Answers
When people consume alcohol for at least 1 to 3 months or even consume large
quantities for at least 7 to10 days, a ____________ response can occur within ___
to 24 hours after cessation of alcohol consumption. The withdrawal response is
relieved immediately by consuming additional alcohol. - ✅✅ withdrawal
6
The signs and symptoms of alcohol withdrawal may range from a simple tremor to
delirium tremens characterized by autonomic ___________, diaphoresis,
tachypnea, hyperthermia, and diaphoresis. Other features of alcohol use disorder
include ascites, hepatosplenomegaly, and melena. Thinning of hair, spider
________, and gynecomastia also are seen. - ✅✅ hyperactivity
Angioma
Combining ___________ and ___________ treatments can increase smoking
cessation rates from 8% to14% when compared with minimal behavioral
interventions such as brief advice on quitting - ✅✅ behavioral
Pharmacological
Combination interventions usually include behavioral components delivered by
specialized smoking cessation counselors combined with nicotine replacement
therapy. Combination interventions are made up of at least four sessions and are
more successful with more sessions. Adding ___________ interventions to
pharmacotherapy increases cessation rates from 18% in persons receiving
pharmacotherapy alone to 21% in those using a combination of pharmacotherapy
and behavioral support. - ✅✅ behavioral
A 16-year-old white male comes into your office requesting medical marijuana for
his anxiety and depression. He explains that he has been using it for years and
acquired it from friends. Whenever he is without it for a few days, he finds his
depression and anxiety recur and sometimes even has episodes of severe anxiety
with chest tightening, tingling sensations, racing heart, and dizziness. He has never
sought mental health resources in the past and denies having similar symptoms in
grade school or middle school. Looking back on his life he says his experience
growing up at home and school were great and explicitly denies any traumatic
,experiences. He produces some literature published by an academic university he
finds online supporting his reason to use marijuana. What is the most likely cause
of his symptoms?
Choices:
1. Generalized anxiety disorder
2. Major Depressive Disorder with anxious features
3. Panic - ✅✅ Cannabis withdrawal
Differentiating endogenous psychiatric illnesses from the effects of substance use
requires a timeline of the symptoms. Panic attacks, anxiety, anhedonia, depressed
mood, and insomnia are effects that occur with __________ withdrawal. - ✅✅
cannabis
Cannabis withdrawal typically occurs in heavy users and starts within the first
_______, and symptoms usually peak by day ________. - ✅✅ week
Three
A 40-year-old male with a history of alcohol use disorder is admitted to the
hospital for skin lacerations following a motor vehicle accident. Urgent care is
given with intravenous fluids and sutures where required. On physical
examination, the blood pressure is 130/82 mmhg. The pulse is 86/min, respiratory
rate is 18/min, and temperature is 98.7 F. After 5 hours, the nurse goes to draw
blood, and the patient refuses, citing restlessness and agitation. The patient yells
and states that his heart is pounding and he would not let anyone come close to
him. He has a previous history of hepatitis C that has been treated. What is the next
step in management?
Choices:
1. Administer lithium
2. Administer oxazepam
3. Administer lactulose
4. Administer diazepam - ✅✅ Administer oxazepam
___________ is an FDA-approved benzodiazepine used for the treatment of
alcohol withdrawal, management of anxiety disorders, and agitation. - ✅✅
Oxazepam
,For alcohol withdrawal in adults, administer oxazepam 15 mg PO TID. Diazepam
should not be used in this patient because it is metabolized in the liver. Oxazepam,
on the other hand, is excreted through the _________. - ✅✅ kidneys
CAGE stands for the following: (1) Have you felt the need to _______ down your
drinking?, (2) Have people __________ you or criticized you about your
drinking?, (3) Have you felt ________ about your drinking?, (4) Have you ever
used alcohol as an _______ opener? A max score is a 4 and a low is 0. - ✅✅ CUT
ANNOYED
GUILTY
EYE
Patients in ______________ have not recognized their drinking as an issue and
need help to reach that bridge. - ✅✅ precontemplation
Those in ______________ recognize the issue but have not prepared a plan to
begin crossing the bridge towards recovery. - ✅✅ contemplation
When a patient is in the __________ stage, a provider can help set up a plan of
action, such as obtaining a doctors appointment. - ✅✅ preparation
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?