with slow pupillary reflex
17
Q

What drug would you expect to be the cause of paranoia, agitation, hallucinations and distorted body image?

A

Pcp

18
Q

What are the affects on HR, BP, reflexes and the pupils in a patient using PCP?

A

Tachycardia
HTN
Increased reflexes
Miosis

19
Q

What are two things that should not be done in a patient suspected of PCP intoxication and why?

A

Do not acidify urine (precipitates myoglobin)

Do not use restraints (rhabdomyolysis)

20
Q

What happens to HR and BP in patients using cocaine and how would you treat these patients ?

A

Hypertension & tachycardia - nitroprusside

21
Q

What are 4 serious complications of cocaine abuse ?

A

Myocardial infarction
Stroke
Rhabdomyolysis
Renal failure

22
Q

What is a sign of chronic cocaine abuse?

A

Choreoathetotic movements due to dopamine depletion

23
Q

What are 5 organic causes of enuresis ?

A
Sickle cell trait 
UTI
Diabetes
Seizure 
Sacral simple? (tethered cord)
24
Q

What is the appropriate short term treatment for nocturnal enuresis? Why is imipramine no longer used?

A

Intranasal desmopressin

*imipramine associated with overdose

25
Q

What are 4 possible organic causes of daytime enuresis after age 3?

A

UTI
Diabetes mellitus
Diabetes insipidus
Kidney disease

26
Q

What is the condition in with symptoms are not compatible with any medical cause but symptoms are not faked ?

A

Conversion disorder

27
Q

What is the belief that something is wrong with oneself but takes on psychotic dimensions (such as “my pancreas has wings”)?

A

Somatic delusions

28
Q

By what age should infants be able to sleep through the night?

A

4 months

29
Q

What condition causes children to awaken during the first 1/3 of the night with sweating, tachycardia and tachyons but they are disoriented and don’t recall what occurred? What should be done in this situation ?

A

Night terrors - do not intervene. Make sure the environment if safe to prevent injury to self. Benzodiazepines may be used to decrease slow wave sleep frequency

30
Q

What are some things a pediatrician must do after an international adoption?

A
Verify vaccines
TB screening 
CBC, lead
?hep B, HIV, syphilis, hep C
Vision/hearing screen
Developmental assessment Q3 months
31
Q

How would you monitor for discontinuation of marijuana use ?

A

Serial urine THC:creatinine ratio