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Describe the stages of change model for addiction recovery.

1. Pre-contemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
a. Established change
6. Relapse (NOTE: can happen at any time)


Define an alcohol brief intervention.

A short, evidence-based, structured conversation ab out alcohol consumption with a patient/client that seeks in a non-confrontational way to motivate and support the individual to think about and/or plan a change in their drinking behaviour in order to reduce their consumption and/or their risk of harm


Give some examples of screening tests for alcohol misuse.

3. PAT (for A&E)
4. TWEAK (for antenatal care)


Describe the FAST test.

1. How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year?

2. How often during the last year have you failed to do what was normally expected from you because of your drinking?

3. How often during the last year have you been unable to remember what happened the night before because you had been drinking?

4. Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?


Describe what sort of results (in AUDIT and FAST) would indicate alcohol dependence.

Low risk:


What advice would you give someone to help them cut down on drinking?

F – feedback about personal risk/impairment

R – emphasis on personal responsibility to change

A – advice (with permission) to cut down/abstain

M – menu of options for changing drinking habits and setting targets

E – emphatic interviewing

S – self-efficacy and interviewing style that enhances people’s belief in their ability to change


List the functions of association cortices in the brain.

1. Integration of sensory input
2. Relate sensory input to past experiences
3. Recognise what the sensory input is and what it means


What problems can be caused by damage to the dominant hemisphere?

1. Localisation of language
2. Left-right orientation
3. Calculation
4. Visual agnosia


What problems can be caused by damage to the non-dominant hemisphere?

1. Apraxia for dressing and construction (e.g. copying shapes)
2. Sensory inattention
3. Anosognosia – “not recognising that you are ill”


List the functions of the prefrontal cortex.

1. Executive function, e.g. planning, problem solving, selective attention
2. Personality
3. Monitors behaviour – exercises control


List the tests done to test frontal lobe function, and what exactly each one tests.

1. Abstract thinking - similarities
2. Verbal fluency - mental flexibility
3. Motor series test - programming
4. Conflicting instructions - sensitivity to interference
5. Go/no go - inhibitory control
6. Prehension behaviour - environmental autonomy


List the primary and secondary lymphoid organs.

1. Thymus
(2. Bone marrow)

1. Spleen
2. Lymph nodes
3. Tonsils
4. Mucosa associated lymphoid tissue


What is the lymphoreticular system?

Lymphoid organs PLUS bone marrow


Draw a diagram of a lymph node.

1. Capsule
2. Subcapscular space
3. Cortex
4. Medullary cords/sinuses
5. Afferent/efferent lymphatic vessels
6. Nodal artery/vein


Describe the 2 mechanisms of filtering in lymph nodes.

1. Lymph enters subcapsular space
2. Rate of flow decreases rapidly
3. Any solid particles (e.g. bacteria, debris) settle out as the lymph touches cortex cells

1. Whatever settles out of the lymph is phagocytosed by macrophages
2. Fixed macrophages in the lymph nodes, e.g. stellate macrophages, histiocytes


What are the histological features of lymph nodes in a B cell immune response?

1. Lymph node gets bigger
2. Outer cortex/medullary cords get bigger
3. Lymphoid nodules appear with a pale centre and cap of small lymphocytes
a. Function: memory cell production


What are the histological features of lymph nodes in a T cell immune response?

1. Lymph node gets bigger
2. Deep cortex (paracortex) gets bigger


Describe the histology of the spleen.

1. Red pulp
a. Function: filters blood; removes parasites

2. White pulp
a. Structure: lymphocytes in a periarterial sheath; contains central artery
b. Function: forms lymphoid nodules


What is the reaction centre?

Remains of disappearing lymphoid nodules after an immune response; contain macrophages