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Adult Psych Boards > Substance Use > Flashcards

Substance Use Flashcards

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1
Q

Screening tool for substance use for adolescents

A

CRAFFT

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2
Q

Best type of therapy for those who have had significant consequences from substance use

A

12 step facilitation therapy

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3
Q

AUDIT Screening Tool for alcoholism is best for which population

A

lower prevalence drinkers (women, heavy, dependent, minority)

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4
Q

Minimum score on CIWA for SEVERE alcohol withdrawal

A

16

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5
Q

Maximum score on CIWA for MILD alcohol withdrawal

A

8

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6
Q

Minimum score on CIWA for MODERATE alcohol withdrawal

A

9

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7
Q

Entity that monitors drug related ED visits

A

DAWN (Drug Abuse Warning Network)

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8
Q

Alcoholism makes patients susceptible to infections due to ______ (inc/decr) sequestration of neutrophils

A

Increased

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9
Q

Alcoholism makes patients susceptible to infections due to ______ (inc/decr) fixed macrophage phagocytic capacity

A

Decreased

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10
Q

Alcoholism makes patients susceptible to infections due to ______ (inc/decr) white blood cell production

A

Decreased

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11
Q

Alcoholism makes patients susceptible to infections due to ______ (inc/decr) cell mediated immunity

A

Decreased

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12
Q

Percentage of adults with alcohol use disorder

A

4-6%

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13
Q

GABA _ receptor is target in alcohol withdrawal?

A

A

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14
Q

Use of medication to alleviate withdrawal symptoms to make a smoother transition to into a recovery program is what type of therapy?

A

Detoxification with Medication-Assisted Therapy

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15
Q

Patient has tried naltrexone for AUD with minimal effectiveness/adverse effects. Next med?

A

Acamprosate

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16
Q

Abstinence Violation Effect

A

Feeling despondent after a relapse

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17
Q

It is advised that women drink less than __ drinks per week

A

7

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18
Q

It is advised that men drink less than __ drinks per week

A

14

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19
Q

Heavy drinking for wome includes ___ or more drinks in a day, and ___ or more drinks in a week.

A

4, 8

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20
Q

Heavy drinking for men includes ___ or more drinks in a day, and ___ or more drinks in a week.

A

5, 15

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21
Q

Crack cocaine causes pathological findings in this body part

A

Lungs

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22
Q

Severe _____(insert substance) use leads to tea-colored urine, weight loss, cardiomyopathy, arrythmia, hyperemic nostrils, dilated pupils

A

Cocaine

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23
Q

Mu receptor responsible for physical dependence of opioids

A

Mu-2

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24
Q

Mu-1 receptors are responsible for central perception of ____

A

pain

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25
Q

Lofexidine is a _____ agonist

A

alpha 2

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26
Q

Lofexidine reduces withdrawal symptoms by reducing ___ in the bloodstream

A

noradrenaline

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27
Q

T/F: Delusions are a part of the diagnostic criteria for inhalant intoxication.

A

False

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28
Q

T/F: Tremors develop shortly after inhalant intoxication .

A

True

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29
Q

“Bagging” for inhalant use can cause ___ to happen around the nose or mouth

A

rashes

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30
Q

THC has a high/low lipid affinity

A

HIGH

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31
Q

Psychosis is activated by ___ receptor via THC

A

CB1

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32
Q

Dronabinol is a ___ agonist

A

CB1

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33
Q

Gene cluster associated with nicotine dependence

A

CHRNA (3,4,5)

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34
Q

Maternal use of cocaine leads to higher risk of placental ______

A

Abruption

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35
Q

Caffeine metabolite that leads to psychostimulant effects

A

Paraxanthines

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36
Q

Paraxanthines bind to ___ receptors

A

Adenosine

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37
Q

Opioids suppress production of ______

A

noradrenaline

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38
Q

During opioid withdrawal there is excessive production of ______ in the locus coeruleus

A

Noradrenaline

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39
Q

Pharm intervention with most evidence for adolescents with cannabis use disorder

A

NAC

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40
Q

Cocaine increases risk of EPS by reducing number of this type of dopamine receptor in the striatal pathway

A

D1

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41
Q

Treatment of neonatal abstinence syndrome from opioids

A

Morphine sulfate

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42
Q

Approximate rate of comorbid substance use disorders (non-nicotine) in patients with schizophrenia

A

41.7%

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43
Q

Most appropriate laboratory test for heavy alcohol use in the past few weeks

A

Phosphatidyl ethanol (PEth)

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44
Q

Most common psychiatric comorbidity in pregnant patients with opioid use disorders

A

Mood disorders

45
Q

Caffeine has psychostimulatory effects due to _____ receptor blockade

A

Adenosine

46
Q

Caffeine withdrawal involves upregulation of _____ receptors

A

Adenosine

47
Q

First line class of medications to give during cocaine intoxication

A

Alpha blockers

48
Q

Alpha blockers used to address cocaine intoxication (2)

A

Phenoxybenzamine, phentolamine

49
Q

Opioids –> mu receptors –> activate mesolimbic system –> signals VTA –> dopamine released from the VTA to the _____

A

nucleus accumbens

50
Q

The only requirement for AA is ____

A

a desire to stop drinking

51
Q

Sudden sniffing death occurs in ____ users

A

hydrocarbon

52
Q

Cardiac dysrhtymias due to hyrdrocarbon use is known as

A

Sudden sniffing death

53
Q

A side effect of hydrocarbons is increased/decreased sensitization of myocardium

A

increased

54
Q

2AG is a full agonist at the ____ receptor

A

CB1

reward, anxiety, coordination, appetite, learning, sleep,cognition

55
Q

AEA is a partial agonist at the _____ receptor

A

CB1

56
Q

First line treatment for cannabis use disorder is _____

A

CBT (or psychotherapeutic intervention)

57
Q

Meperidine’s metabolite, normeperidine, which may accumulate, causing irritability, tremors, and, potentially, _______.

A

Seizures

58
Q

Dronabinol is classified as a Schedule _____ drug.

A

III

59
Q

Cannabis is classified as a Schedule ___ drug

A

I

60
Q

Lorazepam and Diazepam are classified as Schedule _____ drugs

A

IV

61
Q

Specifiers for substance-induced anxiety include: “with onset during ____,” “with onset during ____,” and “with onset after ____ use.”

A

Intoxication, withdrawal, medication

62
Q

Pts with Wernicke-Korsakoff syndrome can have brain damage in this region

A

Diencephalon

4 parts: thalamus, epithalamus, subthalamus, and hypothalamus

63
Q

______ (medication type) should be avoided in patients with inhalant use disorder due to increased risk of ventricular tachyarrythmias

A

Catecholamines

64
Q

Need to address sympathomimetic toxidrome (hyperthermia) due to amphetamine overdose within ___ minutes.

A

15

Aggressive cooling methods and administration of benzodiazepines

65
Q

MDMA (ecstasy) + SSRIs can lead to ____

A

Serotonin Syndrome

66
Q

CAGE Questionairre Acronym

A

Cut, Annoyed, Guilty, Eye-Opener

67
Q

A score of __ on the CAGE questionnaire could be indicative of alcohol abuse

A

2

68
Q

Pt with a hx of heroin abuse (abstinent for years; on methadone treatment), now in need of liver transplant. How do you proceed with methadone treatment?

A

No changes; continue current dosing.

69
Q

Morning glory seeds and catnip, taken in sufficient quantity, can mimic the intoxication produced by ____

A

LSD

70
Q

Betel nuts are chewed in some parts of the world to produce a mild ___ and sensation of floating in space.

A

Euphoria

71
Q

Nutmeg taken in a high enough dose can induce depersonalization, derealization, and a sensation of ____ in the limbs.

A

Heaviness

72
Q

Use of inhalants is highest between __ and ___ years of age

A

8 to 17 years old

73
Q

Magnan’s sign

A

Psychosis secondary to long term cocaine use

74
Q

CT/MRI findings in pt with long term hydrocarbon use

A

Loss of brain mass and degeneration of white matter

toxic leukoencephalopathy

75
Q

Ofloxacin can lead to a false positive for _____.

A

Amphetamines

76
Q

Start of withdrawal for short acting opioids (heroin)

A

6-24 hours after the last dose

77
Q

Start of withdrawal with long acting opioids (methadone)

A

12-72 hours after the last use

78
Q

Duration of withdrawal with short acting opioids

A

4-10 days

79
Q

Duration of withdrawal with long acting opioids

A

10-20 days

80
Q

Carbohydrate-deficient transferrin (CDT) can detect heavy alcohol use in patients up to __ months prior to testing

A

2

81
Q

In opioid withdrawal, neurons in the locus coeruleus are no longer inhibited which leads to increased NE release due to increase in ____ production.

A

cAMP

82
Q

Studies have shown that upregulation of ____ receptors can reduce ethanol intake

A

Glutamate

GLT1 transporter has been area of interest

83
Q

For substance/medication induced bipolar and other related disorder, symptom must develop within ____of substance intoxication or withdrawal or medication use

A

1 month

84
Q

Alcohol is identified in ___ of fatally injured motor vehicle drivers

A

28%

85
Q

Alcohol acts as a potent inhibitor of carboxyesterases and butyrylcholinesterase, and suppresses the first-pass metabolism and elimination of _____.

A

Cocaine

Therefore increases bioavailability of cocaine. NOT THE SAME FOR METH

86
Q

Most important risk factor for developing opioid use disorder

A

Genetic factors

87
Q

Buprenorphine has a decreased risk of overdose compared to methadone due to causing less ____ _____.

A

Respiratory depression

88
Q

Naltrexone is preferred over acamprosate due to the latter having TID dosing and has shown more efficacy for AUD per the ___ trial

A

COMBINE

89
Q

Which of the following labs tests is used to judge tolerance for AUD

A

BAC; if pt appears sober at levels above 200, likely have a moderate tolerance

CDT and GGT are better for monitoring abstinence

90
Q

Inhaling spray paint is known as ___

A

Chroming

91
Q

Utilizing inhalants while a rag soaked with a substance that is then placed over the nose or mouth is known as ___

A

Huffing

92
Q

TWEAK and T-ACE questionnaires, are well validated for screening of ___ non-adolescent patients for alcohol use

A

pregnant

93
Q

4P’s Plus screen has been validated for screening of substance use in pregnant non-adolescent patients, however does not screen for ___ use

A

Alcohol

94
Q

NIDA Quick screen is the first-line recommended screening tool in pregnant non-adolescent patients for _____ use

A

Drug

95
Q

T/F: Recurrent or prolonged exposure to hydrocarbons may lead to white matter degeneration.

A

True

96
Q

Men who consume no more than _ drinks per day and no more than __ drinks per week is considered to have lower-risk drinking

A

4, 14

97
Q

In women, lower-risk drinking is considered if no more than __ drinks are consumed per day and no more than __ drinks per week.

A

3, 7

98
Q

First line for LSD intoxication

A

Benzos (lorazepam)

antipsychotics are second line

99
Q

Most common organ system affected by inhalant use

A

Pulmonary System

100
Q

Most appropriate treatment for pregnant patient with opioid use disorder

A

Buprenorphine/naloxone combo (biggest reduction of risk for Neonatal abstinence syndrome)

Methadone safe in pregnancy but increases risk of NAS

101
Q

Chronic benzene use can lead to this hematologic syndrome

A

Aplastic anemia

102
Q

__% of smokers die from tobacco related causes

A

50%

103
Q

Hritability of alcohol use disorder

A

50 - 60%

104
Q

Acamprosate is known for blocking ___ receptors and for possible stimulation of ____ receptors

A

NMDA (blocked), GABA (possible stimulation)

105
Q

Disulfuram is known for this side effect at higher doses/long term use

A

Peripheral Neuropathy

106
Q

Toulene embryopathy has overlap of symptoms with this syndrome

A

Fetal Alcohol Syndrome

107
Q

a commonly abused inhalant, can lead to metabolic acidosis with an elevated anion gap, hypokalemia, and hypophosphatemia.

A

Toulene (presence of high urinary hippuric acid, a metabolite of toluene, also supports intoxication suspicion)

108
Q

This switch from dopamine to ___based efferent to the accumbens (accumbens-thalamocortical circuitary) is the hallmark of chronic addiction seen in drug users

A

glutamate

109
Q
A

Adult Psych Boards (18 decks)

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