Substance Use Disorder

Question 1

What is the substance abuse triad?

Answer 1

psychological dependence or craving

physiologic dependence

tolerance

Question 2

what is the NIAA consumption amount of alcohol that increases health risks?

Answer 2

Men under 65- 14 per week, 4 drinks a day
women and adults over 65- more than 7 standard drinks per week on average

Question 3

how many criteria does a patient require to be classified as “mild” alcohol use disorder?

Answer 3

2-3 required for mild.

Question 4

there is a strong association with alcoholism and what type of disorders?

Answer 4

psychiatric

Question 5

what is CAGE?

Answer 5

screening tool for alcoholism.

Ever felt you should CUT down
Have people ANNOYED you by criticizing your drinking
Have you ever felt GUILTY about drinking
Have you ever taken a drink in the first thing in the morning (EYE OPENER)

Question 6

What is a complication of alcohol use disorder due to thiamine deficiency?

Answer 6

Wernicke Encephalopathy

Question 7

What is the triad of Wernicke Encephalopathy syndrome?

Answer 7

Encephalopathy (disorientation, inattentiveness)
OCC dysfunction
Gait ataxia

Question 8

What is a late consequence of chronic WE?

Answer 8

Korsakoff syndrome

Question 9

What does Korsakoff syndrome cause

Answer 9

anterograde/retrograde amnesia. long term memory and cognitive skill impairment is less common.

Question 10

mild alcohol withdrawal symptoms usually being within how long?

Answer 10

6- 24 hrs. of last drink.

Question 11

What are some sx of mild alcohol withdrawal

Answer 11

anxiety
restlessness
insomnia
diaphoresis
palpitations
headache
alcohol craving

Question 12

what are some physical signs of alcohol withdrawal?

Answer 12

tachycardia, hypertension, tremor

Question 13

within how many days will mild alcohol withdrawal sx resolve?

Answer 13

one to two days

Question 14

within what time frame will you have severe sx of alcohol withdrawal such as hallucinations?

Answer 14

12-24 hours and resolves within another 1-2 days

Question 15

if you were to have a seizure from alcohol withdrawal, what is the usual time frame for it to occur?

Answer 15

6-48 hrs.

Question 16

what is the “kindling effect”?

Answer 16

risk of seizures increase with repeated withdrawals from alcohol

Question 17

what is Delirium Tremens?

Answer 17

fluctuating disturbances in attention and cognition that may include hallucinations

Question 18

delirium begins within what time frame for severe alcohol withdrawal?

Answer 18

72-96 hours after last drink

Question 19

what is the leading preventable cause of mortality worldwide?

Answer 19

tobacco use disorder

Question 20

What are the major causes of mortality due to tobacco use disorder?

Answer 20

cardiovascular
pulmonary
and cancers

Question 21

clear evidence of less than how many minutes of counseling advice at each patient encounter can increase rates of quitting tobacco?

Answer 21

5 mins

Question 22

what is the peak of nicotine withdrawal? and it subsides over the course of what time frame?

Answer 22

peaks in first three days and slowly subsides over the course of about one month.

Question 23

what are some signs associated with nicotine withdrawal?

Answer 23

increased appetite, weight gain, depression, insomnia, irritability, anxiety, restlessness.

Question 24

what is the long acting treatment of nicotine withdrawal?

Answer 24

nicotine patch

Question 25

what is the short acting treatment of nicotine withdrawal?

Answer 25

gum or lozenge

Question 26

what is a medication used for nicotine withdrawal?

Answer 26

buproprion (wellbutrin)

Question 27

MOA of Buproprion (Wellbutrin)

Answer 27

Inhibits reuptake of norepinephrine and dopamine as well as act as nicotinic receptor antagonist.

Question 28

What drug can be used for nicotine withdrawal that is a partial nicotine agonist, stimulates dopamine activity but to a much smaller degree than nicotine, and reduces cravings and withdrawal sx?

Answer 28

Varenicline (Chantix)

Question 29

Effects of marijuana use occur within how many minutes and last what amount of time?

Answer 29

10-20 min, last 23 hrs.

Question 30

number of days cannabis is detected in urine for short term and long term users

Answer 30

4-6 days and 20-50 days.

Question 31

two phases of marijuana use with moderate users

Answer 31

mild euphoria followed by sleepiness

Question 32

the increase in opioid users directly correlates with what?

Answer 32

prescribed opioids

Question 33

ophthalmologic findings of acute opioid toxicity

Answer 33

miosis

Question 34

what condition is not uncommon, rapidly correctable, and easily confused with acute opioid toxicity?

Answer 34

hypoglycemia

Question 35

what is the clinical picture of acute stimulant intoxication?

Answer 35

diaphoresis tachy elevated BP mydriasis Hyperactivity acute brain syndrome with confusion and disorientation