Miscellaneous substance

Question 1

23 yo in ER after party. Dehydration, dilated pupils, HTN, elevated CPK. Which drug did he take?

Answer 1

MDMA

Question 2

35 yo in ED with hypoventilation, blue lips, pinpoint pupils, crackles on lung auscultation, mild arrhythmia on EKG. Most likely drug of abuse?

Answer 2

Codeine

Question 3

A state of general fatigue, hyper somnolence, and depression may be seen during a patient’s withdrawal from

Answer 3

Cocaine

Question 4

While intoxicated with a psychomimetic drug, a young man reports “seeing sounds” and a “pattern of colors like fireworks or colored flames” associated with real auditory stimuli. What best describes this type of sensory experience?

Answer 4

Synesthesia

Question 5

After cannabis ingestion (in chronic use) ut can be detected in urine for how long?

Answer 5

One month

Question 6

Best describes the intervention goal associated with contemplation stage of substance abuse tx using motivational enhancement therapy?

Answer 6

Acknowledge ambivalence and evoke reasons to change

Question 7

The large number of CB1 cannabinoid R found int he hippocampus best explains cannabis’ negative effects on

Answer 7

Short term memory

Question 8

Acute caffeine withdrawal symptoms include

Answer 8

Headache

Question 9

What is NOT likely to be an effective intervention for a physician with a substance abuse problem?

Answer 9

Observing the patient until he/she becomes motivated to seek tx

Question 10

Which drug causes euphoria, a feeling like “flying above the dance floor”, social withdrawal, nystagmus

Answer 10

Ketamine

Question 11

What does the pentobarbital challenge test do?

Answer 11

Estimates the starting dose of pentobarbital used for barbiturate detoxification

Question 12

Person who smokes a pack of cig/day stops smoking and has a need for cig after every meal. This is…

Answer 12

Environmental trigger

Question 13

Motivational interviewing of patients with addictive disorders addresses what?

Answer 13

Ambivalence about becoming drug free

Question 14

Maximum duration of PCP in the urine

Answer 14

8 days

Question 15

40 yo dentists is referred for evaluation by staff members who are concerned about his erratic behavior, staying excessively late at the office and problems with dexterity in treating pts. He complains of numbness and weakness of limbs, loss of dexterity, and loss of balance. Which drugs is the dentist most likely abusing?

Answer 15

Nitrous oxide

Question 16

Neurotoxicity associated with MDMA is ass. with deficits in neurons that produce which of the following NT?

Answer 16

Serotonin

Question 17

18 yo pt in ER with clouded sensorium, agitation, and hyperactivity, mild paranoia, pressured speech, and euphoric, thought labile mood. On exam: HTN, tachycardia, and vertical nystagmus. The most likely used?

Answer 17

PCP

Question 18

Use of which substance in adolescence is associated with development of schizophrenia?

Answer 18

Cannabis

Question 19

Teen with sleepiness, nausea, red eyes, sores around mouth, which substance?

Answer 19

Aerosol inhalants

Question 20

17 yo pt is brought to the ER by friends who report that he ingested a drug 2 hours earlier. Pt’s behavior after the drug is relaxed and tranquil but talkative. Soon after the patient complains of drowsiness, dizziness, and nausea. On exam: labile. Toxin negative for benzo, barbiturates, and opioids. Psych alerts ED of possibility of respiratory difficulty. What drug?

Answer 20

Gamma-hydroxybutyrate

Question 21

Substance found n several OTC symptom cold remedies and is abused to produce a dissociative feeling

Answer 21

Dextrometorphan

Question 22

Psychotherapy for addiction utilizes a disease-model approach and emphasizes acceptance of the disease and surrender to help beyond oneself

Answer 22

12-step facilitation

Question 23

Drug of abuse associated with sis of bruxism, anorexia, diaphoresis, decreased ability to orgasm, and hot flashes

Answer 23

MDMA/ ecstasy

Question 24

A muscular male patient pmts to an outpatient psych clinic complaining of discomfort in public places and excessive irritability. Though warm outside, the patient is dressed in heavy, baggy clothes, making him appear bigger than he is. The patient’s belief that he is shrinking greatly distresses him. Which of the following is the most likely dx for the patient?

Answer 24

Anabolic androgenic steroid abuse

Question 25

17 yo ot is brought to ED after reporting recent cocaine use to teacher. In ED pt is agitated, hyperaroused, unable to concentrate on interview. Pt denies hallucinations, however appears very distractible, freightened. Tachycardic. Most appropriate intervention?

Answer 25

Lorazepam 2MG

Question 26

The class of meds with greatest prevalence for prescription drug abuse

Answer 26

Pain relievers

Question 27

Which dx criteria helps to establish dx of substance dependence vs abuse?

Answer 27

Recurrent unsuccessful efforts to control use