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20 Cards in this Set
- Front
- Back
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241. If the question asks for the most effective management of alcohol abuse or prevention of relapse, what is the correct answer?
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a. Alcoholics Anonymous.
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242. Outpatient management of alcohol dependence?
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a. Prevent further alcohol intake
b. prevent individuals from driving a car or operating machinery c. sedate patient if he or she becomes agitated d. transfer to inpatient |
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243. acute inpatient management of alcohol dependence?
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a. Prevent more Wernicke-Korsakoff syndrome (ataxia, nystagmus, ophthalmoplegia, amnesia): Give IV or IM thiamine and magnesium ASAP. Also give B12 and folate.
b. Benzodiazepine choice is chlordiazepoxide or diazepam. c. Choose short-acting benzodiazepine and only if the question describes patients with severe liver disease (prevent toxic metabolites)-lorazepam or oxazepam. d. Do not give seizure prophylaxis; repeated seizures should be treated with diazepam. e. Haldol is never the answer (reduces seizure threshold). |
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244. Chronic maintenance management of alcohol dependence?
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a. Refer to inpatient rehabilitation for outpatient group therapy (AA)
b. never give drug therapy without group psychotherapy c. naloxone and acamprosate decrease relapse rate only when given with psychotherapy. d. Disulfiram has poor compliance and hasn't been shown to be effective. |
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245. When do you see minor alcohol withdrawal symptoms and what are these?
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a. 6 hours
1. insomnia 2. tremulousness 3. mild anxiety 4. headache 5. diaphoresis 6. palpitations |
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246. treatment of minor alcohol withdrawal symptoms?
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a. Give thiamine, folate, multivitamin, and glucose.
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247. When do you see alcohol hallucination withdrawal symptoms and what are these?
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a. 12-24 hours
b. visual hallucinations c. may also be auditory and tactile hallucinations d. if there are hallucinations with disorientation, altered mental status, alcoholic hallucinosis is not the answer. |
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248. When do you see alcohol withdrawal seizures and what type are these?
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a. 48 hours
b. tonic-clonic seizures. |
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249. Management of withdrawal seizures with alcohol dependence?
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a. Get CT scan if repeated seizures to rule out structural or infectious cause.
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250. When do you see delirium tremens and what are the symptoms?
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a. 48-96 hours.
b. Hallucinations c. Disorientation d. tachycardia e. hypertension f. low-grade fever g. agitation h. diaphoresis |
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251. exam tip for delirium tremens?
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a. Time of onset is important (48-96 hours).
b. This is the diagnosis of the case describes symptoms 2 days after last drink. |
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252. A 38-year-old man presents to the emergency department with acute onset, right lower quadrant abdominal pain. He undergoes an appendectomy. Two days after surgery. These found in his room, disoriented and agitated, and he is claiming to see snakes in his room. Physical exam reveals tachycardia and temperature of 101.2°F. Which of the following is the most likely diagnosis?
a. Alcoholic hallucinations b. delirium tremens c. Korsakoff psychosis d. fentanyl withdrawal e. pulmonary embolism |
1. answer: B- delirium tremens should always be suspected. The clue is that symptoms occur more than two days after the last drink. The question doesn't need to give you a history of alcohol use.
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253. Signs and symptoms of alcohol intoxication?
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a. Talkative
b. sullen c. gregarious d. Moody |
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254. treatment of alcohol intoxication?
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a. Mechanical ventilation if severe.
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255. Signs of alcohol withdrawal?
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a. Tremors
b. hallucinations c. seizures d. delirium. |
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256. Treatment of alcohol withdrawal?
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a. Long-acting benzos
b. no seizure prophylaxis c. Disulfiram or naloxone for adjunct to supervise therapy after acute withdrawal. |
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257. Signs and symptoms of amphetamines and cocaine withdrawal?
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a. Euphoria
b. hypervigilance c. autonomic hyperactivity d. weight loss e. pupil dilatation f. disturbed perception g. stroke h. MI |
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258. treatment of cocaine or amphetamine intoxication?
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a. Short-term use of antipsychotics, benzodiazepines, propranolol
b. Vitamin C to promote excretion. |
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259. Signs and symptoms of cocaine or amphetamine withdrawal?
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a. Anxiety
b. tremors c. headache d. increased appetite e. depression f. risk of suicide |
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260. treatment of cocaine or amphetamine withdrawal?
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a. Antidepressants.
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