ADEPT Test / CSAM Questions With
Solutions
Evaluate for depression at admission to detoxification, as well as at the time of
discharge,regardless of days of sobriety days Evaluate for depression at admission to
detoxification, as well as at the time of discharge, regardless of days of sobriety days
Evidence has been limited on the use of antidepressant medications in patients with co-occuring
depression and alcohol use disorder (AUD). However, meta-analysis study has shown that
antidepressants outperformed placebo in the treatment of depression in patients with AUD
(Iovineo). Another study also showed that among patients with depression and AUD, those who
were not given antidepressant medication at the time of discharge, 100% resumed alcohol use in
4 months (Greenfield). Another study showed that medication treatment for depression with
AUD has significant benefit (Nuens) * Iovineo, Antidepressants for major depressive disorder
and dysthymic disorder in patients with comorbid AUD:
A first time user of oxycodone reports a sudden rush of euphoria and energy. Which of the
following neurological pathways is primarily responsible for this effect?
Dorsal raphe nucleus projections to nucleus accumbens
Nucleus accumbens projections to ventral tegmental area
, ADEPT Test / CSAM Questions With
Solutions
Ventral tegmental area projections to dorsal raphe nucleus
Ventral tegmental area projections to nucleus accumbens Ventral tegmental area
projections to nucleus accumbens
The positive reinforcing effects of substances and pleasurable behaviors due to dopaminergic
projections from the ventral tegmental area (VTA) to the nucleus accumbens (NAcc) represents
the neural mechanism most consistently implicated in the development of addiction, especially in
early stages. The NAcc along with the olfactory tubule are located in the ventral striatum. The
dorsal raphe nucleus is a midbrain cluster of serotonergic neurons, which may be relevant for the
effects of certain substances such as hallucinogens and MDMA, but is not as universally
implicated in substance and behavioral positive reinforcement.
1. As part of a research study, volunteers with severe opioid use disorder receive monetary
vouchers for providing opioid-negative urine samples. Which of the following best describes this
behavioral treatment strategy?
twelve-step facilitation
contingency management
cognitive behavioral therapy
, ADEPT Test / CSAM Questions With
Solutions
community reinforcement
motivational enhancement contingency management
2. A 28-year-old male is brought to the ED by his roommate for agitation after a prolonged
cocaine binge. His BP is 160/90 and HR is 125. The most appropriate medication would be:
IV haloperidol
IV lorazepam
IV labetalol
IV chlorpromazine
sublingual clonidine IV lorazepam
3. You are treating a 17-year-old for acne and depression. During one of the visits, the patient
mentions that he occasionally "dabs" with his friends using a vape device. His mother asks you
about a recent news article that she read regarding vaping related lung injury. Which of the
following is thought to be one of the causative agents in electronic vaping use associated lung
injury (EVALI)?
vitamin D acetate in THC containing vape devices
fentanyl adulteration in nicotine liquid for vape devices
vitamin E acetate in THC containing vape devices
, ADEPT Test / CSAM Questions With
Solutions
cannabis resin
caffeine adulteration in nicotine liquid for vape devices vitamin E acetate in THC
containing vape devices
4. A patient presents to you in the emergency room with an overdose from IV heroin/fentanyl.
She is treated with naloxone and now demanding to leave. You see that she has been to the ER
5x in the last 6 months with a similar presentation. After discussing the efficacy of
buprenorphine and methadone, she remains uninterested. Your next strategy to minimize risk for
overdose and death is:
referral to needle exchange program
referral to methadone OTP
next day appointment in addiction clinic
provide naloxone kit
rive first dose of buprenorphine prior to discharging from the ER provide naloxone kit
5. A 50-year-old male presents to a primary care clinic with his wife for his annual physical
exam. He reports that he recently completed an inpatient detoxification and rehabilitation
program for severe alcohol use disorder. He states that he felt very depressed prior to his
admission, but that he feels no symptoms of depression currently. Which of the following is true
regarding the treatment of patients with co-occurring depression and alcohol use disorder?
Solutions
Evaluate for depression at admission to detoxification, as well as at the time of
discharge,regardless of days of sobriety days Evaluate for depression at admission to
detoxification, as well as at the time of discharge, regardless of days of sobriety days
Evidence has been limited on the use of antidepressant medications in patients with co-occuring
depression and alcohol use disorder (AUD). However, meta-analysis study has shown that
antidepressants outperformed placebo in the treatment of depression in patients with AUD
(Iovineo). Another study also showed that among patients with depression and AUD, those who
were not given antidepressant medication at the time of discharge, 100% resumed alcohol use in
4 months (Greenfield). Another study showed that medication treatment for depression with
AUD has significant benefit (Nuens) * Iovineo, Antidepressants for major depressive disorder
and dysthymic disorder in patients with comorbid AUD:
A first time user of oxycodone reports a sudden rush of euphoria and energy. Which of the
following neurological pathways is primarily responsible for this effect?
Dorsal raphe nucleus projections to nucleus accumbens
Nucleus accumbens projections to ventral tegmental area
, ADEPT Test / CSAM Questions With
Solutions
Ventral tegmental area projections to dorsal raphe nucleus
Ventral tegmental area projections to nucleus accumbens Ventral tegmental area
projections to nucleus accumbens
The positive reinforcing effects of substances and pleasurable behaviors due to dopaminergic
projections from the ventral tegmental area (VTA) to the nucleus accumbens (NAcc) represents
the neural mechanism most consistently implicated in the development of addiction, especially in
early stages. The NAcc along with the olfactory tubule are located in the ventral striatum. The
dorsal raphe nucleus is a midbrain cluster of serotonergic neurons, which may be relevant for the
effects of certain substances such as hallucinogens and MDMA, but is not as universally
implicated in substance and behavioral positive reinforcement.
1. As part of a research study, volunteers with severe opioid use disorder receive monetary
vouchers for providing opioid-negative urine samples. Which of the following best describes this
behavioral treatment strategy?
twelve-step facilitation
contingency management
cognitive behavioral therapy
, ADEPT Test / CSAM Questions With
Solutions
community reinforcement
motivational enhancement contingency management
2. A 28-year-old male is brought to the ED by his roommate for agitation after a prolonged
cocaine binge. His BP is 160/90 and HR is 125. The most appropriate medication would be:
IV haloperidol
IV lorazepam
IV labetalol
IV chlorpromazine
sublingual clonidine IV lorazepam
3. You are treating a 17-year-old for acne and depression. During one of the visits, the patient
mentions that he occasionally "dabs" with his friends using a vape device. His mother asks you
about a recent news article that she read regarding vaping related lung injury. Which of the
following is thought to be one of the causative agents in electronic vaping use associated lung
injury (EVALI)?
vitamin D acetate in THC containing vape devices
fentanyl adulteration in nicotine liquid for vape devices
vitamin E acetate in THC containing vape devices
, ADEPT Test / CSAM Questions With
Solutions
cannabis resin
caffeine adulteration in nicotine liquid for vape devices vitamin E acetate in THC
containing vape devices
4. A patient presents to you in the emergency room with an overdose from IV heroin/fentanyl.
She is treated with naloxone and now demanding to leave. You see that she has been to the ER
5x in the last 6 months with a similar presentation. After discussing the efficacy of
buprenorphine and methadone, she remains uninterested. Your next strategy to minimize risk for
overdose and death is:
referral to needle exchange program
referral to methadone OTP
next day appointment in addiction clinic
provide naloxone kit
rive first dose of buprenorphine prior to discharging from the ER provide naloxone kit
5. A 50-year-old male presents to a primary care clinic with his wife for his annual physical
exam. He reports that he recently completed an inpatient detoxification and rehabilitation
program for severe alcohol use disorder. He states that he felt very depressed prior to his
admission, but that he feels no symptoms of depression currently. Which of the following is true
regarding the treatment of patients with co-occurring depression and alcohol use disorder?
