CARN study material Questions And
Answers
5 stages of addiction - -1. First Use
2. Continued use
3. Tolerance
4. Dependence
5. Addiction
-6% of U.S patients misuse their pain management prescriptions. Three
common patient populations affected are Cancer, MVA and __________
________ - -Sickle Cell
-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 in countless patients quests towards recovery. -
-Methadone
-Which of these medications are used for treating alcohol abuse?
Acamprosate
Varenicline
Methadone
Bupropion - -Acamprosate
-Which of these medications are used for tobacco disorder?
Acamprosate
Varenicline
Methadone
Bupropion - -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. - -
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. - -street names
,-Patients under the influence of methamphetamine can have the following
signs or symptoms: ___________ appetite, nausea, psychosis, tachycardia,
hypertension, ___________ body temperature, panic attack, mydriasis,
__________ sleep patterns, violent, bizarre, and erratic behavior,
hallucinations, irritability, seizures, and death from high doses. - -decreased
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 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 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,
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 used to help her symptoms?
Choices:
1. Tolerance and acamprosate
2. Tolerance and - -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 - -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 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. What is the
, most common reason for marijuana use, amongst teenagers and young
adults?
Choices:
1. Stress management
2. Experimentation
3. Social conformity
4. Pleasurable sensation - -Social conformity
-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 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 likely ingest?
Choices:
1. Alcohol
2. 3,4-Methylenedioxymethamphetamine (MDMA)
3. Phencyclidine
4. Cannabis - -3,4-Methylenedioxymethamphetamine (MDMA)
-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 __________. - -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 ____________. - -mood
syndrome
-____________ nervous system depressants like alcohol and opiates can
diminish deep tendon __________ as opposed to producing clonus. - -Central
reflexes
-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 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. Today he visits in a
restless state. Which of the following do you suspect to see on history or
physical exam in this patient?
Answers
5 stages of addiction - -1. First Use
2. Continued use
3. Tolerance
4. Dependence
5. Addiction
-6% of U.S patients misuse their pain management prescriptions. Three
common patient populations affected are Cancer, MVA and __________
________ - -Sickle Cell
-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 in countless patients quests towards recovery. -
-Methadone
-Which of these medications are used for treating alcohol abuse?
Acamprosate
Varenicline
Methadone
Bupropion - -Acamprosate
-Which of these medications are used for tobacco disorder?
Acamprosate
Varenicline
Methadone
Bupropion - -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. - -
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. - -street names
,-Patients under the influence of methamphetamine can have the following
signs or symptoms: ___________ appetite, nausea, psychosis, tachycardia,
hypertension, ___________ body temperature, panic attack, mydriasis,
__________ sleep patterns, violent, bizarre, and erratic behavior,
hallucinations, irritability, seizures, and death from high doses. - -decreased
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 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 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,
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 used to help her symptoms?
Choices:
1. Tolerance and acamprosate
2. Tolerance and - -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 - -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 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. What is the
, most common reason for marijuana use, amongst teenagers and young
adults?
Choices:
1. Stress management
2. Experimentation
3. Social conformity
4. Pleasurable sensation - -Social conformity
-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 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 likely ingest?
Choices:
1. Alcohol
2. 3,4-Methylenedioxymethamphetamine (MDMA)
3. Phencyclidine
4. Cannabis - -3,4-Methylenedioxymethamphetamine (MDMA)
-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 __________. - -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 ____________. - -mood
syndrome
-____________ nervous system depressants like alcohol and opiates can
diminish deep tendon __________ as opposed to producing clonus. - -Central
reflexes
-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 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. Today he visits in a
restless state. Which of the following do you suspect to see on history or
physical exam in this patient?
