Substance Related Disorders

Question 1

sporadic consumption of alcohol/drugs w/ no adverse consequences

Answer 1

substance use

Question 2

frequency of alcohol/drug use may vary, there are adverse consequences experienced by the user

Answer 2

abuse

Question 3

state of adaptation that is manifested by a drug class-specific withdrawal syndrome

Answer 3

physical dependence

Question 4

a subjective need for a specific psychoactive substance, either for its positive effect or to avoid negative effects of its abstinence

Answer 4

psychological dependence

Question 5

primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations

Answer 5

addiction

Question 6

Leading cause of impotence in the US

Answer 6

drug use

Question 7

How many positive responses to the CAGE questionairre do you need to diagnose alcohol dependence?

Answer 7

Two or more

Question 8

Quantification of risky or hazardous drinking in men and women

Answer 8

men 14 drinks a week. women 7 drinks a week

Question 9

Associated with failure to fulfill work obligations, use in hazardous situation, legal problems related to use, continued use despite interpersonal problems

Answer 9

alcohol abuse

Question 10

a maladaptive patterns of use associated with 3 or more of the following, occurring at any time in the same 12-month period: tolerance, withdrawal, large quantities, desire to cut down, continues despite physical/psychosocial problems

Answer 10

alcohol dependence

Question 11

Substance that leads to most substance-related deaths

Answer 11

alcohol

Question 12

Quantification of moderate drinking

Answer 12

Men: 2 drinks or less a day
Women: 1 drink or less a day

Question 13

Quantification of binge drinking

Answer 13

Men: 5 or more drinks in a row. Women: 4 or more drinks in a row

Question 14

What happens when concentration of ETOH in stomach becomes too high?

Answer 14

mucus secretion and pyloric valve closure results in slowed absorption

Question 15

catalyzes conversion of alcohol into acetaldehyde, which is toxic

Answer 15

alcohol dehydrogenase (ADH)

Question 16

catalyzes conversion of acetaldehyde into acetate

Answer 16

aldehyde dehydrogenase (ALDH)

Question 17

How long might the processes of ETOH metabolization continue to damage liver cells?

Answer 17

weeks to months. Clinical and chemical effects often become worse before disease resolves

Question 18

What are the three patterns of hepatocellular injury?

Answer 18

fatty liver, alcoholic hepatitis, cirrhosis

Question 19

Increased resistance to flow in portal venous system that manifests as ascites, splenomegaly, and through portosystemic shunts

Answer 19

portal hypertension

Question 20

Where are the three portosystemic shunts located?

Answer 20

lower rectum, esophagus, umbilical veins

Question 21

Occurs in persons who have been drinking heavily for many years—rare to see in persons younger then 35YO: Caused by thiamine deficiency due to poor nutrition/malabsorption

Answer 21

Wernicke-Korsakoff Syndrome

Question 22

acute symptoms which are completely reversible when treated w/ high dose thiamine. Characterized by gait ataxia, vestibular dysfunction, confusion and ocular abnormalities

Answer 22

Wernicke’s encephalopathy

Question 23

chronic condition where only 20% of patients recover—can be treated w/ po thiamine. Characterized by impaired recent memory and anterograde amnesia

Answer 23

Korsakoff’s Syndrome

Question 24

Highest prevalence unemployed men in their 20s w/ only a high school education in urban areas. Use is highly associated with use of other legal and illegal substances

Answer 24

cocaine

Question 25

2nd to cannabis most widely abused drug in the world. 5% of the U.S. population have used it

Answer 25

methamphetamine

Question 26

Displaces epinephrine, norepinephrine, dopamine & serotonin into the synaptic cleft. Also inactivates neurotransmitter reuptake systems. Results in surge of adrenergic stimulation

Answer 26

methamphetamine

Question 27

Appearance is malnourished, agitated, disheveled. They are tachycardic, HTN, hypercapnic, hyperthermic

Answer 27

methamphetamine intoxication

Question 28

Biggest risk for meth intoxication

Answer 28

cardiovascular collapse

Question 29

Blocks presynaptic reuptake pumps for dopamine, norepinephrine and serotonin. Also blocks voltage-gated membrane sodium ion channels

Answer 29

cocaine

Question 30

increased energy, alertness, sociability; elation or euphoria; decreased fatigue, need for sleep and appetite; “total body orgasm”. tachycardia, pupil dilation, diaphoresis, nausea

Answer 30

cocaine intoxication

Question 31

Psychoactive component—delta-9-tetrahydrocannabinol (THC). Most commonly used illegal substance worldwide

Answer 31

Cannabis

Question 32

occur frequently in patients w/ cannabis disorders

Answer 32

mood and anxiety disorders

Question 33

T/F There is substantial degree of heritability of cannabis dependence

Answer 33

True. 60%

Question 34

Physiologic signs of use include: tachycardia, increased BP, increased RR, conjunctival injection, dry mouth, increased appetite

Answer 34

cannabis intoxication

Question 35

substances whose primary effects include the alteration of sensory perception, mood & thought pattern

Answer 35

hallucinogens

Question 36

acute intoxication w/ dysphoria, fear, agitation or other unwanted effects predominate

Answer 36

bad trip

Question 37

recurrence of symptoms associated w/ hallucinogen after the effects of the acute intoxication have worn off, may occur months or years after the last use of the drug

Answer 37

flashback

Question 38

Involves the interaction of numerous neurotransmitters. serotonergic activity may cause serotonin syndrome

Answer 38

hallucinogens

Question 39

Neuropsychiatric symptoms, person remains oriented and aware their experience is drug-induced

Answer 39

LSD

Question 40

OTC in cold and cough preparations. Anticholinergic delirium & acetaminophen toxicity have occurred

Answer 40

Dextromethorphan (DXM)

Question 41

N/V often precede the onset of psychedelic effects. active ingredient in peyote cactus

Answer 41

mescaline

Question 42

Dissociative anesthetic similar to ketamine. Commonly added to cigarettes, marijuana, or other herbs for smoking

Answer 42

Phencyclidine (PCP)

Question 43

Distinguishing features of intoxication include: bizarre violent behavior, nystagmus, catatonic stupor/coma

Answer 43

Phencyclidine (PCP)

Question 44

Wide variety of chemical structures mainly hydrocarbons, nitrites or nitrous oxide. Highly volatile, lipid soluble and absorbed from the pulmonary system. initial euphoria is followed by lethargy

Answer 44

inhalants

Question 45

Most frequently used inhalants

Answer 45

glue, shoe polish, and toulene

Question 46

Adverse effect of benzene use

Answer 46

can cause aplastic anemia and malignancy

Question 47

Immediate effects: slurred speech, ataxia, disorientation, HA, hallucinations, violent behavior, seizures. Long-term: neurocognitive impairment, cerebellar dysfunction and peripheral neuropathy

Answer 47

inhalant intoxication

Question 48

Agonist at nicotinic subtype of acetylcholine receptors. Activates the dopamine reward system. Increases circulation of norepinephrine and epinephrine

Answer 48

nicotine

Question 49

activate specific transmembrane neurotransmitter receptors (mu, kappa, delta) that couple G proteins. Activation of CNS mu receptors results in euphoria, respiratory depression, analgesia and miosis

Answer 49

opiods

Question 50

Features of intoxication includes depressed mental status, decreased respiratory rate, decreased tidal volume, miotic pupils

Answer 50

opiod toxicity

Question 51

Vital signs of intoxication include low heart rate, mild hypotension, hypothermia

Answer 51

opiod toxicity

Question 52

used to increase respirations to 12 or greater NOT to attain a normal level of consciousness

Answer 52

naloxone (opioid antagonist)