Substance Abuse

Question 1

Risk factors for drug abuse

Answer 1

Low self esteem and poor coping skills

Alienation from conventional norms

Homosexual

Use of performance enhancing drugs

Parenteral use/abuse of drugs

Child abuse, inconsistent parenting

Drug use among close friends

Early academic failure

Disconnect from family, school, community

Early behavior problems

Depression, conduct disorder and antisocial personality

Question 2

What can impact the validity of drug tests

Answer 2

Urine specific gravity and creatinine concentration

Question 3

Immediate effects of inhalant abuse

Answer 3

Decreased inhibition, drowsiness, lightheadedness. May lead to ataxia and disorientation.

On exam sluggish pupillary response and bradycardia

Question 4

Presentation of extreme intoxication with inhalants

Answer 4

Generalized muscle weakness, confusion, hallucinations, ataxia, delirium, nystagmus, lack of coordination

Urine tox is negative

Question 5

Most common fatal complication for inhalant abuse

Answer 5

Cardiac arrhythmia

Question 6

Acute effects of marijuana use

Answer 6

Dry mouth
Dilated pupils
Drowsiness
Distortion of time

Question 7

How do you monitor discontinuation of marijuana use

Answer 7

Serial measurements of urine THC:creatinine ratio. Should decrease as marijuana use is discontinued

Question 8

How does marijuana withdrawal present

Answer 8

Irritability, insomnia, tremors and nystagmus

Peaks within 4 days and can last 2 wks

Question 9

Presentation of amphetamine abuse

Answer 9

Tachycardia, high blood pressure, sweating, agitation, fever, hyperthermia, dilated pupils.

May feel like insects are crawling on the skin

Question 10

How does narcotic and opiate toxicity present

Answer 10

Pinpoint but reactive pupils, cyanosis, respiratory depression.

Shallow respirations, bradycardia, hypotension, low temp.

Question 11

How does toxicity with propoxyphene present

Answer 11

A narcotic

Ventricular arrhythmia, seizure and or pulmonary edema

Question 12

Tx of opiate toxicity

Answer 12

Naloxone

Question 13

How does barbiturate intoxication present

Answer 13

These are sedatives

Bradycardia, bradypnea
Hypotension, hypothermia, hypo bowel sound

Normal pupil size but hyporeactive reflex. NYSTAGMUS

Question 14

Organophosphate toxicity

Answer 14

Constructed pupil

Sweating, tearing, abdominal pain, wheezing, respiratory distress

Question 15

What are common hallucinogens

Answer 15

Mescaline, psilocybin, jimsonweed, LSD, PCP, ecstasy

Question 16

How does PCP intoxication present

Answer 16

Wide eyed and violent

May also have anasarca and asymmetric pupils

Vertical and horizontal nystagmus

Question 17

The 5 A’s for brief intervention in smoking cessation

Answer 17

Ask about use 
Advise to quit 
Assess willingness 
Assist in quit attempt 
Arrange follow up