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46 Cards in this Set
- Front
- Back
What serum marker is a sensitive indicator of alcohol use?
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gamma-glutamyltransferase
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When do alcoholics in withdrawal exhibit delirium tremens?
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2-5 days after last drink
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What are the signs of delirium tremens?
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1) autonomic hyperactivity (tachycardia, tremors, anxiety)
2) psychotic sxs (hallucinations, delusions) 3) confusion |
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A man is brought to the ER with severely depressed respirations, pinpoint pupils, and seizures. What is wrong with him?
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Opioid intoxication.
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A man is brought to the ER with fever, rhinorrhea, nausea, stomach cramps, piloerection, and dilated pupils. What is happening?
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Opioid withdrawal. Also have anorexia, insomnia, anxiety, diarrhea, yawning.
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A man is brought to the ER with pupil dilation, HTN, tachycardia, euphoria, prolonged wakefulness, arrhythmia, delusions, and hallucinations. What is wrong?
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Amphetamine overdose.
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A man is brought to the ER with depression, lethargy, HA, stomach cramps, hunger, and hypersomnolence. What is going on?
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Amphetamine withdrawal.
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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?
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Cocaine intoxication.
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Overdose with what illegal drug can cause sudden cardiac death?
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Cocaine.
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Withdrawal from cocaine can cause what sxs?
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- severe depression
- suicidality - hypersomnolence - fatigue - severe psychological craving |
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Intoxication with what illegal drug causes nystagmus, ataxia, delirium, and homocidality?
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PCP
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What illegal drug causes marked anxiety or depression, visual hallucinations, flashbacks, and pupil dilation?
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LSD
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Which 2 illegal drugs do not have withdrawal sxs?
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- LSD
- marijuana |
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What illegal drug causes inc. appetite, euphoria, paranoid delusions, perception of slowed time, and impaired judgement?
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Marijuana
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Barbiturate overdose is manifested by:
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- respiratory depression
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Barbiturate withdrawal can cause life-threatening:
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cardiovascular collapse
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Benzodiazepine overdose causes:
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- amnesia
- ataxia - somnolence - minor respiratory depression - additive effects w/ETOH |
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Benzodiazepine withdrawal causes:
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- rebound anxiety
- seizures - tremor - insomnia |
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Mallory-Weiss syndrome =
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Longitudinal esophageal lacerations at GE junction caused by excessive vomiting. Pain. Complication of alcoholism.
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An alcoholic presents with jaundice, hypoalbuminemia, coagulation factor deficiencies, portal HTN, and asterixis. What is going on with his liver?
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Cirrhosis.
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What is the triad of Wernicke's encephalopathy?
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ophthalmoplegia, ataxia, confusion
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What is Korsakoff's psychosis?
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memory loss, confabulation, personality change, associated with mammillary body hemorrhage
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What vitamin deficiency causes Wernicke-Korsakoff's?
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Thiamine
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Heroin addicts are at high risk for what 6 things?
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1) overdose
2) right-side endocarditis 3) AIDS 4) hepatitis 5) abscesses 6) hemorrhoids |
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What are 2 opioid receptor antagonists useful in heroin overdose?
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Naloxone, naltrexone
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What long-acting oral opiate is used for heroin detox or maintenance?
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Methadone
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When is a person delirious?
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- develops rapidly
- waxing & waning level of consciousness - disorganized thinking - hallucinations - illusions - disturbed sleep/wake cycle - cognitive dysfunction |
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Is delirium reversible?
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Often yes, check for drug and anticholinergic effects.
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When is a person demented?
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- gradual drop in cognition
- memory deficits - aphasia, apraxia, agnosia - loss of abstract thought - impaired judgement |
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Is dementia reversible?
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Mostly not.
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How do you know when you're having a major depressive episode?
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SIGECAPS for > 2 wks:
- sleep disturbance - lose interest - guilt - loss energy - loss concentration - change appetite - psychomotor retardation or agitation - suicidal thoughts |
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Lifetime prevalence depression:
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male - 5-12%
female - 10-25% |
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Dysthymia =
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mild depression lasting at least 2 yrs
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Munchausen's syndrome =
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chronic Hx of multiple hospitalizations and willingness to receive invasive procedures
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Munchausen's syndrome by proxy =
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illness in a child is caused by parent - child abuse! must report!
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Pseudocyesis =
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false belief of being pregnant
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Conversion =
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motor or sensory sxs suggest disorder but tests & PE negative
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Somatoform pain disorder =
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prolonged pain not explained completely by illness
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Somatization disorder =
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variety of complaints in multiple organ systems but no findings
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Hypochondriasis =
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fear of having illness despite reassurance of contrary
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Asperger disorder =
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Milder form of Autism involving social relationship problems. Normal intelligence. No cognitive defects.
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Rett disorder =
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X-linked, only in girls. Loss of development and mental retardation by age 4. Hand-wringing stereotype.
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Narcoleptic sleep episodes start with ___ sleep.
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REM
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Cataplexy =
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loss of all muscle tone following strong emotional stimulus
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What is the definition of schizophrenia?
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Periods of psychosis and disturbed behavior with decline in functioning > 6 months
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Lifetime prevalence of schizophrenia =
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1.5% males and females, blacks and whites
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