SUD 2

Question 1

Of all the psychiatric illnesses, which illness is most likely to cause aggression?

Answer 1

Substance use disorder.

**All psychiatric illnesses can cause aggression, however, you are more likely to face substance induced aggression simply because of the sheer number of cases of aggression and violence that are substance induced.

Question 2

What are the psychological symptoms of MDMA (ecstasy) intoxication?

Answer 2

1. euphoria
2. Increased sociability
3. Increased interpersonal sensitivity
4. Hypervigilance/hyperactivity
5. Anxiety
6. Anger
7. Impaired judgment
8. Possible psychosis - hyper sexuality, paranoia.

Question 3

What does MDMA (ecstasy) stand for?

Answer 3

Methylenedioxymethamphetamine.

Question 4

What are the possible physical effects of MDMA (ecstasy)?

Answer 4

Fever
HA
Cyanosis
Vomiting (leading to dehydration)
sob
ataxia
tremor

Question 5

What are the 3 most serious life threatening SE of MDMA (ecstasy)

Answer 5

Severe Hypertension
MI
Ischemic colitis

Question 6

Cannabis intoxication presents as what psychological and physical symptoms?

Answer 6

Psych - euphoria, paranoia, anxiety, sense of slowed time, psychomotor retardation, impaired judgment.

Physical- conjunctival injection, increased appetite, dry mouth, dry mouth.

Question 7

Ketamine intoxication presents as

Answer 7

• Belligerence
• Impulsivity
• Psychomotor agitation
• Impaired judgment
• Nystagmus
• HTN
• Ataxia
• Dysarthria
• Muscle rigidity

Question 8

What is Diacetylmorphine?

Answer 8

Heroin

Question 9

Heroin intoxication presents as?

Answer 9

Euphoria, followed by apathy, psychomotor retardation, pinpoint pupil dilation, respiratory depression, sedation, slurred speech, and impaired memory/attention.

Question 10

What lab value is MOST RELIABLY elevated in chronic alcohol abuse?

What other lab abnormalities are also seen?

Answer 10

GGT elevation in 80% of patients

Also… MCV decrease, and increased uric acid, AST, ALT and Triglyceride.

Question 11

How does chronic alcohol use effect NDMA and GABA receptors?

Answer 11

Upregulated NDMA (glutamatergic/excitatory) receptors

Down regulated GABA receptors.

Question 12

What is the approximate time frame after last etoh drink to develop:

1. Shakes?
2. Psychosis?
3. Seizures?
4. DTs?

Answer 12

1. 6-8h
2. 8-12h
3. 12-24 h
4. 3-7 days