Substance Abuse & Psychiatry

Front 1

What serum marker is a sensitive indicator of alcohol use?

Back 1

gamma-glutamyltransferase

Front 2

When do alcoholics in withdrawal exhibit delirium tremens?

Back 2

2-5 days after last drink

Front 3

What are the signs of delirium tremens?

Back 3

1) autonomic hyperactivity (tachycardia, tremors, anxiety)
2) psychotic sxs (hallucinations, delusions)
3) confusion

Front 4

A man is brought to the ER with severely depressed respirations, pinpoint pupils, and seizures. What is wrong with him?

Back 4

Opioid intoxication.

Front 5

A man is brought to the ER with fever, rhinorrhea, nausea, stomach cramps, piloerection, and dilated pupils. What is happening?

Back 5

Opioid withdrawal. Also have anorexia, insomnia, anxiety, diarrhea, yawning.

Front 6

A man is brought to the ER with pupil dilation, HTN, tachycardia, euphoria, prolonged wakefulness, arrhythmia, delusions, and hallucinations. What is wrong?

Back 6

Amphetamine overdose.

Front 7

A man is brought to the ER with depression, lethargy, HA, stomach cramps, hunger, and hypersomnolence. What is going on?

Back 7

Amphetamine withdrawal.

Front 8

A man is brought to the ER in a euphoric state, with pupil dilation, HTN, but claims he feels bugs crawling over him. What does he have?

Back 8

Cocaine intoxication.

Front 9

Overdose with what illegal drug can cause sudden cardiac death?

Back 9

Cocaine.

Front 10

Withdrawal from cocaine can cause what sxs?

Back 10

- severe depression
- suicidality
- hypersomnolence
- fatigue
- severe psychological craving

Front 11

Intoxication with what illegal drug causes nystagmus, ataxia, delirium, and homocidality?

Back 11

PCP

Front 12

What illegal drug causes marked anxiety or depression, visual hallucinations, flashbacks, and pupil dilation?

Back 12

LSD

Front 13

Which 2 illegal drugs do not have withdrawal sxs?

Back 13

- LSD
- marijuana

Front 14

What illegal drug causes inc. appetite, euphoria, paranoid delusions, perception of slowed time, and impaired judgement?

Back 14

Marijuana

Front 15

Barbiturate overdose is manifested by:

Back 15

- respiratory depression

Front 16

Barbiturate withdrawal can cause life-threatening:

Back 16

cardiovascular collapse

Front 17

Benzodiazepine overdose causes:

Back 17

- amnesia
- ataxia
- somnolence
- minor respiratory depression
- additive effects w/ETOH

Front 18

Benzodiazepine withdrawal causes:

Back 18

- rebound anxiety
- seizures
- tremor
- insomnia

Front 19

Mallory-Weiss syndrome =

Back 19

Longitudinal esophageal lacerations at GE junction caused by excessive vomiting. Pain. Complication of alcoholism.

Front 20

An alcoholic presents with jaundice, hypoalbuminemia, coagulation factor deficiencies, portal HTN, and asterixis. What is going on with his liver?

Back 20

Cirrhosis.

Front 21

What is the triad of Wernicke's encephalopathy?

Back 21

ophthalmoplegia, ataxia, confusion

Front 22

What is Korsakoff's psychosis?

Back 22

memory loss, confabulation, personality change, associated with mammillary body hemorrhage

Front 23

What vitamin deficiency causes Wernicke-Korsakoff's?

Back 23

Thiamine

Front 24

Heroin addicts are at high risk for what 6 things?

Back 24

1) overdose
2) right-side endocarditis
3) AIDS
4) hepatitis
5) abscesses
6) hemorrhoids

Front 25

What are 2 opioid receptor antagonists useful in heroin overdose?

Back 25

Naloxone, naltrexone

Front 26

What long-acting oral opiate is used for heroin detox or maintenance?

Back 26

Methadone

Front 27

When is a person delirious?

Back 27

- develops rapidly
- waxing & waning level of consciousness
- disorganized thinking
- hallucinations
- illusions
- disturbed sleep/wake cycle
- cognitive dysfunction

Front 28

Is delirium reversible?

Back 28

Often yes, check for drug and anticholinergic effects.

Front 29

When is a person demented?

Back 29

- gradual drop in cognition
- memory deficits
- aphasia, apraxia, agnosia
- loss of abstract thought
- impaired judgement

Front 30

Is dementia reversible?

Back 30

Mostly not.

Front 31

How do you know when you're having a major depressive episode?

Back 31

SIGECAPS for > 2 wks:
- sleep disturbance
- lose interest
- guilt
- loss energy
- loss concentration
- change appetite
- psychomotor retardation or agitation
- suicidal thoughts

Front 32

Lifetime prevalence depression:

Back 32

male - 5-12%
female - 10-25%

Front 33

Dysthymia =

Back 33

mild depression lasting at least 2 yrs

Front 34

Munchausen's syndrome =

Back 34

chronic Hx of multiple hospitalizations and willingness to receive invasive procedures

Front 35

Munchausen's syndrome by proxy =

Back 35

illness in a child is caused by parent - child abuse! must report!

Front 36

Pseudocyesis =

Back 36

false belief of being pregnant

Front 37

Conversion =

Back 37

motor or sensory sxs suggest disorder but tests & PE negative

Front 38

Somatoform pain disorder =

Back 38

prolonged pain not explained completely by illness

Front 39

Somatization disorder =

Back 39

variety of complaints in multiple organ systems but no findings

Front 40

Hypochondriasis =

Back 40

fear of having illness despite reassurance of contrary

Front 41

Asperger disorder =

Back 41

Milder form of Autism involving social relationship problems. Normal intelligence. No cognitive defects.

Front 42

Rett disorder =

Back 42

X-linked, only in girls. Loss of development and mental retardation by age 4. Hand-wringing stereotype.

Front 43

Narcoleptic sleep episodes start with ___ sleep.

Back 43

REM

Front 44

Cataplexy =

Back 44

loss of all muscle tone following strong emotional stimulus

Front 45

What is the definition of schizophrenia?

Back 45

Periods of psychosis and disturbed behavior with decline in functioning > 6 months

Front 46

Lifetime prevalence of schizophrenia =

Back 46

1.5% males and females, blacks and whites