CARN LATEST EXAMS TEST PAPER QUESTIONS AND
ANSWERS SURE A+
✔✔An 18-year-old male in college with a history of anxiety, attention deficit hyperactivity
disorder, insomnia, and daily chronic cannabis use comes in to see his provider for a
follow-up. Since starting a part-time job, he is required to have a primary care physician
and had arranged a physical. Over a series of visits, psychotropics are discussed,
psychotherapy is initiated, and he is counseled about the detrimental effects of
marijuana on his mental health. He is ready to quit and would like recommendations as
to how he should approach this as prior attempts have failed. What is the most likely
risk for failing the cessation of marijuana?
Choices:
1. Impulsivity
2. Fear of losing their job
3. Fear of academic repercussions
4. Discomfort tolerating the cessation - ✔✔Discomfort tolerating the cessation
✔✔Most medications for alcohol addiction help reduce cravings. _________ helps
through deterrence. - ✔✔Disulfiram
,✔✔The ______________ of sertraline with disulfiram, thioridazine, pimozide, or
monoamine oxidase inhibitors, including linezolid or methylene blue, is contraindicated.
- ✔✔coadministration
✔✔the typical marijuana toxicity results in somnolence, mild euphoria, and occasional
agitation. Although agitation may be present, patients typically do not present with
aggressive behavior, nystagmus, or hypertension. This is more common in agents such
as ________ cannabinoid exposure - ✔✔synthetic
✔✔Opioid agonist therapy is the agreed upon recommendation for treatment of opioid
use disorder (OUD) in ____________ females. Medically supervised opioid withdrawal
is not recommended due to ________ stress. - ✔✔pregnant
fetal
✔✔______________ from opioids in patients with OUD who become pregnant is not
recommended as evidence reveals higher rates of relapse and danger to mother and
fetus with opioid relapse. - ✔✔Abstinence
✔✔The diagnosis of opioid use disorder is established in the DSM-5 guidelines and
requires that the individual has significant impairment or distress as a result of opioid
use. To establish the diagnosis, ______ or more of the eleven criteria must be present
within a year. - ✔✔two
✔✔The eleven criteria for _______ are: continued use despite worsening physical or
psychological health, continued use leading to social and interpersonal consequences,
decreased social or recreational activities, difficulty fulfilling professional duties at school
or work, large amounts of time spent trying to obtain, or recover from taking them,
taking more than intended, the individual has cravings, the individual is unable to
decrease the amount used, tolerance, using despite it being physically dangerous
settings, and withdrawal symptoms if not taking opioids. - ✔✔OUD
✔✔The CDC recommends that for safety in patients seeking repeated opiates; perform
a urine drug test first, as it can possibly identify patients who might be at higher risk for
opioid overdose misuse. If necessary treatment should be initiated with _________-
_________ medications. - ✔✔short-acting
✔✔There is a mounting body of evidence that demonstrates that _______-_______
pain control therapies are as effective and less harmful than long-term opioid use for
chronic pain syndromes. - ✔✔non-opioid
✔✔Infections resulting from intravenous drug use involve 30% to 40% of all _________
valve infectious endocarditis (TVIE) cases. - ✔✔tricuspid
, ✔✔The most prominent adverse effect of diphenhydramine is sedation.
Diphenhydramine is a potent _____________ agent that also causes dry mouth and
throat, increased heart rate, pupil dilation, urinary retention, constipation, hallucinations,
or delirium. Other adverse effects include motor impairment, flushed skin, blurred vision,
abnormal sensitivity to bright light, difficulty concentrating, memory loss, visual
disturbances, irregular breathing, dizziness, irritability, itchy skin, confusion, increased
body temperature, erectile dysfunction, and vomiting. Development of twitching may be
delayed until the drowsiness begins to cease. - ✔✔anticholinergic
✔✔People on methadone or buprenorphine will likely develop a __________
dependence on the medication but will be less likely to engage in the behaviors of
addiction that can be so disruptive in the lives of people with substance use disorders. -
✔✔physiological
✔✔The most common comorbidities with chronic noncancerous pain (CNCP) are
_________ and ____________. Duloxetine and venlafaxine both are FDA-approved for
general anxiety disorders. There is some evidence for the effectiveness of lamotrigine
for post-traumatic stress disorder (PTSD), valproic acid for panic disorder, pregabalin
for social phobia and generalized anxiety disorder, gabapentin for social phobia. -
✔✔anxiety
depression
✔✔________________ are more effective for pain caused by arthritis, post-herpetic
neuralgia (shingles), fibromyalgia, diabetic neuropathy, peripheral neuropathy, spinal
cord injury, stroke, radiculopathy, pelvic pain, migraine, facial pain, and low-back pain.
The mechanism of pain relief due to antidepressants is not completely understood. -
✔✔Antidepressants
✔✔Antidepressants can cause an increase in neurotransmitters that reduce pain
signals. Patients might feel the pain relief within 7 to 10 days, but the maximum effect is
after several weeks. ____________ are the most common antidepressant used for pain
control. - ✔✔Tricyclics
✔✔Nalbuphine is a mixed opioid agonist-antagonist used to treat pain. In a patient
taking morphine or codeine, the addition of nalbuphine may precipitate a ___________
syndrome. - ✔✔withdrawal
✔✔Phenelzine is a ___________ _________ inhibitor used as an antidepressant and
can cause serotonin syndrome when used in combination with sumatriptan. -
✔✔monoamine oxidase
✔✔___________ substance use disorder (SUD) requires 4-5 symptoms of SUD be
present within a 12 month period.If 2-3 symptoms are present the SUD is considered
mild, and SUD is severe with 6+ symptoms present. - ✔✔Moderate
ANSWERS SURE A+
✔✔An 18-year-old male in college with a history of anxiety, attention deficit hyperactivity
disorder, insomnia, and daily chronic cannabis use comes in to see his provider for a
follow-up. Since starting a part-time job, he is required to have a primary care physician
and had arranged a physical. Over a series of visits, psychotropics are discussed,
psychotherapy is initiated, and he is counseled about the detrimental effects of
marijuana on his mental health. He is ready to quit and would like recommendations as
to how he should approach this as prior attempts have failed. What is the most likely
risk for failing the cessation of marijuana?
Choices:
1. Impulsivity
2. Fear of losing their job
3. Fear of academic repercussions
4. Discomfort tolerating the cessation - ✔✔Discomfort tolerating the cessation
✔✔Most medications for alcohol addiction help reduce cravings. _________ helps
through deterrence. - ✔✔Disulfiram
,✔✔The ______________ of sertraline with disulfiram, thioridazine, pimozide, or
monoamine oxidase inhibitors, including linezolid or methylene blue, is contraindicated.
- ✔✔coadministration
✔✔the typical marijuana toxicity results in somnolence, mild euphoria, and occasional
agitation. Although agitation may be present, patients typically do not present with
aggressive behavior, nystagmus, or hypertension. This is more common in agents such
as ________ cannabinoid exposure - ✔✔synthetic
✔✔Opioid agonist therapy is the agreed upon recommendation for treatment of opioid
use disorder (OUD) in ____________ females. Medically supervised opioid withdrawal
is not recommended due to ________ stress. - ✔✔pregnant
fetal
✔✔______________ from opioids in patients with OUD who become pregnant is not
recommended as evidence reveals higher rates of relapse and danger to mother and
fetus with opioid relapse. - ✔✔Abstinence
✔✔The diagnosis of opioid use disorder is established in the DSM-5 guidelines and
requires that the individual has significant impairment or distress as a result of opioid
use. To establish the diagnosis, ______ or more of the eleven criteria must be present
within a year. - ✔✔two
✔✔The eleven criteria for _______ are: continued use despite worsening physical or
psychological health, continued use leading to social and interpersonal consequences,
decreased social or recreational activities, difficulty fulfilling professional duties at school
or work, large amounts of time spent trying to obtain, or recover from taking them,
taking more than intended, the individual has cravings, the individual is unable to
decrease the amount used, tolerance, using despite it being physically dangerous
settings, and withdrawal symptoms if not taking opioids. - ✔✔OUD
✔✔The CDC recommends that for safety in patients seeking repeated opiates; perform
a urine drug test first, as it can possibly identify patients who might be at higher risk for
opioid overdose misuse. If necessary treatment should be initiated with _________-
_________ medications. - ✔✔short-acting
✔✔There is a mounting body of evidence that demonstrates that _______-_______
pain control therapies are as effective and less harmful than long-term opioid use for
chronic pain syndromes. - ✔✔non-opioid
✔✔Infections resulting from intravenous drug use involve 30% to 40% of all _________
valve infectious endocarditis (TVIE) cases. - ✔✔tricuspid
, ✔✔The most prominent adverse effect of diphenhydramine is sedation.
Diphenhydramine is a potent _____________ agent that also causes dry mouth and
throat, increased heart rate, pupil dilation, urinary retention, constipation, hallucinations,
or delirium. Other adverse effects include motor impairment, flushed skin, blurred vision,
abnormal sensitivity to bright light, difficulty concentrating, memory loss, visual
disturbances, irregular breathing, dizziness, irritability, itchy skin, confusion, increased
body temperature, erectile dysfunction, and vomiting. Development of twitching may be
delayed until the drowsiness begins to cease. - ✔✔anticholinergic
✔✔People on methadone or buprenorphine will likely develop a __________
dependence on the medication but will be less likely to engage in the behaviors of
addiction that can be so disruptive in the lives of people with substance use disorders. -
✔✔physiological
✔✔The most common comorbidities with chronic noncancerous pain (CNCP) are
_________ and ____________. Duloxetine and venlafaxine both are FDA-approved for
general anxiety disorders. There is some evidence for the effectiveness of lamotrigine
for post-traumatic stress disorder (PTSD), valproic acid for panic disorder, pregabalin
for social phobia and generalized anxiety disorder, gabapentin for social phobia. -
✔✔anxiety
depression
✔✔________________ are more effective for pain caused by arthritis, post-herpetic
neuralgia (shingles), fibromyalgia, diabetic neuropathy, peripheral neuropathy, spinal
cord injury, stroke, radiculopathy, pelvic pain, migraine, facial pain, and low-back pain.
The mechanism of pain relief due to antidepressants is not completely understood. -
✔✔Antidepressants
✔✔Antidepressants can cause an increase in neurotransmitters that reduce pain
signals. Patients might feel the pain relief within 7 to 10 days, but the maximum effect is
after several weeks. ____________ are the most common antidepressant used for pain
control. - ✔✔Tricyclics
✔✔Nalbuphine is a mixed opioid agonist-antagonist used to treat pain. In a patient
taking morphine or codeine, the addition of nalbuphine may precipitate a ___________
syndrome. - ✔✔withdrawal
✔✔Phenelzine is a ___________ _________ inhibitor used as an antidepressant and
can cause serotonin syndrome when used in combination with sumatriptan. -
✔✔monoamine oxidase
✔✔___________ substance use disorder (SUD) requires 4-5 symptoms of SUD be
present within a 12 month period.If 2-3 symptoms are present the SUD is considered
mild, and SUD is severe with 6+ symptoms present. - ✔✔Moderate
