Psychiatric effects of drugs and alcohol Flashcards

1
Q

Common factor model of substance abuse and mental illness

A

The idea that one common factor predisposes to both substance use and mental illness e.g. genetic factor or socioeconomic status

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

Secondary use model of substance abuse and mental illness

A

The idea that patients use substances to alleviate symptoms of mental illness

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

Supersensitivity model of substance abuse and mental illness

A

The idea that mentally unwell patients are unusually sensitive to the negative consequences of substance use which leads to a diagnosis of substance use disorder

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

Secondary illness model of substance abuse and mental illness

A

The idea that substance use disorders lead to mental illness

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

Most common hallucinations seen in alcoholic hallucinosis

A

Unstructured voices or sounds that are threatening

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

Differences between alcoholic hallucinosis and schizophrenia

A

Later age of onset of symptoms in alcoholic hallucinosis
Onset of alcohol preceding symptoms in alcoholic hallucinosis
Remission of symptoms during abstinence in alcoholic hallucinosis
Lack of thought disorder in alcoholic hallucinosis
Thought congruence in alcoholic hallucinosis

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

Classic triad of Wernicke’s encephalopathy

A

Confusion
Ataxia
Nystagmus

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

Percentage of patients with Wernicke’s encephalopathy who present with the classic triad

A

10%

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

Vitamin deficiency causing Wernicke’s encephalopathy

A

Thiamine deficiency (vitamin B1)

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

Type of memory most affected by Korsakoff’s syndrome

A

Anterograde memory

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

Are of the brain lesions are most often seen in Korsakoff’s syndrome

A

Dorsomedial thalamus

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

Areas of the brain where lesions cause confabulation in Korsakoff’s syndrome

A

Frontal
Diencephalic

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

Type of cells in the cerebellum where degeneration is seen in chronic alcohol use

A

Purkinje cells

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

Clinical features of cerebellar degeneration associated with chronic alcohol abuse

A

Limb ataxia
Dysarthria

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

Clinical features of hepatic encephalopathy due to liver failure

A

Altered conscious level
Flapping tremor
Hyperreflexia
Extensor plantar reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Syndrome seen in those who make a partial recovery from hepatic encephalopathy

A

Hepatocerebral degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clinical features of hepatocerebral degeneration

A

Tremor
Choreoathetosis
Dysarthria
Gait ataxia
Dementia/cognitive impairment

18
Q

Type of alcohol associated with Marchiafava-Bignami syndrome

A

Red wine

19
Q

Pathological findings in Marchiafava-Bignami syndrome

A

Demyelination of the corpus callosum and adjacent subcortical white matter

20
Q

Clinical features of Marchiafava-Bignami syndrome

A

Dementia
Spasticity
Dysarthria
Gait changes
Coma

21
Q

Clinical features of central pontine myelinolysis

A

Pain in the limbs
Bulbar palsy
Quadriplegia
Disordered eye movements
Vomiting
Confusion
Coma/locked in syndrome

22
Q

Electrolyte abnormality seen in alcoholic pancreatitis

A

Hypocalcaemia

23
Q

Hallmark of amphetamine induced psychosis

A

Paranoia

24
Q

Specific features seen in amphetamine induced psychosis

A

Limited negative symptoms
Visual hallucinations
Congruent affect
Hyperactivity
Disinhibited sexual behaviour
Confusion and incoherence but no formal thought disorder

25
Q

Disorder seen after hallucinogen use where the patient experiences flashbacks to the hallucinogenic experience they had at the time of taking the substance

A

Hallucinogen persisting perception disorder

26
Q

Drug associated with amotivational syndrome in chronic use

A

Cannabis

27
Q

Percentage of patients with Wernicke’s encephalopathy who present with confusion

A

80%

28
Q

Lifetime suicide risk in dependent drinkers

A

10-15%

29
Q

Percentage of alcoholics who develop cerebellar degeneration

A

33%

30
Q

Brain area where gliosis and small haemorrhages are seen in patients with Wernicke’s encephalopathy

A

Mamillary bodies

31
Q

Brain area at which alcohol blocks the consolidation of new memories into old memories

A

Hippocampus

32
Q

Type of memory most affected in Korsakoff syndrome

A

Episodic memory

33
Q

Affect of Korsakoff’s syndrome on intelligence on the WAIS

A

Intelligence is preserved

34
Q

Normal result in a digit span memory test for someone with Korsakoff’s syndrome

A

Normal

35
Q

Features of Korsakoff’s syndrome

A

Inability to form new memories
Apathy
Lack of initiative
Lack of insight
Preserved implicit memory

36
Q

Most common presenting symptom of Wernicke’s encephalopathy

A

Confusion

37
Q

Mortality rate of untreated Wernicke’s encephalopathy

A

10-20%

38
Q

Percentage of patients with Wernicke’s encephalopathy who go on to develop Korsakoff’s if untreated

A

80%

39
Q

Medication which should be avoided in a patient with Wernicke’s encephalopathy

A

IV glucose

40
Q

Symptoms most likely to improve when Wernicke’s is treated

A

Confusion
Ophthalmoplegia

41
Q

Most common symptom of Korsakoff syndrome

A

Amnesia