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Gurpal

Part II ISQ Club - Addiction

43 posts in this topic

Part II ISQs on two topics will be posted twice a week. You are encouraged to post a reply in the thread, stating whether you think an ISQ is true or false and why (eg. a short explanation, with reference to the textbook you used). Please only deal with one ISQ in each post and include the question as the first line of your post. All ISQs are taken from previous posts by Forum members.

In a few days this ISQ Club thread will be moved to the Question Bank board. If you submit an answer, your status will be changed to 'Question Bank member' and you will be able to see the Question Bank board. Please allow up to 48 hours for this change to happen.

JUST 6 WEEKS LEFT UNTIL THE EXAM! OVER 300 POSTS IN THE QUESTION BANK BOARD!

1. LSD intoxication is associated with formication

2. LSD causes physical dependence

3. Ecstasy is associated with a withdrawal state

4. A typical British 12 year old boy is expected to sniff glue within the next 6 months

5. Alcohol detoxification cannot usually be done at home in a 65 year old man

6. On a medical ward, problem drinkers can be identified by plasma viscosity

7. The genetic link between alcohol dependence and depression are determined by gender

8. Confabulation in the elderly most commonly occurs in Korsakoff’s syndrome

9. Maternal deprivation in early childhood predisposes to alcoholism

10. Chronic alcoholism can cause Parkinson's disease

11. In medical inpatients, plasma viscosity can be used as a screening test for problem drinkers

12. Memory for implicit tasks is affected in Korsokoff’s syndrome

13. Benzodiazepines cause dependence after 2 months of treatment

14. Tinnitus is more likely in benzodiazepine withdrawal than generalized anxiety disorder

15. Ataxia is seen in amphetamine use

16. Pantothenic acid leads to Wernickes encephalopathy

17. The onset of Wernicke’s encephalopathy can be chronic

18. In treating dependence, the action stage is easily brought about by discussing the harmful effects of drugs

19. Procyclidine abuse causes visual hallucinations

20. Offences after drinking are reduced by police regularly visiting public houses by midnight

21. MDMA users show hypo-osmolarity

22. One of the questions on the CAGE questionnaire is are you aggressive?

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1) LSD intoxication is associated with formication

False - It is associated with cocaine

2) LSD causes physical dependence

False

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3.Ecstasy is associated with a withdrawal state

False Page 141 Bird,Buckley and Harrison

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5.Alcohol detoxification cannot usually be done at home in a 65 year old man

TRUE

Indications for in patient detoxification include

past history of withdrawal seizures or epilepsy

co morbid severe mental illness

elderly/frail patients

intercurrent acute illness

failed out patients attempts

Core Psychiatry pg 431

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13.Benzodiazepine cause dependence after 2 months of treatment

false

Very few people become dependent with periods of use lessthan 3 months

3-12 months 10%-20% will become dependent

longer than a year 20-45%

Pg 445 Core Psy

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Ans: 18

true

Stages of change: Precontemplation stage--->Contemplation stage--->Action stage--->Maintenance stage--->Relapse.

By using tecniques of motivational interviewing the action stage can be easily brought forward to Maintenance stage as the client is ready for action.

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Q22. One of the questionaire in CAGE is are you aggressive?

Answer is false.

C is recognize need to cut down.

A is annoyed when critizied.

G is guilty about drinking.

E is eye opening drinking.

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6. On a medical ward, problem drinkers can be identified by plasma viscosity

FALSE

Plasma viscosity measured by ESR

MCV useful marker of alcohol dependence.

(Pg 456, Oxford Txt of Psych, 3rd Ed, Gelder et al)

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11. In medical inpatients, plasma viscosity can be used as a screening test for problem drinkers

FALSE

Plasma viscosity measured by ESR

MCV useful marker of alcohol dependence.

(Pg 456, Oxford Txt of Psych, 3rd Ed, Gelder et al)

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18. In treating dependence, the action stage is easily brought about by discussing the harmful effects of drugs

FALSE

Balance sheet of harm & benefits.

Motivational interviewing.

(Pg 351, Comp to Psych St, 6th Ed, Johnstone et al)

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16. Pantothenic acid leads to Wernickes encephalopathy

FALSE

Panthotenic acid aka Vit B5.

Wernickes encephalopathy caused by thiamine deficiency

(Pg 402, Synopsis of Psych, Kaplan & Sadock, 8th Ed)

“Naturally occurring pantothenic acid deficiency in humans is very rare and has been observed only in cases of severe malnutrition.

Pantothenic acid deficiency in humans has been induced experimentally by administering a pantothenic acid antagonist together with a pantothenic acid deficient diet.

Participants in this experiment complained of headache, fatigue, insomnia, intestinal disturbances, and numbness and tingling of their hands and feet.

In a more recent study, participants fed only a pantothenic acid free diet did not develop clinical signs of deficiency, though some appeared listless and complained of fatigue.”

http://lpi.oregonstate.edu/infocenter/vitamins/pa/

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15. Ataxia is seen in amphetamine use

TRUE

(Pg 410, Synopsis of Psy, 8th Ed, Kaplan & Sadock)

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19. Procyclidine abuse causes visual hallucinations

TRUE

(Pg 980, Synopsis of Psy, 8th Ed, Kaplan & Sadock)

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21. MDMA users show hypo-osmolarity

FALSE

Hyperosmolarity

“…MDMA stimulates central nervous system release of serotonin and inhibits serotonin reuptake thus increasing serotonin levels acutely. In animal models serotonin stimulates the release of anti-diuretic hormone. Additionally, a controlled study in humans also demonstrated that acute MDMA administration caused anti-diuretic hormone release. These data strongly suggest that MDMA can indeed cause syndrome of inappropriate antidiuretic hormone secretion.

Almost all causes of hyponatremia (except for psychogenic polydipsia) are associated with anti-diuretic hormone release, and will thus be associated with an elevation in urine osmolarity, regardless of the patient’s extracellular fluid volume status.”

http://www.ijmt.net/3_5/3_5_30.html

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17. The onset of Wernicke’s encephalopathy can be chronic

FALSE

Acute

(Pg 346, Comp to Psych St, 6th Ed, Johnstone et al)

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12. Memory for implicit tasks is affected in Korsokoff’s syndrome

FALSE

“Memory acquisition is impaired, in that there is a disruption of the transfer from working memory to long-term memory, though both of these kinds of memory are still intact. Only explicit memory is impaired; implicit memory is still intact.”

http://courses.umass.edu/psy315h/exam2.htm

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10. Chronic alcoholism can cause Parkinson's disease

FALSE

Korsakoff syndrome

(Pg 450, Oxford Txt of Psych, 3rd Ed, Gelder et al)

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8. Confabulation in the elderly most commonly occurs in Korsakoff’s syndrome

FALSE

Dementia

(Pg 54, Symptoms in the mind, 2nd Ed, Sims)

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RE Q. 21 NMDA users show hypo-osmolarity

I think it is true....

In Core psychiatry p. 443 re deaths from ecstasy :

'causes also included syndrome of inapproptiate ADH secretion, which in combination with excessive attempts by the user to rehydrate him/herself has led to cerebral oedema....'

???

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RE Q. 19. Procyclidine abuse causes visual hallucinations

Probably true

Companion ...p. 139 re procyclidine use:

' ..because they can produce an exacerbation of positive psychotic features...'.

Visual hallucinations are positive psychotic features, although less likely than auditory, hence I think it is true.

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RE Q 16 Pantothenic acid leads to Wernickes encephalopathy

False

There are different reasons for Wernicke but ultimately all of them are connected to Thiamine deficiency

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1. False - it is cocaine that is associated with formication.

2. False - LSD does not cause physical dependence.

3. False - Ecstasy is not associated with a withdrawal state.

4. False - only a small minority of 12 year old boys will sniff glue in the next 6 months.

5. False - while elderly and infirm people should be detoxed in hospital, a 65 year-old man who is reasonably physically well and has had no previous withdrawal seizures etc should have home detox.

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6. False - plasma viscosity is very non-specific and so could not be used as a screening tool for alcohol abuse in a medical ward.  MCV is useful in this case.

7. False - the genetic link between alcohol dependence and depression is not determined by gender.

8. False - confabulation in the elderly is most associated with dementia.

9. False - maternal deprivation in early childhood does not predispose to alcohol problems (Manchester Course).

10. False

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11. False - MCV can be used as screening tool for alcohol problems.

12. False - memory for explicit tasks is affected in Korsakoff's Syndrome.

13. False - BDZs do not usually result in dependence until more long-term use is established, i.e. 10-20% dependent after 3 months.

14. True - tinnitus is more likely in BDZ withdrawal compared with GAD.

15. False - ataxia is not seen in amphetamine abuse. This is more associated with alcohol or BDZ intoxication.

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