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Child Psychiatry Boards > Substance Disorders > Flashcards

Substance Disorders Flashcards

1
Q

What are the 2 key brain structures that play the largest role in addiction?

A

Nucleus accumbens
Ventral tegmental area

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2
Q

DTs are most likely to develop how long after last alcoholic drink?

A

2-3 days

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3
Q

High levels of Carbohydrate-Deficient Transferrin (CDT) in the blood can be a marker of what?

A

heavy alcoholism

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4
Q

What is Ethyl Glucoronide (EtG) , which is found in urine, used as a biomarker to test for?

A

Tests for ethanol use, to monitor alcohol abstinence in situations where drinking is prohibited, only for last 5 days

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5
Q

The symptoms associated with acute alcohol withdrawal are related to overactivity of which neurotransmitter.

A

Glutamate (major excitatory NT in brain)

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6
Q

If Werniicke’s encephalopathy is left untreated, pt develops anterograde amnesia and confabulation. What is the disorder?

A

Korsakoff syndrome

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7
Q

A patient has been drinking and develops ataxia + nystagmus + opthalmoplegia. What d/o are they struggling with and what is treatment?

A

Wernicke’s encephalopathy

TX: thiamine

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8
Q

What part of the brain is damaged in chronic alcoholics?

A

mamillary bodies

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9
Q

Which antabuse med inhibits metabolism of aldehyde dehydrogenase?

A

disulfiram

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10
Q

Lets say a patient gets a a urine drug screen. Put the following drugs in order from shortest to longest duration of which they would still screen positive.

Heroin, amphetamines, alcohol, cannabis, PCP, cocaine, benzos

A

Alcohol - 12 hours
Amphetamine - 48 hrs
Cocaine: 3 days
Heroin- 72 hours
Benzos: 7 days
PCP - 8 days
Cannabis/MJ- 4 weeks

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11
Q

Which maintenance tx for opioid withdrawal is best first choice for adolescents?

A

Buprenorphine (partial mu agonist)

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12
Q

What are the pupils like in acute intoxication with alcohol/benzos/sedatives?

A

pupillary constriction (miosis)

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13
Q

If a teen comes in and has recently used a stimulant (ie cocaine, meth) and is in a hypertensive crisis, what medication would you treat them with?

A

B-blockers or nitroprusside

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14
Q

What is tx for someone who is intoxicated with hallucinogen/PCP who is having seizures or agitation ?

A

Diazepam

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15
Q

What is tx for someone who is intoxicated with hallucinogen/PCP who is having HTN ?

A

Phentolamine

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16
Q

What is tx for someone who is intoxicated with hallucinogen/PCP who is in panic, paranoia or psychosis ?

A

close observation in quiet room, benzos

17
Q

Which illicit substance can potentially cause the following symptoms:
-sudden sniffing death syndrome (leads to withdrawal seizures)
-interfere with oxygen supply to vital tissues –> injury to RBC/anemia, hypoxia, cardiac arrhythmias, bone marrow injury, impaired immunologic fxn
-demyelination (symptoms similar to MS), brain atrophy

A

Inhalants

18
Q

What is MDMA aka?

A

ecstasy

19
Q

What NT does ecstasy cause release of and from where?

A

Serotonin release from raphe nucleus

20
Q

Which illicit substance can lead to rhabdomylosis, sweating, hyperthermia, dehydration and involuntary jaw clenching and grinding?

A

Ecstasy

21
Q

What are the stages of change?

A

precontemplation
contemplation
preparation/determination
action
maintenance
relapse

22
Q

What drug is contraindicated in someone with cocaine-induced myocardial ischemia?

A

Using a nonselective beta-blocker (ie propranolol) can lead to unopposed alpha-1 receptor activation. This results in heightened peripheral vasoconstriction and can increase blood pressure and coronary artery vasoconstriction.

23
Q

During intoxication with PCP will you see miosis or mydriasis?

A

miosis

24
Q

Which substances align with these MOA?
1. Agonism at 5-HT2A receptors in the central nervous system (CNS)
2. NMDA receptor antagonists
3. Blockade of dopamine reuptake
4. Activation of cannabinoid receptors

A
  1. LSD
    2.Ketamine or PCP
  2. Cocaine, methamphetamines
  3. Cannabis
25
Q

Pt p/w synesthesia (perceiving colors as tastes), altered perception of time, and hallucinations, along with signs such as tachycardia, hypertension, dilated pupils, and heightened tactile sensitivity has most likely taken what substance?

A

LSD

26
Q

The classic triad of respiratory depression, altered mental status, and constricted pupils is indicative of toxicity of what substance?

A

opioid toxicity

27
Q

C/f respiratory depression occurs in lieu of opioids when patient has RR is less than ___ bpm.
(above or below)

A

12 bpm

Child Psychiatry Boards (12 decks)

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