Quiz: Substance Abuse and Dependence

A 24-year-old woman comes to the emergency room because she “can‟t stand the addiction to cocaine anymore.” She tells the physician that she has been using cocaine in increasing amounts for the past 2 years, and now her use is totally out of control. Which of the following systems is involved in this drug‟s capacity for such a high addiction potential in human beings?

A Serotonergic B GABA-ergic C Dopaminergic D Noradrenergic

28-year-old woman is seen for postpartum blues by the psychiatrist. She states she is depressed because she “did this to her child.” The infant has growth retardation, microphthalmia, short palpebral fissures, midface hypoplasia, a short philtrum, a thin upper lip, and microcephaly. Which is the most likely diagnosis of the mother (besides the postpartum blues)?

A Bipolar disorder B Major depression C Hypochondriasis D Alcohol dependence

A 19-year-old man is brought to the emergency room by his distraught parents, who are worried about his vomiting and profuse diarrhea. On arrival, his pupils are dilated, his blood pressure is 175/105 mm Hg, and his muscles are twitching. His parents report that these symptoms started 2 hours earlier. For the past few days he has been homebound because of a sprained ankle, and during this time he has been increasingly anxious and restless. He has been yawning incessantly and has had a runny nose. From which of the following drugs is this man most likely to be withdrawing

A Heroin B Alcohol C Benzodiazepine D PCP

A 50-year-old man is brought to the emergency department by ambulance. His respirations are shallow and infrequent, his pupils are constricted, and he is stuporous. Hewas noted to have suffered a grand mal seizure in the ambulance. On which of the following drug? is this man most likely to have overdosed?

A Cocaine B LSD C An opiate D PCP

After ensuring adequate ventilation for the patient in the previous vignette, which of the following interventions should be next?

A Intravenous naloxone B Intravenous phenobarbitol C Intravenous diazepam D Forced diuresis

. A college freshman, who has never consumed more than one occasional beer, is challenged to drink a large quantity of alcohol during his fraternity house‟s party. In a nontolerant person, signs of intoxication usually appear when the blood alcohol level reaches what range?

A 20 to 30 mg/dL B 100 to 200 mg/dL C 300 mg/dL D 400 mg/dL

. A college freshman, who has never consumed more than one occasional beer, is challenged to drink a large quantity of alcohol during his fraternity house‟s party. In a nontolerant person, signs of intoxication usually appear when the blood alcohol level reaches what range?

A 20 to 30 mg/dL B 100 to 200 mg/dL C 300 mg/dL D 400 mg/dL

0. A 35-year-old man stumbles into the emergency room. His pulse is 100 beats/minute, his blood pressure is 170/95 mm Hg, and he is diaphoretic. He is tremulous and has difficulty relating a history. He does admit to insomnia the past two nights and sees spiders walking on the walls. He has been a drinker since age 19, but has not had a drink in 3 days. Which of the following is the most likely diagnosis?

A Alcohol-induced psychotic disorder B Wernicke psychosis C Alcohol withdrawal delirium D Alcohol intoxication

Which of the following is the most appropriate initial treatment for the patient from the previous vignette?

A Intramuscular halopendol B Intramuscular chlorpromazine C Oral diazepam D Intravenous naloxone

26 year old woman presents to the psychiatrist with 1 month history of severe anxiety. She states that 1 month ago she was “ normal, laid-back person”. Since that time she rates her anxiety as an 8 in a scale of 1 to 10. She notes she is afraid to leave the house unless she checks that the door is locked at least 5 times. Which of the following would most likely cause these kinds of symptoms?

A Alcohol intoxication B Amphetamine withdrawal C Caffeine withdrawal D Cocaine intoxication

A 64-year-old man is admitted to the emergency room after he was witnessed having a seizure on the sidewalk. Postictally, the patient was noted to be agitated and disoriented. Vital signs include: blood pressure 165/105 mm Hg, pulse 120 beats/minute. From the following list, which is the most likely diagnosis?

A Cocaine intoxication B Alcohol withdrawal C PCP withdrawal D Cocaine withdrawal

A 35-year-old man comes to the psychiatrist for treatment of his heroin addiction. He has been an addict for over 6 years, and has been injecting heroin for 5 of those 6 years. Three previous attempts at quitting have all been unsuccessful. Which of the following medications is the best option for this man?

A Methadone B Buprenorphine C Levomethadyl D Naltrexone

A 13-year-old girl is brought to the emergency department by her mother because the girl thinks she is “going crazy.” The girl states that at a friend‟s party several hours previously she was given a white tablet to take, which she did. She is now agitated and restless and convinced that she canfly. She also notes that she is having visual, auditory, and tactile hallucinations. On examination, she is noted to have tachycardia, tremors, hypertension, and mydriasis. Which of the following substances did she most likely ingest?

A Cannabis B Cocaine C LSD D Heroin

The essential features of Somatoform Disorders are the following except?

A Somatic complaints must include GIT symptoms B No physiological mechanisms to explain the patient's complaint. C Associated psychological factors account for the presenting syndrome. D Presence of physical or somatic complaints without any demonstrable organic findings.

The following are considered as types of Somatoform Disorders Except?

A Hypochondriasis. B Somatoform pain disorder. C Somatization disorder. D Somatic delusions.

The following is the somatoform disorder that have equal incidence in both sexes:

A Somatoform pain disorder. B Hypochondriasisbody dysmorphire. C Conversion disorder. D Somatization disorder.

As regard to conversion disorder the following are true except:

A One of the main features is that the patient is not disturbed or concerned about his symptoms. B b The production of such symptoms is voluntary due to conscious mechanisms. C Clinical examination and investigations reveal no organic lesion. D There are one or more symptoms affecting voluntary motor or sensory function.

The following are a psychological factor that contribute to Somatoform Disorders except:

A Hypersensitivity to bodily functions and sensations and low threshold for pain or physical discomfort. B Pre-morbid personality disorder is not related to C the development of the disorder. c. Suppression of anger towards others with turning of anger towards self. D Repression of wishes or impulses expressed through body complaints.

The essential features of Body dysmorphic disorder is all of the following except:

A If a slight physical anomaly is present, the person concern is grossly excessive. B The belief is of delusional intensity, as in delusione disorder (somatic type). C Complaint is out of proportion to any minor objective physical abnormality. D Patients complain of defect, e.g. wrinkles, hair loss, too small breast or penis, aging spots, short stature.

The best treatment strategy for Body dysmorphic disorder includes the following:

A Treatment with serotonergic drugs (SSRIs) effectively reduces symptoms in at least 50% of patients. B Dermatological procedures give the best results C Plastic surgery to correct the problem. D Electroconvulsive therapy is the most effective in 80% of cases.

The following are true as regard to hypochondriasis:

A The belief is of delusional intensity B The disturbance lasts at least one weak. C Clinical examination and investigation reveal some. abnormalities. D Men and women are equally affected.

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