MH701 Exam Substance Abuse, Pediatrics, Geriatrics Test Exam Questions And Answers Verified 100% Correct

MH701 Exam Substance Abuse, Pediatrics, Geriatrics Test Exam Questions And Answers Verified 100% Correct Why is it important to normalize thiamine levels first (before feeding) with Wernicke's? - ANSWER Otherwise most of glucose will become lactic acid which can lead to metabolic acidosis Thiamine function in body - ANSWER Lipid/glucose metabolism, maintain normal amino acid/neurotransmitter levels, propagation of neural impulses How can Wernicke's-Korsakoff's Syndrome be diagnosed? - ANSWER Clinical symptoms, blood and liver function tests, MRI to show degeneration of mammillary bodies Cocaine/crack effects on body - ANSWER Pupil dilation, tachycardia, elevated BP, n/v, insomnia, grandiosity/impaired judgement, restlessness, convulsions When taking MDMA, it is important that person drinks large quanitities of water to prevent ____ and ____ - ANSWER Dehydration and hyperthermia When MDMA is repeated, it can cause complete depletion of ____ - ANSWER Serotonin stores LSD effects on body - ANSWER Fear of going crazy, paranoid, anxiety/dep, synesthesia (colors are heard), depersonalization, hallucinations, grandiosity PCP effects on body - ANSWER Vertical or horizontal nystagmus, ataxia, muscle rigidity, seizure, blank stare, belligerence, assaultiveness, impulsiveness, hallucinations, paranoia, bizarre/regressive/violent behavior Synthetic cathinone (bath salts) effects on body - ANSWER Paranoia, extreme distrust, panic attacks, hallucinations, increased libido, increased friendliness, extreme agitation and violent behavior Increased HR, BP, chest pain; dehydration, kidney failure For alcohol: benzo (short-term then taper off), anticonvulsants (prophylactically for withdrawal...), beta blockers (inderal) (to decrease overstimulation of CNS), haldol, vitamins (multi, thiamine) For opioids: clonidine For benzos: reversal agent- romazicon For barbs: phenobarbitol (to help wean off) - ANSWER Pediatric metabolism considerations - ANSWER Hypermetabolic, inefficient metabolism Pediatric surface area considerations - ANSWER Greater surface area, so easier dehydration/temperature loss Pediatric body fat considerations - ANSWER Increases during first year of life, then decreases gradually until puberty; less body fat than adults Pediatric liver considerations - ANSWER Larger parenchyma Liver size relative to body mass is greater Liver mass of toddler is 40-50% greater than adults 6 yr old is 30% greater Hepatic metabolism is greater (than adults) In infants, CYP450 and phase II metabolizing enzymes are generally absent (then rapidly develop over first few years of life) Children tend to clear drugs more rapidly than adults, may require higher mg/kg than adult dosing to achieve the same plasma levels Pediatric kidney considerations - ANSWER Renal metabolism is greater (than adults) By age 1, GFR and renal tubular mechanisms for secretion have reached adult levels but, fluid intake may be greater in children than adults more rapid renal clearance Pediatric BBB considerations - ANSWER Permeable (same as adults) at >4 months old Pediatric protein binding considerations - ANSWER Less protein binding (than adults) (Drugs that are protein bound penetrate tissue better and are excreted faster) General dosing of psychotropic meds- pediatrics v. adults - ANSWER Dosed similarly or peds may be dosed more frequently First-line antidepressants in children - ANSWER Fluoxetine, Citalopram, Sertraline According to research, which is the only antidepressant shown to be effective in kids? - ANSWER Fluoxetine Antidepressant BBW in kids - ANSWER Suicidal thoughts (esp in early tx and while tapering off) Close monitoring (weekly) for first month SSRI late-onset side effects in pediatrics - ANSWER apathy, emotional blunting, emotional disinhibition, weight gain Antidepressants in adolescents? - ANSWER Fluoxetine, Escitalopram Medications used for anxiety in pediatrics - ANSWER Fluoxetine, fluovoxamine, sertraline, paroxetine Why are TCAs not used in pediatrics? - ANSWER Risk for serious cardiac adverse effects Benadryl in pediatrics shows link to ___ - ANSWER Dementia FDA approved OCD medications for pediatrics - ANSWER Sertraline (≥6 yrs old), fluoxetine (≥7 yrs old), fluvoxamine (≥8 yrs old) and the TCA clomipramine (≥ 10 yrs old) Can Clomipramine be used as first-line tx for OCD in pediatrics? - ANSWER No- risk for hypotension, arrhythmia, seizures Common mania symptoms in adolescents - ANSWER psychosis (delusions [like persecutory], hallucinations), grandiose notions about their power/worth/relationships, flight of ideas Brain alterations in BPD - ANSWER alterations in PFC altered development of white matter decreased amygdala volume BPD treatment for peds/adolescents - ANSWER Atypical antipsychotics- faster response, greater efficacy (Aripiprazole for >13 yo for 12 weeks) Which BPD med is contraindicated in girls of child-bearing age? - ANSWER Valproic acid ADHD brain changes in pediatrics - ANSWER Abnormalities of fronto-subcortical pathways (frontal cortex and basal ganglia), reticular-activating system, structural abnormalities leading to neurotransmitter abnormalities (dopamine & norepinephrine dysfunction) Psychostimulant medication MOA (generalized) - ANSWER increase epinephrine, improve mood, energy and wakefulness