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NU665 - Exam 1 with precise detailed answers
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Mild SUD MODERATE SEVERE early remission sustained remission - Correct answer ✔2-3 sx 4-5 SX 6 or more sx no criteria except cravings for at least 3 mos. and < no criteria except craving for >12 mos pulsatile release pattern - Correct answer ✔release of extended release drugs I.e. stimulants false sense of security-still able to be misused I.e. stimulants
how do you resensitize drug receptors for pleasurable effects? - Correct answer ✔substance needs to be withdrawn-leads to cravings when are nicotinic receptors desensitized - Correct answer ✔time that one cigarette is finished resensitized in ~45 mins most commonly abused substances (in order) most commonly USED substance - Correct answer ✔alcohol-tobacco-MJ (in that order) caffeine onset of caffeine w/d sx peak resolution - Correct answer ✔12-24 hrs peak 24-48 hrs resolution 1 week nicotine w/d sx onset peak duration - Correct answer ✔onset 2 hrs peak 24-48 hrs last weeks-months
what percent of people w/ OUD have another psychiatric d/o? - Correct answer ✔90% what percent of people with OUD will attempt suicide at least once? - Correct answer ✔15% fatal withdrawals - Correct answer ✔ETOH BZDs heroine w/d onset and peak methadone w/d onset and peak - Correct answer ✔1. 6-8 hrs, 2-3 days, resolves 7-10 days
onset hrs after last use hallucinogen intoxication sx - Correct answer ✔synesthesia (see sounds, taste words etc) hallucinations illusions hallucinogen persisting perception disorder - Correct answer ✔"flashbacks" that occur in 15-80% of users DSM- solvents volatile substances - Correct answer ✔other names for inhalants MAT options - Correct answer ✔naltrexone (opioid antagonist) methadone (opioid agonist) Suboxone (partial agonist) subutex (bup only) goals of MAT - Correct answer ✔1. reduce adverse effects of OUD (relapse, crime, death)
nucleus accumbens (pleasure center) the brains pleasure center - Correct answer ✔nucleus accumbens-dopamine powerhouse Counteradaptation - Correct answer ✔initial positive reward feelings are followed by development of tolerance-greater amounts of substance are needed to achieve diminishing levels of positive rewards SBIRT - Correct answer ✔Screening, Brief Intervention, and Referral to Treatment SAMHSA PRINCIPLES OF MOTIVATIONAL INTERVIEWING - Correct answer ✔Change talk roll with resistance-avoid challenging person's resistance and accept ambivalence contingency management in SUD treatment - Correct answer ✔behavioral reinforcement based approach w/in CBT model accountable care organizations - Correct answer ✔groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients medicare pts get right care at right time and she in the cost savings
what is the mainstay of integrated care settings? - Correct answer ✔screenings (medical and mental health) what are 2 new services in collaborative integrative care model - Correct answer ✔1. BH care manager
when does paraphilia become paraphilia d/o? - Correct answer ✔when criteria B -harm to self or others is met what must you differentiate from paraphilia d/o's? - Correct answer ✔1. non pathological sexual fantasies (most important)
doesn't include individuals in late adolescence in relationship w 12 or 13 YO autogynephilia - Correct answer ✔Sexual arousal of genital male associated with the idea or image of being a woman. new subcategory of pedophilia - Correct answer ✔infantophilia who is most vulnerable to paraophilic d/o's? - Correct answer ✔personality d/os with low self esteem, anger management, low empathy, delaying gratification fewer than ___% of sex offenders in US have sexual sadism d/o ___% of those that have committed sexually motivated homicides have d/o - Correct answer ✔10 % 35-75% poor prognosis for pharaphilic d/o's - Correct answer ✔1. early onset
elevated HTN: stage 1 stage 2 - Correct answer ✔normal: <120/< elevated: 120-129/< stage 1: 130-139 or diastolic 80- stage 2: >/=140 or diastolic at least 90 HTN medications - Correct answer ✔thiazides, ACEI's, ARBs, CCB BB no longer many now only CAD, post MI, HF etc people with high cholesterol have ___ the risk for heart disease - Correct answer ✔twice the risk dyslipidemia screening criteria - Correct answer ✔NIH: all ages 9-11 and again at 17-21 YO adults: age 20 then q5 years criteria to perform full lipid panel on no cardiac risk factors lipid panel vs cardiac risk factors - Correct answer ✔1. total-C >
what is a possible side effect of statins - Correct answer ✔myalgias -weak/achy sx DM risk factors - Correct answer ✔1. >45 YO
pre dm diabetes - Correct answer ✔1. <
what are you looking for in UA in diabetes pt - Correct answer ✔ketones protein what is first sign of kidney disease - Correct answer ✔protein in urine UTI positive urine - Correct answer ✔leukocytes and nitrates DM meds - Correct answer ✔biguanides GLP-1 (metformin) SGLT-1/2 (glucoseuria caused) DPP4 (genuvia-watch high tryglycerides and don't want pancreatitis) BMI underweight normal overweight obese - Correct answer ✔1. <18.
new addiction in DSM5 - Correct answer ✔gambling 2 neurobiological processes of addiction - Correct answer ✔1. reinforcements-DA reward center
primary care in BH settins - Correct answer ✔health homes universal screenings navigators (nurses, SW_ fiscal integration STABLE project - Correct answer ✔standard for bipolar excellence project -identification and management of bipolar d/o what does stable resource kit include - Correct answer ✔1. 2 depression screening tools
