Word Associations

Question 1

dorsal striatum

Answer 1

binge / intoxication area of brain
habit

Question 2

nucleus accumbens

Answer 2

binge / intoxication area of brain
REINFORCEMENT
ventral striatum
core of NA, pleasure

Question 3

ventral tegmental area (VTA)

Answer 3

binge / intoxication area of brain
DOPAMINE
REWARD
substantia nigra

Question 4

hippocampus

Answer 4

preoccupation / anticipation area of brain
with amygdala = LEARNING/MEMORY with emotional context (ex. cravings occur based on specific memory and conditioned withdrawal)

Question 5

anterior cingulate cortex

Answer 5

preoccupation / anticipation area of brain

Question 6

prefrontal cortex

Answer 6

preoccupation / anticipation area of brain: ACC & hippocampus
last part of brain to develop in youth

Question 7

amygdala

Answer 7

withdrawal area of brain
with hippocampus = LEARNING/MEMORY with emotional context (ex. cravings occur based on specific memory and conditioned withdrawal)

Question 8

basal/bed nucleus of stria terminalis

Answer 8

withdrawal area of brain

Question 9

what specific type of endocarditis is highly associated with IVDU

Answer 9

tricuspid valve endocarditis (right sided heart endocarditis)

Question 10

flumazenil

Answer 10

TREATMENT for BZD OD, reverses BZD sedation

contraindicated if other substances because likely to INDUCE SEIZURE

INHIBITS GABA-A ligand gated chloride ion channel

Question 11

phenelzine

Answer 11

MAOI - when in combo with any serotonin med - serotonin syndrome

Question 12

funky chicken / tweaking

Answer 12

chronic methamphetamine use leads to choreiform / parkinsonian movements

Question 13

z drugs

Answer 13

BZD-like effects, not detectable in UDS
zolpidem, zopiclone, zolepon
schedule V

Question 14

confabulation

Answer 14

seen in KORSAKOFF syndrome
confabulations can be spontaneous or provoked

Question 15

anabolic steroids –> cancer

Answer 15

benign hepatic neoplasm formation –> hepatocellular cancer

can provide B1/B6/B12/linoleic acid/nicotinamide to help prevent

Question 16

cocaine in pregnancy

Answer 16

baby: placental abruption, neonatal intracranial bleeds, low birthweight, prematurity, low head circumference

mother: HTN emergency, seizure, migraine

Question 17

nystagmus

Answer 17

PCP - NMDA receptor antagonist
rotary nystagmus is pathognomonic to PCP

Question 18

conjunctival injection

Answer 18

THC

Question 19

tx for AUD in decompensated cirrhosis

Answer 19

acamprosate

Question 20

increase in delta FosB

Answer 20

EtOH withdrawal

Question 21

hyperthermia causing death

Answer 21

in amphetamine (ex. phentermine) overdose

Question 22

naloxone challenge

Answer 22

0.1mg (30min) 0.2mg (30min) 0.4mg
if no AEs, ok to administer naltrexone

Question 23

labs that indicate anabolic steroid use

Answer 23

ELEVATION: Hgb/Hct, LDL
LOW: sperm count, HDL, LH, sex hormone

Question 24

MPTP

Answer 24

substance made accidentally when trying to produce merperidine
leads to EXTREME RIGID MVMT/parkinsonian to paralysis “can’t move” toxicity seen in ER setting, may mention chemistry graduate student that does recreational drugs

Question 25

hypersexual

Answer 25

cathinone intoxication

Question 26

bruxism, jaw clenching, restless legs

Answer 26

ectasy (MDMA)

Question 27

hep C renal disease

Answer 27

membranoproliferative glomerulonephritis w/ or w/o mixed cryoglobulinemia (normal C3, elevated C4) dx include hematuria, hypertension, proteinuria

Question 28

mitragynine

Answer 28

kratom, partial mu agonist, antagonist at delta and kappa opioid receptor

Question 29

repetitive movements

Answer 29

seen in amphetamine intoxication (tx with bzd)

Question 30

suddenly awakens to baseline even if intubated

Answer 30

GHB toxicity

Question 31

specific type of kidney injury in inhalant toxicity

Answer 31

renal tubular acidosis, hypokalemia

Question 32

exogenous pigments, hands and face

Answer 32

inhalation of volatile hydrocarbons

Question 33

insula

Answer 33

part of brain that helps identify hunger/thirst/hot/cold stimuli and have emotional response

Question 34

OFC

Answer 34

REWARD processing area of brain that brings meaning to specific action (ex. video game accomplishment = accomplishment on anything/test)

Question 35

false positive THC screen by...

Answer 35

pantoprazole (PPI)

Question 36

hematuria

Answer 36

ketamine cystitis

Question 37

DSM Criteria for UD

Answer 37

C cut down, unsuccessful H hazardous use E excessive use W withdrawal T time increased using/recovering, finding H health effects A activities changed T tolerance C cravings O obligations lost to drug P personal problems/family 2-3 mild, 4-5 mod, >6 severe

Question 38

specific marker for recent ETOH use

Answer 38

CDT - carbohydrate deficient tranferrin

Question 39

enteroceptive

Answer 39

mood states that precipitate substance use with exteroceptive = cues and priming

Question 40

exteroceptive

Answer 40

environment to senses (smelling/seeing substance) with enteroceptive = cues and priming