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Behavioral Medicine - Alcohol & Substance Abuse

Beschreibung

Alcohol & Substance Abuse
campbellpa2017
Quiz von campbellpa2017, aktualisiert more than 1 year ago
campbellpa2017
Erstellt von campbellpa2017 vor fast 9 Jahre
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Zusammenfassung der Ressource

Frage 1

Frage
Which of the following has the highest alcohol by volume (ABV) percentage?
Antworten
  • Beer
  • Wine
  • Nyquil
  • Terpin Hydrate w/ DM

Frage 2

Frage
Which of the following is NOT an opioid?
Antworten
  • Valium
  • Ultram
  • Suboxone
  • Demerol

Frage 3

Frage
Which of the following is NOT a benzodiazepine?
Antworten
  • Ambien
  • Soma
  • Opana
  • Klonopin

Frage 4

Frage
Which of the following is NOT a stimulant?
Antworten
  • dextroamphetamine
  • dextromethorphan
  • methylphenidate
  • modafinil

Frage 5

Frage
Alcohol intoxication disinhibits frontal cortical regulation of behavior.
Antworten
  • True
  • False

Frage 6

Frage
Which of the following may occur as a result of Abstinence Syndrome/Withdrawal from ETOH? (Check all that apply)
Antworten
  • insomnia
  • anxiety
  • tremor
  • hypotension
  • bradycardia
  • hallucinations
  • seizures
  • delirium

Frage 7

Frage
ETOH is toxic to virtually all bodily tissues.
Antworten
  • True
  • False

Frage 8

Frage
The euphoria associated with opioid abuse wanes when physiologic dependence occurs.
Antworten
  • True
  • False

Frage 9

Frage
Opioid intoxication may cause... (Check all that apply)
Antworten
  • euphoria
  • increased energy
  • sedation
  • nausea/vomiting
  • diarrhea
  • pupil dilation

Frage 10

Frage
Short-term use of opioids is NOT associated with a hangover effect.
Antworten
  • True
  • False

Frage 11

Frage
Which of the following may occur in Abstinence Syndrome/Withdrawal from Opioids? (Check all that apply)
Antworten
  • Flu-like illness: myalgias, headache, fatigue, rhinorrhea, sneezing, hot and cold sweats, N&V, diarrhea, abdominal cramps
  • Signs of CNS depression: somnolence, ataxia, bradycardia, decreased BP, miosis
  • involuntary muscle twitches, restless legs syndrome, piloerection, tremor

Frage 12

Frage
Complications of non-lethal overdose on opioids may include all of the following EXCEPT:
Antworten
  • aspiration
  • pneumonia
  • bowel impaction
  • A & C only
  • All of the above

Frage 13

Frage
The effects of Sedative-Hypnotic/Anxiolytic intoxication mimic ETOH intoxication in that both may cause: disinhibition of frontal cortical regulation of behavior, ataxia, slurred speech, memory “blackouts,” sexual dysfunction, loss of consciousness, cardiovascular and respiratory collapse
Antworten
  • True
  • False

Frage 14

Frage
sedative-hypnotic/anxiolytic intoxication may manifest as mood changes and irritability.
Antworten
  • True
  • False

Frage 15

Frage
Withdrawal from sedative-hypnotics/anxiolytics differs from ETOH withdrawal in that: it may last for weeks and has a higher incidence of seizures.
Antworten
  • True
  • False

Frage 16

Frage
Which of the following symptoms may be the result of acute stimulant intoxication:
Antworten
  • Hypersomnolence
  • Delusions
  • Auditory/Visual Hallucinations
  • Only B & C
  • All of the above

Frage 17

Frage
Which of the following may be the result of stimulant withdrawal? (Check all that apply)
Antworten
  • Severe depression with elevated risk of suicide
  • Anorexia and decreased food intake
  • Severe fatigue
  • Severe hypersomnolence

Frage 18

Frage
Medical complications associated with stimulant abuse may include:
Antworten
  • tachycardia
  • myocardial infarction
  • CVA
  • malnourishment
  • All of the above

Frage 19

Frage
The short half-life of cocaine (48 min) coupled with its intensive levels of intoxication helps drive the severe cravings and compulsiveness associated with its use.
Antworten
  • True
  • False

Frage 20

Frage
Which of the following time estimates of addictive progression - from start to end-stage - is/are accurate? (Check all that apply)
Antworten
  • Alcohol 10-40 years
  • Heroin 20-40 years
  • Cocaine 5-10 years

Frage 21

Frage
While commonly known to cause relaxation and euphoria, marijuana may conversely cause stimulation, agitation, and dysphoria in others.
Antworten
  • True
  • False

Frage 22

Frage
In young, chronic users (no pun intended), marijuana may arrest cognitive development and cause memory impairments.
Antworten
  • True
  • False

Frage 23

Frage
Binge drinking is defined by:
Antworten
  • 5+ drinks/occasion x 1 in past 30 days
  • 5+ drinks/occasion more than once in past 30 days
  • 10+ drinks/occasion x 1 past 30 days
  • 10+ drinks/occasion more than once in past 30 days
  • None of the above

Frage 24

Frage
Nearly 1 in 4 persons, ages 12 and older, in the U.S. met criteria for "binge drinking" in a 2013 national survey.
Antworten
  • True
  • False

Frage 25

Frage
About what percent of substance use disorders are estimated to go untreated each year in the U.S.?
Antworten
  • 30%
  • 50%
  • 60%
  • 90%

Frage 26

Frage
At-risk drinking for men and women ages 65+ years old is considered to be:
Antworten
  • More than 2 drinks in a day (or more than 6 per week)
  • More than 3 drinks in a day (or more than 7 in a week)
  • More than 4 drinks in a day (or more than 10 a week)
  • More than 5 drinks in a day (or more than 12 a week)

Frage 27

Frage
At-risk drinking for men under 65+ years old is considered to be:
Antworten
  • More than 2 drink in a day (or more than 5 drinks in a week)
  • More than 3 drinks in a day (or more than 10 in a week)
  • More than 4 drinks in a day (or more than 14 in a week)
  • More than 5 drinks in a day (or more than 20 in a week)

Frage 28

Frage
Broadly speaking, the DSM-IV defines substance abuse as: recurrent or continued substance use despite adverse effects.
Antworten
  • True
  • False

Frage 29

Frage
Which of the following are characteristic of substance dependence? (Check all that apply)
Antworten
  • loss of control of use (i.e. compulsive use)
  • tolerance (i.e. increased tolerance with decreased effect)
  • withdrawal (or active avoidance of withdrawal)
  • use to avoid negative effects rather than obtain positive ones (i.e. no euphoria; just trying to avoid being sick)

Frage 30

Frage
The DSM-V groups criteria for substance use disorders into broad categories which include: (Check all that apply)
Antworten
  • Impaired contol
  • Risky use
  • Social impairment
  • Pharmacological criteria

Frage 31

Frage
The DSM-V lists 11 criteria for classifying the severity of substance use disorders (SUD); which of the following does NOT accurately represent one of those classifications?
Antworten
  • Mild SUD: 1-3 criteria met
  • Moderate SUD 4-5 criteria met
  • Severe SUD: 6+ criteria met

Frage 32

Frage
Physiological dependence and addiction are synonymous.
Antworten
  • True
  • False

Frage 33

Frage
Physiological dependence may occur with non-problematic administration of a drug as it is intended to be used for the alleviation of symptoms.
Antworten
  • True
  • False

Frage 34

Frage
SBIRT is an effective, evidence-based, and reimbursable method for dealing with substance use disorders in the context of an office visit. SBIRT stands for:
Antworten
  • Selective Behavioral Intervention and Relapse Test
  • Substances, Behaviors, Interventions, Reactions, and Treatments
  • Screening Brief Intervention and Referral to Treatment
  • Self-directed Behavioral Interviewing and Rehabilitative Teaching
  • Support-Based Interventions, Relapse-prevention, and Treatment

Frage 35

Frage
Which of the following accurately describe their purpose and function in the SBIRT method: (Check all that apply)
Antworten
  • Screening: quickly assess use and severity of alcohol, illicit drug, and prescription drug abuse.
  • Brief Intervention: a 3-5 minute motivational and awareness-raising intervention given to risky or problematic substance users.
  • Referral to Treatment: referrals to specialty care for pts with substance use disorders.

Frage 36

Frage
Which of the following are NOT considered to be "Standard Drinks" per current U.S. guidelines? (Check all that apply)
Antworten
  • 12 oz. PBR
  • 12-16 oz. Four Loko
  • 5 oz. Franzia
  • 1.5 oz. Maker's Mark

Frage 37

Frage
This man is an alcoholic.
Image:
66625668-2075-40b9-b100-68d4daf03b74 (image/jpeg)
Antworten
  • True
  • False

Frage 38

Frage
The CAGE questionnaire is a screening tool for ETOH abuse/dependence. Which of the following is/are NOT accurately representing the acronym?
Antworten
  • C: have you ever felt you should Cut down on your use of ETOH?
  • A: do you ever get Annoyed by others criticizing your ETOH use?
  • G: have you ever felt bad or Guilty because of your drinking?
  • E: do you find that you drink Every day/night that you are able to do so?

Frage 39

Frage
CAGE-AID is the same CAGE screening questions used for ETOH use, except it's "Adapted to Include Drugs" (AID).
Antworten
  • True
  • False

Frage 40

Frage
The key to the Brief Intervention in the SBIRT, includes all of the following EXCEPT:
Antworten
  • Raise the subject
  • Provide feedback
  • Enhance motivation
  • Negotiate a plan
  • Contract for safety

Frage 41

Frage
A patient in the "Pre-Contemplation" stage has no current intention of changing his or her behavior.
Antworten
  • True
  • False

Frage 42

Frage
In the stages of change outlined by motivational interviewing, what comes after Contemplation (aware a problem exists; no commitment to action):
Antworten
  • Preparation (intent upon taking action)
  • Action (active modification of behavior)
  • Maintenance (sustained change - new behavior replaces old)
  • Relapse (fall back into old patterns of behavior)

Frage 43

Frage
Using the "readiness ruler" motivational strategy, one might address a patient by asking him or her:
Antworten
  • "Are you ready to quit?"
  • "On a scale of 1-10 how ready are you to quit or cut down? And why?"
  • "Who is the ruler of your readiness to quit?"
  • "Are you willing to take any measure it takes to quit?"

Frage 44

Frage
Using the motivational strategy of "decisional balance", what questions might you ask the patient: (Check all that apply)
Antworten
  • What do you like about drinking? What are the pros/positive aspects of drinking?
  • What would you dislike about not drinking – disadvantages?
  • What do you dislike about drinking? What are the cons/disadvantages?
  • What would you like about not drinking? What are the benefits of not drinking?

Frage 45

Frage
What are the elements of a good plan, based on the SBIRT model? (Choose all that apply)
Antworten
  • It reduces harm and/or provides an important learning experience
  • It matches the patient’s level of readiness to change
  • It is concrete, specific, measureable, and realistic
  • It ensures the patient will not use/abuse substances before the next appointment
  • Patient agrees to it and is able to repeat it back to you

Frage 46

Frage
Patients with substance use disorders and/or those who need additional assistance with problematic use often require referrals to specialty care.
Antworten
  • True
  • False

Frage 47

Frage
Which of the following are important factors to consider when making a referral for treatment?
Antworten
  • Past treatment history, what worked, what didn't, and why.
  • Inpatient vs. outpatient
  • Insurance/ability to pay
  • Patient's worries regarding treatment
  • All of the above are important

Frage 48

Frage
When making a referral for treatment, you should reassure the patient that you won’t abandon them, regardless of how treatment turns out.
Antworten
  • True
  • False

Frage 49

Frage
The largest promise of the SBIRT approach lies in which patient population?
Antworten
  • At-risk pts w/out current SUD
  • Chronic risk pts w/ recurrent SUD
  • Medical pts w/ co-morbid SUD
  • Dual-diagnosis pts w/ mental illness & SUD

Frage 50

Frage
Controlling for environmental influences, everyone is born with the same risk of developing SUDs.
Antworten
  • True
  • False

Frage 51

Frage
What's your Holmes Stress Scale right now?
Antworten
  • 261
  • 300+
  • You do NOT want to know...
  • Mental math stresses me out.
  • AHHHHHHHHHHHHHHHHHHH!

Frage 52

Frage
Protective factors increase resiliency.
Antworten
  • True
  • False

Frage 53

Frage
What is the most common cause of secondary HTN?
Antworten
  • ETOH
  • Cocaine
  • TOB
  • PA school

Frage 54

Frage
Name that SUD! PE: pt w/ RUQ or mid-gastric pain, HTN and/or tachycarida, and a slight tremor.
Antworten
  • ETOH
  • Opiods
  • Sedative/hypnotics/anxiolytics
  • Stimulants
  • Marijuana

Frage 55

Frage
Name that SUD! PE: mydriasis, malnutrition/weight loss, tachycarida, and poor hygiene.
Antworten
  • ETOH
  • Opioids
  • Sedative-hypnotic/anxiolytic
  • Stimulant
  • Marijunana

Frage 56

Frage
Name that SUD! PE: pt w/ flu-like sxs, nodding off during exam, murmur of SBE.
Antworten
  • ETOH
  • Opioids
  • Sedative-hypnotic/anxiolytics
  • Stimulants
  • Marijuana

Frage 57

Frage
Name that SUD! Labs: pt w/ elevated MCV, LFTs (especially GGT), and glucose
Antworten
  • ETOH
  • Opioids
  • Stimulants
  • Sedative-hypnotic/anxiolytics
  • Marijuana

Frage 58

Frage
Name that SUD! Labs: pt w/ elevated LFTs due to HCV, seropostive for STDs.
Antworten
  • ETOH
  • Opioids
  • Stimulants
  • Sedative-hypnotic/anxiolytics
  • Marijuana

Frage 59

Frage
While abstinence is recommended, a pt w/ mild to moderate SUD may be able to return to "normal" use.
Antworten
  • True
  • False

Frage 60

Frage
Abstinence is necessary for pts for pt's w/ a hx of moderate to severe ETOH, sedative hypnotic/anxiolytic, and stimulant SUDs; however, abstinence is rarely an effective strategy for pts w/ a hx of opioid SUD.
Antworten
  • True
  • False

Frage 61

Frage
Which of the following may be indications for inpatient substance abuse tx?
Antworten
  • medical complications (e.g. h/o seizures in withdrawal)
  • unstable living environment
  • risk of loss of job, marriage, etc.
  • All of the above

Frage 62

Frage
While abstinence is worth a try if the patient is motivated; less than 10% remain abstinent and in recovery from opioid SUDs.
Antworten
  • True
  • False

Frage 63

Frage
What is the treatment of choice for opioid SUDs if long-term abstinence is not achieved?
Antworten
  • Specialized long-term inpatient care (e.g. residential treatment)
  • Narcotics Anonymous (NA)
  • Cognitive Behavioral Therapy (CBT)
  • Medication Assisted Treatment (MAT)

Frage 64

Frage
Medication Assisted Treatment (MAT) for Opioid Dependence includes which of the following medications? (Check all that apply)
Antworten
  • Methadone
  • Buprenorphine (e.g. Suboxone, Subutex, Zubsolv, Bunavail)
  • Naltrexone (ReVia, Vivitrol)
  • Modafinil (Provigil)
  • Acamprosate (Campral)

Frage 65

Frage
Which of the following are benefits of methadone tx for opioid dependence? (Check all that apply)
Antworten
  • Long-acting full agonist opioid (T½  24 hours)
  • Blockade (“pseudo-blockade”): No effect if use opioids
  • Relatively inexpensive
  • Easily available by Rx
  • Relatively few drug-drug interactions

Frage 66

Frage
Which of the following are disadvantages of methadone tx for opioid dependence? (Check all that apply)
Antworten
  • Incomplete relief of withdrawal or craving
  • Potential for sedation if dose too high, or if taken with benzodiazepine
  • Potential for lethal overdose
  • Must be discontinued when opioid analgesics needed
  • Relatively Expensive

Frage 67

Frage
Which of the following are advantages of buprenorphine tx for opioid dependence? (Check all that apply)
Antworten
  • No potential for overdose even at extremely high doses, due to “ceiling effect” (unless a large dose is combined with a large dose of benzodiazepine)
  • No sedation
  • Easily available by Rx
  • Relatively inexpensive
  • Very few drug-drug interactions

Frage 68

Frage
Which of the following are disadvantages of buprenorphine tx for opioid dependence? (Check all that apply)
Antworten
  • Occasional treatment failures
  • Multiple drug-drug interactions
  • Must visit clinic for daily dose
  • Very expensive if patient does not have insurance ($250-800 mo)
  • incomplete relief of withdrawal or craving (rare)

Frage 69

Frage
Methadone is the strongly and unanimously recommended treatment of choice for pregnant women to reduce risk of complications
Antworten
  • True
  • False

Frage 70

Frage
Since the Drug Abuse Treatment Act of 2000 (DATA 2000), PAs can now Rx Buprenorphine for Office-Based Opioid Treatment (OBOT).
Antworten
  • True
  • False

Frage 71

Frage
Suboxone, a sublingual film and combination of buprenorphine and naloxone, is specifically formulated to prevent abuse and associated overdose.
Antworten
  • True
  • False

Frage 72

Frage
Buprenorphine, sublingual tablets without naloxone, is available, primarily for pregnant women and rare patients who have sensitivity to naloxone.
Antworten
  • True
  • False

Frage 73

Frage
Naltrexone benefits in MAT for Opioid Dependence (Check all that apply)
Antworten
  • Long-acting pure opioid antagonist (PO T½ = 4h for parent drug (13h for active metabolite)
  • once a day PO dosing
  • Preferentially displaces opioids at receptors, blocking all opioid effects (i.e. if patient uses opioids, they have no effect)
  • available as monthly IM injection
  • Generally good compliance rates

Frage 74

Frage
Naltrexone disadvantages in MAT for Opioid Dependence (Check all that apply)
Antworten
  • Need to monitor LFTs due to hepatic toxicity (rare)
  • Notoriously poor compliance with PO tabs
  • Must be discontinued when opioid analgesics needed (e.g., surgery; compare to buprenorphine)
  • IM injections are extremely expensive ($800-1200mo) if not covered by insurance
  • Unreliable mechanism of action; can result in accidental OD

Frage 75

Frage
Naltrexone advantages in MAT for ETOH Dependence (Check all that apply)
Antworten
  • Impedes activation of endorphins and enkephalins (endogenous opioid reward system) by alcohol
  • Reduces craving for alcohol
  • Causes sickness in pts that use ETOH to disincentivize relapse
  • Reduces euphoria if alcohol is consumed
  • Better compliance rate with PO dosing than when using for opioid dependence (even better efficacy w/ IM injections)

Frage 76

Frage
This drug (used in MAT for ETOH dependence) interrupts the metabolism of ethanol, resulting in accumulation of acetaldehyde that causes acute illness with potential sxs of nausea, vomiting, hypotension, facial flushing, tachycardia and palpitations, anxiety, chest pain, SOB, headache.
Antworten
  • naltrexone
  • disulfiram
  • acamprosate
  • modafinil

Frage 77

Frage
Studies have shown disulfiram (antabuse) to be no better than placebo in the tx of ETOH dependence.
Antworten
  • True
  • False

Frage 78

Frage
For some people, drinking alcohol causes an increase in glutamate and corresponding decrease in GABA in the CNS, which is associated with feeling anxious, restless, ill-at-ease. This drug enhances GABA and modulates glutamate, thereby restoring a healthy balance in CNS.
Antworten
  • naltrexone
  • disulfiram
  • modafinil
  • acamprosate
  • buprenorphine

Frage 79

Frage
Which of the following are used in MAT for Cocaine Dependence? (Check all that apply)
Antworten
  • disulfiram
  • modafinil
  • baclofen
  • naltrexone
  • buprenorphine

Frage 80

Frage
Addiction is a chronic, relapsing and remitting, illness, and like other chronic diseases (e.g. diabetes, HTN), there is no cure - only effective treatment.
Antworten
  • True
  • False

Frage 81

Frage
Relapse is a normal, expected part of the recovery process.
Antworten
  • True
  • False

Frage 82

Frage
Recovery from SUDs is:
Antworten
  • usually a single event in time during treatment in which a pt finally makes a conscious effort to fully and completely abstain from use
  • a process where, over time, a person has shorter, less frequent episodes, and longer periods of sobriety in between
  • not possible, because addiction is a lifelong disease
  • unlikely to occur in the vast majority of all SUDs
  • up to the addict, who must inevitably hit "rock bottom" before turning away from substance use/abuse
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