CARN study material: Final Exam
Study Guide Latest 2024 Update
Questions and Correctly Solved
Answers!
A
VI
5 stages of addiction - ANSWER 1. First Use
2. Continued use
3. Tolerance
TU
4. Dependence
5. Addiction
6% of U.S patients misuse their pain management prescriptions. Three common patient
IS
populations affected are Cancer, MVA and __________ ________ - ANSWER
Sickle Cell
M
This medication acts on the same opioid receptors as commonly abused opioids without
reaching a point of euphoria. Also being long acting it has been used for over 40 years
O
in countless patients quests towards recovery. - ANSWER Methadone
Which of these medications are used for treating alcohol abuse?
A
Acamprosate
N
Varenicline
Methadone
JP
Bupropion - ANSWER Acamprosate
Which of these medications are used for tobacco disorder?
Acamprosate
Varenicline
Methadone
Bupropion - ANSWER Varenicline
Bupropion
,This substance is a full agonist of trace amine-associated receptors (TAAR1). Activation
TAAR1 causes the increase of cAMP and inhibition of serotonin, dopamine, and
norepinephrine transporters. The inhibition of monoamine transporters causes the
reuptake and metabolism of catecholamines. - ANSWER Methamphetamine
The following are "_________ _______" for methamphetamine: meth, crystal meth,
crystal, speed, scootie, yellow powder, crank, ice, spoosh, glass, chalk, redneck
cocaine, yellow barn, Tina, and tick-tick. - ANSWER street names
A
Patients under the influence of methamphetamine can have the following signs or
symptoms: ___________ appetite, nausea, psychosis, tachycardia, hypertension,
VI
___________ body temperature, panic attack, mydriasis, __________ sleep patterns,
violent, bizarre, and erratic behavior, hallucinations, irritability, seizures, and death from
high doses. - ANSWER decreased
TU
increased
disturbed
A 65-year-old female presents to the clinic to seek a re-prescription of her pain
medication. She had a motor vehicle collision (MVC) 8 months ago that left her with
IS
chronic neuralgia in bilateral arms along with low back pain. She was prescribed
oxycodone/acetaminophen 7.5/325 mg q6 hours. Her last scheduled refill was 20 days
ago with a 30 day supply. She returns early claiming she needed multiple dosages
M
sooner than directed due to unmanaged pain. Current vital signs are normal, but she is
diaphoretic, tearing, restless, and occasionally yawning. When the provider explains,
O
controlled medications cannot be prescribed in this manner, the patient states, "You
don't understand. I need to feel normal. Without it, I feel worse than I used to feel at
baseline. Please!" What stage of addiction is the patient in and what medication can be
A
used to help her symptoms?
N
Choices:
1. Tolerance and acamprosate
JP
2. Tolerance and - ANSWER Dependence and methadone
A patient presents to the emergency department with agitation, mydriasis, hypertension,
and tachycardia. He states that he snorted "some crystals" with friends and that he feels
energetic and anxious. He reports that his friends told him this is a treatment for weight
loss and this is the reason why he tried it. Which is true of the drug most likely used by
this patient?
Choices:
,1. Partial agonist of trace amine-associated receptors (TAAR1)
2. Gamma-aminobutyric acid (GABA) receptor agonist
3. Full agonist of trace amine-associated receptors (TAAR1)
4. Full antagonist of dopamine receptors - ANSWER Full agonist of trace
amine-associated receptors (TAAR1)
A 35-year-old woman comes in for her wellness check-up. She has a 13-year-old son
who is going to be starting high school next year and often hear him and his friends
discuss ways to prepare for high school, so they fit in. The mother is concerned her son
A
may use drugs as he often talks about the partying. She wants to know what she can do
it prepare him to avoid smoking cannabis given its surge in popularity amongst youth.
VI
What is the most common reason for marijuana use, amongst teenagers and young
adults?
TU
Choices:
1. Stress management
2. Experimentation
3. Social conformity
4. Pleasurable sensation - ANSWER Social conformity
IS
A young adult patient is dropped off outside the emergency department by her friends,
and they drive off before any history can be obtained. The patient has altered mental
M
status and shows signs of intoxication. Sudden dorsiflexion of her ankle produces a
rhythmic reproduction of her ankle jerk reflex. Which of the following drugs did she most
O
likely ingest?
Choices:
A
1. Alcohol
2. 3,4-Methylenedioxymethamphetamine (MDMA)
N
3. Phencyclidine
4. Cannabis - ANSWER 3,4-Methylenedioxymethamphetamine (MDMA)
JP
Several classes of common street drugs such as cocaine, ecstasy (MDMA), and
amphetamines, increase serotonin levels, which is part of what contributes to the
pleasurable and addictive aspects of their use, and also what can produce a
__________ syndrome and __________. - ANSWER serotonin
clonus
Psychiatric medications such as monoamine oxidase inhibitors (MAOI), selective
serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors
, (SNRI), and tricyclic antidepressants (TCA) manipulate serotonin levels to improve
__________, but too much can produce clonus as part of serotonin ____________. -
ANSWER mood
syndrome
____________ nervous system depressants like alcohol and opiates can diminish deep
tendon __________ as opposed to producing clonus. - ANSWER Central
reflexes
A
A 66-year-old male was prescribed pain medication after a fracture followed by surgery
6 months ago. Since then, his primary care provider has noticed frequent visits to the
VI
office asking for pain medication and multiple injuries justifying the use of it. Every time
there are different vague complaints, but that of pain is consistent. On his last visit, the
primary care took a firm stand and did not agree to continue prescribing the opioids.
TU
Today he visits in a restless state. Which of the following do you suspect to see on
history or physical exam in this patient?
Choices:
1. Constipation
IS
2. Miosis
3. Dilated pupils
4. Bradycardia - ANSWER Dilated pupils
M
Opioid withdrawal onset varies with the type of opioid used. Heroin withdrawal begins in
O
as little as ___ hours, whereas methadone may take 2 to 3 _______. - ANSWER 5
days
A
Opiod withdrawal symptoms may last days to weeks known as protracted abstinence
syndrome. Signs and symptoms of withdrawal include ___________ cramps, agitation,
N
anxiety, cravings, diarrhea, dilated pupils, high blood pressure, insomnia, goosebumps,
muscle pains, ________ nose, shakiness, sneezing, sweating, tachycardia, and tearing.
JP
- ANSWER abdominal
runny
A pregnant female, admitted for possible pyelonephritis, is complaining of significant
anxiety, tremulousness, and irritability. Upon assessment, she is noted to have a blood
pressure of 156/94 mmHg, pulse 103 bpm, and is complaining of nausea. Which of the
following screening tools for this patient's most likely substance use disorder has been
empirically validated for use in pregnant females?
Study Guide Latest 2024 Update
Questions and Correctly Solved
Answers!
A
VI
5 stages of addiction - ANSWER 1. First Use
2. Continued use
3. Tolerance
TU
4. Dependence
5. Addiction
6% of U.S patients misuse their pain management prescriptions. Three common patient
IS
populations affected are Cancer, MVA and __________ ________ - ANSWER
Sickle Cell
M
This medication acts on the same opioid receptors as commonly abused opioids without
reaching a point of euphoria. Also being long acting it has been used for over 40 years
O
in countless patients quests towards recovery. - ANSWER Methadone
Which of these medications are used for treating alcohol abuse?
A
Acamprosate
N
Varenicline
Methadone
JP
Bupropion - ANSWER Acamprosate
Which of these medications are used for tobacco disorder?
Acamprosate
Varenicline
Methadone
Bupropion - ANSWER Varenicline
Bupropion
,This substance is a full agonist of trace amine-associated receptors (TAAR1). Activation
TAAR1 causes the increase of cAMP and inhibition of serotonin, dopamine, and
norepinephrine transporters. The inhibition of monoamine transporters causes the
reuptake and metabolism of catecholamines. - ANSWER Methamphetamine
The following are "_________ _______" for methamphetamine: meth, crystal meth,
crystal, speed, scootie, yellow powder, crank, ice, spoosh, glass, chalk, redneck
cocaine, yellow barn, Tina, and tick-tick. - ANSWER street names
A
Patients under the influence of methamphetamine can have the following signs or
symptoms: ___________ appetite, nausea, psychosis, tachycardia, hypertension,
VI
___________ body temperature, panic attack, mydriasis, __________ sleep patterns,
violent, bizarre, and erratic behavior, hallucinations, irritability, seizures, and death from
high doses. - ANSWER decreased
TU
increased
disturbed
A 65-year-old female presents to the clinic to seek a re-prescription of her pain
medication. She had a motor vehicle collision (MVC) 8 months ago that left her with
IS
chronic neuralgia in bilateral arms along with low back pain. She was prescribed
oxycodone/acetaminophen 7.5/325 mg q6 hours. Her last scheduled refill was 20 days
ago with a 30 day supply. She returns early claiming she needed multiple dosages
M
sooner than directed due to unmanaged pain. Current vital signs are normal, but she is
diaphoretic, tearing, restless, and occasionally yawning. When the provider explains,
O
controlled medications cannot be prescribed in this manner, the patient states, "You
don't understand. I need to feel normal. Without it, I feel worse than I used to feel at
baseline. Please!" What stage of addiction is the patient in and what medication can be
A
used to help her symptoms?
N
Choices:
1. Tolerance and acamprosate
JP
2. Tolerance and - ANSWER Dependence and methadone
A patient presents to the emergency department with agitation, mydriasis, hypertension,
and tachycardia. He states that he snorted "some crystals" with friends and that he feels
energetic and anxious. He reports that his friends told him this is a treatment for weight
loss and this is the reason why he tried it. Which is true of the drug most likely used by
this patient?
Choices:
,1. Partial agonist of trace amine-associated receptors (TAAR1)
2. Gamma-aminobutyric acid (GABA) receptor agonist
3. Full agonist of trace amine-associated receptors (TAAR1)
4. Full antagonist of dopamine receptors - ANSWER Full agonist of trace
amine-associated receptors (TAAR1)
A 35-year-old woman comes in for her wellness check-up. She has a 13-year-old son
who is going to be starting high school next year and often hear him and his friends
discuss ways to prepare for high school, so they fit in. The mother is concerned her son
A
may use drugs as he often talks about the partying. She wants to know what she can do
it prepare him to avoid smoking cannabis given its surge in popularity amongst youth.
VI
What is the most common reason for marijuana use, amongst teenagers and young
adults?
TU
Choices:
1. Stress management
2. Experimentation
3. Social conformity
4. Pleasurable sensation - ANSWER Social conformity
IS
A young adult patient is dropped off outside the emergency department by her friends,
and they drive off before any history can be obtained. The patient has altered mental
M
status and shows signs of intoxication. Sudden dorsiflexion of her ankle produces a
rhythmic reproduction of her ankle jerk reflex. Which of the following drugs did she most
O
likely ingest?
Choices:
A
1. Alcohol
2. 3,4-Methylenedioxymethamphetamine (MDMA)
N
3. Phencyclidine
4. Cannabis - ANSWER 3,4-Methylenedioxymethamphetamine (MDMA)
JP
Several classes of common street drugs such as cocaine, ecstasy (MDMA), and
amphetamines, increase serotonin levels, which is part of what contributes to the
pleasurable and addictive aspects of their use, and also what can produce a
__________ syndrome and __________. - ANSWER serotonin
clonus
Psychiatric medications such as monoamine oxidase inhibitors (MAOI), selective
serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors
, (SNRI), and tricyclic antidepressants (TCA) manipulate serotonin levels to improve
__________, but too much can produce clonus as part of serotonin ____________. -
ANSWER mood
syndrome
____________ nervous system depressants like alcohol and opiates can diminish deep
tendon __________ as opposed to producing clonus. - ANSWER Central
reflexes
A
A 66-year-old male was prescribed pain medication after a fracture followed by surgery
6 months ago. Since then, his primary care provider has noticed frequent visits to the
VI
office asking for pain medication and multiple injuries justifying the use of it. Every time
there are different vague complaints, but that of pain is consistent. On his last visit, the
primary care took a firm stand and did not agree to continue prescribing the opioids.
TU
Today he visits in a restless state. Which of the following do you suspect to see on
history or physical exam in this patient?
Choices:
1. Constipation
IS
2. Miosis
3. Dilated pupils
4. Bradycardia - ANSWER Dilated pupils
M
Opioid withdrawal onset varies with the type of opioid used. Heroin withdrawal begins in
O
as little as ___ hours, whereas methadone may take 2 to 3 _______. - ANSWER 5
days
A
Opiod withdrawal symptoms may last days to weeks known as protracted abstinence
syndrome. Signs and symptoms of withdrawal include ___________ cramps, agitation,
N
anxiety, cravings, diarrhea, dilated pupils, high blood pressure, insomnia, goosebumps,
muscle pains, ________ nose, shakiness, sneezing, sweating, tachycardia, and tearing.
JP
- ANSWER abdominal
runny
A pregnant female, admitted for possible pyelonephritis, is complaining of significant
anxiety, tremulousness, and irritability. Upon assessment, she is noted to have a blood
pressure of 156/94 mmHg, pulse 103 bpm, and is complaining of nausea. Which of the
following screening tools for this patient's most likely substance use disorder has been
empirically validated for use in pregnant females?
