Substance Use/Addiction
What is carfentanil?
Synthetic opioid 10,000 times more potent than morphine and 100 times more potent than fentanyl
How do bulimia and binge-eating disorder differ?
Both involve eating significantly more food than most individuals would eat in a similar period of time, bulimia involves compensatory actions afterwards such as forcing yourself to vomit
How is Parkinson's diagnosed?
medical history and neurological evaluation- no definitive lab test
What is functional neurological disorder?
Symptoms of altered voluntary motor or sensory function that cannot be explained by a neurological or other medical condition or another mental health disorder
If a patient with alcohol presents with impaired consciousness give ________ to prevent/treat _________ ___________
thiamine; Wernicke's encephalopathy
What is the short acting benzo for sleep? What type of issue would it likely be used for?
triazolam (Halcion); sleep onset issues
What are the three main types of opioids?
How do ARFID and anorexia differ?
Both involve restricted food intake, but ARFID doesn't involve any distress about body shape/size or fears of fatness
What is the most common early symptom of Alzheimer's?
difficulty remembering newly learned information, events, or conversations
What is the most common dissociative disorder? What is the treatment?
Dissociative amnesia; treated with psychotherapy and sometimes medication
What two non-nicotine medications are available for smoking cessation?
Varenicline (Chantix) and Bupropion (Zyban)
What is the mechanism of action of Ramelteon (Rozerem)?
melatonin agonist
What is xylazine?
non-opioid veterinary tranquilizer, CNS depressant
What two medication classes can be used to treat anorexia nervosa?
SSRIs and antipsychotics
How do Alzheimer's disease and vascular neurocognitive disease present differently?
Vascular dementia tends to involve speed of thinking and problem solving rather than memory loss
What are the two elements of Depersonalization Disorder?
Depersonalization and Derealization
What medication class should not be used in cocaine intoxication? Why?
beta blockers; unopposed alpha stimulation will cause coronary artery vasoconstriction
Which two medications are first line treatment for restless leg syndrome? What is their mechanism of action?
pramipexole (Mirapex) and ropinirole
The screening tool to identify alcoholism is known as the ________ _______. The tool to determine usage, willingness to change, and make treatment recommendations is the _____ ________. The evaluation tool for alcohol withdrawal is the _______ _____
CAQE questionnaire; Sassi inventory; CIWA scale
What is rumination disorder? What medication should these patients be started on?
What are the two "disturbances" required for diagnosis of delirium?
disturbance in attention and awareness
disturbance in cognition
What is the difference between type 1 and type 2 narcolepsy?
1 occurs with cataplexy
2 without cataplexy
How do benzos and barbiturates respectively affect GABA/chloride channels?
Benzos: increase number of channels open
Barbituates: increase time existing channels are open
Which antidepressant is approved for insomnia? What class is it and what is its mechanism of action?
doxepin (Silenor); works through antihistaminic properties
1- 8 hours after last drink; anxiety, insomnia, nausea, abdominal pain, HTN
2- 24-72 hrs; HTN, increased body temp + heart rate, confusion, hallucinations with insight
3- 72+ hours; hallucinations without insight, fever, seizures, agitation
Enuresis is repeated voiding of urine into bed or clothes with chronological age of at least _____ years
Encopresis is repeated passage of feces into inappropriate places with chronological age of at least ____ years
5; 4
What are the six cognitive domains?
complex attention, executive function, learning and memory, language, perceptual motor, social cognition
What is the difference between hypersomnolence disorder and narcolepsy?
Hypersomnolence is excessive sleepiness at least 3x per week despite having 7 hours of sleep. Narcolepsy is the irrepressible need to sleep/lapsing into sleep at inappropriate times
What is the mechanism of action of disulfiram?
blocks aldehyde dehydrogenase which leads to increased levels of acetaldehyde causing nausea, vomiting, chest pain with alcohol intake
What are the three orexin receptor antagonists?
suvorexant (Belsomra); Lemborexant (Dayvigo); Daridorexant (Quvivig)