Substance Use Flashcards
1
Q
Screening tool for substance use for adolescents
A
CRAFFT
2
Q
Best type of therapy for those who have had significant consequences from substance use
A
12 step facilitation therapy
3
Q
AUDIT Screening Tool for alcoholism is best for which population
A
lower prevalence drinkers (women, heavy, dependent, minority)
4
Q
Minimum score on CIWA for SEVERE alcohol withdrawal
A
16
5
Q
Maximum score on CIWA for MILD alcohol withdrawal
A
8
6
Q
Minimum score on CIWA for MODERATE alcohol withdrawal
A
9
7
Q
Entity that monitors drug related ED visits
A
DAWN (Drug Abuse Warning Network)
8
Q
Alcoholism makes patients susceptible to infections due to ______ (inc/decr) sequestration of neutrophils
A
Increased
9
Q
Alcoholism makes patients susceptible to infections due to ______ (inc/decr) fixed macrophage phagocytic capacity
A
Decreased
10
Q
Alcoholism makes patients susceptible to infections due to ______ (inc/decr) white blood cell production
A
Decreased
11
Q
Alcoholism makes patients susceptible to infections due to ______ (inc/decr) cell mediated immunity
A
Decreased
12
Q
Percentage of adults with alcohol use disorder
A
4-6%
13
Q
GABA _ receptor is target in alcohol withdrawal?
A
A
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
15
Q
Patient has tried naltrexone for AUD with minimal effectiveness/adverse effects. Next med?
A
Acamprosate
16
Q
Abstinence Violation Effect
A
Feeling despondent after a relapse
17
Q
It is advised that women drink less than __ drinks per week
A
7
18
Q
It is advised that men drink less than __ drinks per week
A
14
19
Q
Heavy drinking for wome includes ___ or more drinks in a day, and ___ or more drinks in a week.
A
4, 8
20
Q
Heavy drinking for men includes ___ or more drinks in a day, and ___ or more drinks in a week.
A
5, 15
21
Q
Crack cocaine causes pathological findings in this body part
A
Lungs
22
Q
Severe _____(insert substance) use leads to tea-colored urine, weight loss, cardiomyopathy, arrythmia, hyperemic nostrils, dilated pupils
A
Cocaine
23
Q
Mu receptor responsible for physical dependence of opioids
A
Mu-2
24
Q
Mu-1 receptors are responsible for central perception of ____
A
pain
25
Lofexidine is a _____ agonist
alpha 2
26
Lofexidine reduces withdrawal symptoms by reducing ___ in the bloodstream
noradrenaline
27
T/F: Delusions are a part of the diagnostic criteria for inhalant intoxication.
False
28
T/F: Tremors develop shortly after inhalant intoxication .
True
29
"Bagging" for inhalant use can cause ___ to happen around the nose or mouth
rashes
30
THC has a **high/low** lipid affinity
HIGH
31
Psychosis is activated by ___ receptor via THC
CB1
32
Dronabinol is a ___ agonist
CB1
33
Gene cluster associated with nicotine dependence
CHRNA (3,4,5)
34
Maternal use of cocaine leads to higher risk of placental ______
Abruption
35
Caffeine metabolite that leads to psychostimulant effects
Paraxanthines
36
Paraxanthines bind to ___ receptors
Adenosine
37
Opioids suppress production of ______
noradrenaline
38
During opioid withdrawal there is excessive production of ______ in the locus coeruleus
Noradrenaline
39
Pharm intervention with most evidence for adolescents with cannabis use disorder
NAC
40
Cocaine increases risk of EPS by reducing number of this type of dopamine receptor in the striatal pathway
D1
41
Treatment of neonatal abstinence syndrome from opioids
Morphine sulfate
42
Approximate rate of comorbid substance use disorders (non-nicotine) in patients with schizophrenia
41.7%
43
Most appropriate laboratory test for heavy alcohol use in the past few weeks
Phosphatidyl ethanol (PEth)
44
Most common psychiatric comorbidity in pregnant patients with opioid use disorders
Mood disorders
45
Caffeine has psychostimulatory effects due to _____ receptor blockade
Adenosine
46
Caffeine withdrawal involves upregulation of _____ receptors
Adenosine
47
First line class of medications to give during cocaine intoxication
Alpha blockers
48
Alpha blockers used to address cocaine intoxication (2)
Phenoxybenzamine, phentolamine
49
Opioids --> mu receptors --> activate mesolimbic system --> signals VTA --> dopamine released from the VTA to the _____
nucleus accumbens
50
The only requirement for AA is ____
a desire to stop drinking
51
Sudden sniffing death occurs in ____ users
hydrocarbon
52
Cardiac dysrhtymias due to hyrdrocarbon use is known as
Sudden sniffing death
53
A side effect of hydrocarbons is **increased/decreased** sensitization of myocardium
increased
54
2AG is a full agonist at the ____ receptor
CB1
| reward, anxiety, coordination, appetite, learning, sleep,cognition
55
AEA is a partial agonist at the _____ receptor
CB1
56
First line treatment for cannabis use disorder is _____
CBT (or psychotherapeutic intervention)
57
Meperidine's metabolite, normeperidine, which may accumulate, causing irritability, tremors, and, potentially, _______.
Seizures
58
Dronabinol is classified as a Schedule _____ drug.
III
59
Cannabis is classified as a Schedule ___ drug
I
60
Lorazepam and Diazepam are classified as Schedule _____ drugs
IV
61
Specifiers for substance-induced anxiety include: "with onset during ____," "with onset during ____," and "with onset after ____ use."
Intoxication, withdrawal, medication
62
Pts with Wernicke-Korsakoff syndrome can have brain damage in this region
Diencephalon
| 4 parts: thalamus, epithalamus, subthalamus, and hypothalamus
63
______ (medication type) should be avoided in patients with inhalant use disorder due to increased risk of ventricular tachyarrythmias
Catecholamines
64
Need to address sympathomimetic toxidrome (hyperthermia) due to amphetamine overdose within ___ minutes.
15
| Aggressive cooling methods and administration of benzodiazepines
65
MDMA (ecstasy) + SSRIs can lead to ____
Serotonin Syndrome
66
CAGE Questionairre Acronym
Cut, Annoyed, Guilty, Eye-Opener
67
A score of __ on the CAGE questionnaire could be indicative of alcohol abuse
2
68
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?
No changes; continue current dosing.
69
Morning glory seeds and catnip, taken in sufficient quantity, can mimic the intoxication produced by ____
LSD
70
Betel nuts are chewed in some parts of the world to produce a mild ___ and sensation of floating in space.
Euphoria
71
Nutmeg taken in a high enough dose can induce depersonalization, derealization, and a sensation of ____ in the limbs.
Heaviness
72
Use of inhalants is highest between __ and ___ years of age
8 to 17 years old
73
Magnan's sign
Psychosis secondary to long term cocaine use
74
CT/MRI findings in pt with long term hydrocarbon use
Loss of brain mass and degeneration of white matter
| toxic leukoencephalopathy
75
Ofloxacin can lead to a false positive for _____.
Amphetamines
76
Start of withdrawal for short acting opioids (heroin)
6-24 hours after the last dose
77
Start of withdrawal with long acting opioids (methadone)
12-72 hours after the last use
78
Duration of withdrawal with short acting opioids
4-10 days
79
Duration of withdrawal with long acting opioids
10-20 days
80
Carbohydrate-deficient transferrin (CDT) can detect heavy alcohol use in patients up to __ months prior to testing
2
81
In opioid withdrawal, neurons in the locus coeruleus are no longer inhibited which leads to increased NE release due to increase in ____ production.
cAMP
82
Studies have shown that upregulation of ____ receptors can reduce ethanol intake
Glutamate
| GLT1 transporter has been area of interest
83
For substance/medication induced bipolar and other related disorder, symptom must develop within ____of substance intoxication or withdrawal or medication use
1 month
84
Alcohol is identified in ___ of fatally injured motor vehicle drivers
28%
85
Alcohol acts as a potent inhibitor of carboxyesterases and butyrylcholinesterase, and suppresses the first-pass metabolism and elimination of _____.
Cocaine
| Therefore increases bioavailability of cocaine. NOT THE SAME FOR METH
86
Most important risk factor for developing opioid use disorder
Genetic factors
87
Buprenorphine has a decreased risk of overdose compared to methadone due to causing less ____ _____.
Respiratory depression
88
Naltrexone is preferred over acamprosate due to the latter having TID dosing and has shown more efficacy for AUD per the ___ trial
COMBINE
89
Which of the following labs tests is used to judge tolerance for AUD
BAC; if pt appears sober at levels above 200, likely have a moderate tolerance
| CDT and GGT are better for monitoring abstinence
90
Inhaling spray paint is known as ___
Chroming
91
Utilizing inhalants while a rag soaked with a substance that is then placed over the nose or mouth is known as ___
Huffing
92
TWEAK and T-ACE questionnaires, are well validated for screening of ___ non-adolescent patients for alcohol use
pregnant
93
4P’s Plus screen has been validated for screening of substance use in pregnant non-adolescent patients, however does not screen for ___ use
Alcohol
94
NIDA Quick screen is the first-line recommended screening tool in pregnant non-adolescent patients for _____ use
Drug
95
T/F: Recurrent or prolonged exposure to hydrocarbons may lead to white matter degeneration.
True
96
Men who consume no more than _ drinks per day and no more than __ drinks per week is considered to have lower-risk drinking
4, 14
97
In women, lower-risk drinking is considered if no more than __ drinks are consumed per day and no more than __ drinks per week.
3, 7
98
First line for LSD intoxication
Benzos (lorazepam)
| antipsychotics are second line
99
Most common organ system affected by inhalant use
Pulmonary System
100
Most appropriate treatment for pregnant patient with opioid use disorder
Buprenorphine/naloxone combo (biggest reduction of risk for Neonatal abstinence syndrome)
| Methadone safe in pregnancy but increases risk of NAS
101
Chronic benzene use can lead to this hematologic syndrome
Aplastic anemia
102
__% of smokers die from tobacco related causes
50%
103
Hritability of alcohol use disorder
50 - 60%
104
Acamprosate is known for blocking ___ receptors and for possible stimulation of ____ receptors
NMDA (blocked), GABA (possible stimulation)
105
Disulfuram is known for this side effect at higher doses/long term use
Peripheral Neuropathy
106
Toulene embryopathy has overlap of symptoms with this syndrome
Fetal Alcohol Syndrome
107
a commonly abused inhalant, can lead to metabolic acidosis with an elevated anion gap, hypokalemia, and hypophosphatemia.
Toulene (presence of high urinary hippuric acid, a metabolite of toluene, also supports intoxication suspicion)
108
This switch from dopamine to ___based efferent to the accumbens (accumbens-thalamocortical circuitary) is the hallmark of chronic addiction seen in drug users
glutamate
109
