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DSM5 > Substance use > Flashcards

Substance use Flashcards

1
Q

8 possible symptoms of PCP intoxication

A

-nystagmus
-HTN/tachycardia
-numbness/muted pain response
-ataxia
-dysarthria
-muscle rigidity
-seizures/coma
-hyperacusis

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2
Q

how many symptoms must be present for PCP intoxication

A

2+ within 1 hour of ingestion

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3
Q

universal substance use criteria

A

problematic pattern of use leading to significant impairment with at least 2 manifestations in the past 12 months

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4
Q

3 universal possible manifestations of impaired control in substance use disorder

A

-larger amount or longer period than intended
-unsuccessful attempts to cut down
-a lot of time spent getting, using, recovering from substance
-cravings present

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5
Q

universal severity specifiers for substance use disorders

A

-mild: 2-3 sx
-mod: 4-5 sx
severe: 6+ sx

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6
Q

universal recovery specifiers

A

-in early remission
-in sustained remission
-in controlled environment
-on maintenance therapy

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7
Q

4 possible manifestations of social impairment in substance use disorders

A

-failure to meet role obligations
-continued use despite problems caused/exacerbated by substance
-giving up important activities for substance use
-withdrawal from family/friends

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8
Q

2 possible manifestations of risky use in substance abuse disorders

A

-use in physically unsafe situation
-continued use despite physical or psychological problems caused/exacerbated by use

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9
Q

2 pharmacological criteria for substance use disorders

A

-tolerance develops
-withdrawal occurs

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10
Q

what is true about the length of the withdrawal period in relation to severity of sx

A

longer the duration, less intense the symptoms. Withdrawal tends to be worse from short acting substances but withdrawal from long acting substances takes longer

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11
Q

sedating drugs tend to cause what symptoms/disorders

A

depressive disorders with rebound anxiety on cessation

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12
Q

what symptoms/disorders are associated with stimulant abuse

A

psychotic/anxiety features during intoxication and depression on withdrawal

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13
Q

which lab tests for heavy alcohol use and what results are significant

A

-gamma-glutamyltransferase of >35 (modest elevation)
-carbohydrate deficient transferring >20

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14
Q

which labs can be useful in monitoring abstinence of drinking and why

A

gamma-glutamyltransferase and carbohydrate deficient transferrin because these levels return to normal in a matter of days after drinking cessation

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15
Q

how much alcohol can the body generally metabolize in 1 hour

A

1 beer

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16
Q

8 possible manifestations of alcohol withdrawal and how many must be present for dx

A

at least 2:
-autonomic hyperactivity (increased HR, sweating, etc.)
-increased hand tremor
-insomnia
-N/V
-transient hallucinations/illusions
-psychomotor agitation
-anxiety
-seizures

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17
Q

definition of “with perceptual disturbance”

A

hallucination w/ intact reality testing or illusions in the absence of delirium

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18
Q

what is likely when alcohol withdrawal delirium presents

A

likely a clinically relevant medical condition (liver failure, GI bleed, hypoglycemia, etc.)

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19
Q

typical length of alcohol withdrawal

A

4-5 days after extended periods of heavy drinking

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20
Q

5 predictor of severe alcohol withdrawal

A

-development of delirium
-hx severe withdrawal
-low potassium
-decreased platelets
-systolic HTN

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21
Q

how many sx must be present for dx caffeine intoxication

A

5+ shortly after ingestion

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22
Q

5 sx of caffeine withdrawal and how many must be present for dx

A

at least 3 within 24 hours of cessation:
-HA
-marked fatigue/drowsiness
-dysphoric/depressed mood or irritability
-difficulty concentrating
-flu like sx

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23
Q

what is the hallmark feature of caffeine withdrawal

A

headache

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24
Q

development and course of caffeine withdrawal

A

sx start 12-24h after last dose, peak in 1-2 days and can last up to 9 days

25
Q

how long can you continue to get headaches from caffeine withdrawal

A

up to 21 days

26
Q

what is considered early onset for cannabis use disorder

A

before 15

27
Q

4 possible manifestations of cannabis intoxication and how many must be present for dx

A

2+ within 2h or use”
-conjunctival injection
-increased appetite
-dry mouth
-tachycardia

28
Q

7 possible manifestations of cannabis withdrawal and how many must be present for dx

A

3+ within 1 week of cessation:
-irritability/anger/aggression
-nervousness/anxiety
-sleep difficulty
-decreased appetite/weight loss
-restlessness
-depressed mood
-at least 1 physical sx

29
Q

physical sx associated with cannabis withdrawal

A

abdominal pain
shakiness/tremors
sweating
fever
chills
headache

30
Q

development and course of cannabis withdrawal

A

onset in 24-48 hours after cessation
peak in 2-5 days
resolves in 1-2 weeks

31
Q

how long can PCP be detected in urine

A

8 days (maybe longer with high doses)

32
Q

which hallucinogen has the highest risk of disorder development

A

ecstacy

33
Q

8 possible manifestations of PCP intoxication and how many must be present for dx

A

2+ within 1h of use:
-nystagmus
-HTN/tachycardia
-numbness/diminished pain response
-ataxia
-dysarthria
-muscle rigidity
-seizures/coma
-hyperacusis

34
Q

7 possible manifestations of other hallucinogen intoxication and how many must be present for dx

A

2+:
-dialted pupils
-tachycardia
-sweating
-palitations
-blurry vision
-tremors
-incoordination

35
Q

diagnostic criteria for hallucinogen persisting perception disorder

A

1+ perceptual disturbance experienced after cessation of substance that causes clinically significant distress/functional impairment that is not attributable to another substance or condition

36
Q

which hallucinogen is most likely to cause hallucinogen persisting perception disorder

A

LSD

37
Q

reality testing in hallucinogen persisting perception disorder

A

remains intact

38
Q

what sz might be present in inhalant use disorder

A

peri-oral or peri-nasal rash

39
Q

natural opioids

A

morphine
codeine

40
Q

semi-synthetic opioids with morphine-like action

A

heroine
oxycodone
hydrocodone
hydromorphone
oxymorphone

41
Q

synthetic opioids with morphine-like action

A

methadone
meperidine
tramadol
fentanyl
carfentanil

42
Q

what intoxicating substances are possible when there is lack of pupillary constriction or response to naloxone challenge test

A

benzodiazepines
sedatives
hypnotics
anxiolytics
alcohol

43
Q

3 possible manifestations of opioid intoxication and how many must be present for dx

A

pupillary constriction with 1+:
-drowsiness/coma
-slurred speech
-impairment in attention/memory

44
Q

9 possible manifestations of opioid withdrawal and how many must be present for dx

A

3+ within minutes-days of cessation:
-dysphoric mood
-N/V
-muscle aches
-lacrimation or rhinorrhea
-pupillary dilation, piloerection, or sweating
-diarrhea
-yawning
-fever
-insomnia

45
Q

what 2 sx are associated with more severe opioid withdrawal

A

piloerection and fever

46
Q

tolerance development with sedative, hypnotic, and anxiolytic disorders

A

tolerance develops slower in the brainstem than it does for the high so increased dosages may cause sudden respiratory depression and death without achieving the high

47
Q

most common psych disorders comorbid with substance use disorders

A

antisocial personality disorder
depression
anxiety
bipolar
borderline personality disorder

48
Q

6 possible manifestations of sedative/hypnotic/anxiolytic intoxication and how many must be present for dx

A

1+:
-slurred speech
-Incoordination
-unsteady gait
-nystagmus
-cognitive impairment
-stupor/coma

49
Q

8 possible manifestations of withdrawal from sedative/hypnotics/anxiolytics and how many must be present for dx

A

2+ within a few hours-several days after cessastion:
-autonomic hyperactivity
-hand tremor
-insomnia
-N/V
-transient hallucinations/illusions
-psychomotor agitation
-anxiety
-grand mal seizures

50
Q

development and course of withdrawal from fast acting sedatives/hypnotics/anxiolytics

A

sx in 6-8h
peak on 2nd day
improve by 4th-5th day

51
Q

development and course of withdrawal from longer acting sedatives/hypnotics/anxiolytics
(Diazepam)

A

sx may not develop for >1 week
peek in week 2
sx decrease over 3-4 weeks

52
Q

amphetamine v. cocaine

A

amphetamine is longer acting so it is used less frequently

53
Q

how long can cocaine be detected in urine

A

7-12 days

54
Q

how long can amphetamine be detected in urine

A

up to 4 days (up to 90 in hair samples)

55
Q

9 possible manifestation of stimulant intoxication and how many must be present for dx

A

2+:
-tachycardia/bradycardia
-pupillary dilation
-elevated/lowered BP
-perspiration/chills
-N/V
-weight loss
-psychomotor agitation/retardation
-muscular weakness, respiratory depression, chest pain, or arrhythmias
-confusion, seizures, dyskinesia, dystonia, coma

56
Q

5 possible manifestations of stimulant withdrawal and how many must be present for dx

A

2+ within a few hours-days after cessation:
-fatigue
-vivid nightmares
-insomnia/hypersomnia
-increased appetite
-psychomotor agitation/retardation

57
Q

7 possible manifestation of tobacco withdrawal and how many must be present for dx

A

4+ within 24 hours after cessation:
-irritability/frustration/anger
-anxiety
-difficulty concentrating
-increased appetite
-restlessnes
-depressed mood
-insomnia

58
Q

development and course of nicotine withdrawal

A

begins within 24 hours, peaks in 2-3 days, and lasts 2-3 weeks

DSM5 (18 decks)

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