final exam 6630

final exam 6630

Question 5

 

What is the difference between Ritalin and Focalin?

 

Focalin is a D-isomer

 

Ritalin is the D-isomer

 

Focalin is the S-isomer

 

There is no difference other than the formulations involved.

Question6.

Select the correct description of a somatoform disorder.

 

Somatization disorder – manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical disorder

 

Conversion disorder – pain that causes significant impairment in occupation or social function, induces marked distress, or both

 

Hypochondriasis – persistent belief that one has a serious illness, despite extensive medical evaluation

 

Pain disorder – intentional production or feigning of physical symptoms

Question 7

 

This medication cannot be used for more than 5 days, it is a non-steroidal, anti-inflammatory drug, and it is often substituted for morphine due to its rapid onset and high potency. What is this medication?

 

Naproxen

 

Ketorolac

 

Sulindac

 

Etodolac

Question 8

 

Select the correct description of a somatoform disorder.

 

Somatization disorder – manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical disorder

 

Conversion disorder – pain that causes significant impairment in occupation or social function, induces marked distress, or both

 

Hypochondriasis – persistent belief that one has a serious illness, despite extensive medical evaluation

 

Pain disorder – intentional production or feigning of physical symptoms

Question 9

 

Which of the following psychiatric conditions is present in both domains (i.e., core psychopathology & pain-related psychological symptoms) of chronic pain that will likely lead to an outcome of disability, pain, and poor quality of life?

 

Major depression

 

Personality disorder

 

Anger

 

Anxiety

Question 10

 

Which of the following drugs in the treatment of Alzheimer’s Disease requires administration with food?

 

Memantine

 

Donepezil

 

Rivastigmine

 

Galantamine

 

 

2 points

 

 

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Question 11

 

Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class?

 

It is mainly metabolized by the enzyme carboxylesterase once absorbed.

 

It does not undergo first-pass metabolism by the enzyme carboxylesterase in the liver.

 

It can be cut up and sprinkled onto food so it can bypass first-pass metabolism in the liver.

 

It uses an osmotic releasing oral system technology to slowly deliver the drug to the enzyme carboxylesterase in order to make the drug last longer.

Question 12

 

Disorientation, tremor, hyperactivity, fever, hallucinations, marked wakefulness, and increased autonomic tone are all features that are consistent with which part of alcohol withdrawal?

 

Alcohol withdrawal seizures

 

Korsakoff’s Psychosis

 

Wernicke’s encephalopathy

 

Alcohol withdrawal delirium

Question 13

 

Disulfiram has been proven effective in the treatment of alcoholism, but recently it has been trialed in the management of cocaine addiction. What is the mechanism of action that likely helps produce these aversive effects?

 

Inhibition on dopamine beta-hydroxylase

 

Inhibition on aldehyde dehydrogenase

 

Inhibition on alcohol dehydrogenase

 

Inhibition on aldehyde reductase

 

 

2 points

 

Question 14

 

Choose the correct statement regarding an anti-ADHD medication and its respectful mechanism of action

 

Methylphenidate – blocks reuptake of dopamine in the pre-synaptic neuron and promotes release of dopamine from their storage sites in the pre-synaptic neuron

 

Amphetamines – blocks reuptake of norepinephrine and dopamine into presynaptic neurons

 

Clonidine – blocks reuptake of dopamine in the pre-synaptic neuron and promotes release of dopamine from their storage sites in the pre-synaptic neuron

 

Atomoxetine – acts by blocking the norepinephrine pump on the pre-synaptic membrane

 

Guanfacine – blocks reuptake of norepinephrine and dopamine into presynaptic neurons

 

 

2 points

 

Question 15

 

Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice?

 

Venlafaxine

 

Ketorolac

 

Duloxetine

 

Gabapentin

 

 

2 points

Question 16

 

Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium?

 

Naltrexone

 

Haloperidol

 

Propofol

 

Chlordiazepoxide

 

 

2 points

 

 

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Question 17

 

Which club drug is structurally similar to GABA?

 

3,4 – methylendedioxy-methamphetamine

 

Ketamine

 

γ-hydroxybutyrate

 

Ecstasy

 

 

2 points

 

Question 18

 

FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way.

 

Norepinephrine

 

Serotonin

 

Dopamine

 

Acetylcholine

 

 

2 points

Question 19

 

  1. R. is a 35-year-old woman who presents to your clinic today complaining of ankle pain. She said she was running the trail when she saw a snake. During a quick turn to run away from the snake, she twisted her ankle. Which of the following medications may be a good choice in helping Y. R. with her pain?

 

Oxycodone

 

Amitriptyline

 

Ibuprofen

 

Duloxetine

Question 20

 

Which of the following alcohol screening tools lack sensitivity to detect hazardous/problem drinking?

 

AUDIT

 

AUDIT-C

 

SASQ

 

Question 21

CAGE

SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect.

 

True

 

False

Question 22

 

A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time?

 

Recommend doing a full evaluation to distinguish if this patient is presenting with ADHD symptoms or depressive symptoms

 

Begin a stimulant at appropriate dose once patient’s weight is known

 

Refer to a behavioral counselor

 

Begin an SSRI at lowest initial dose and provide counseling on the increased risk of suicide during the first few months of therapy

 

 

2 points

 

Question 23

 

When can buprenorphine be initiated in a patient who is suffering from an opioid overdose?

 

As soon as the patient is stabilized

 

It should be administered as soon as you find the patient unconscious

 

Right after naloxone is administered to prevent the patient from going back into opioid overdose

 

When the patient is experiencing mild-to-moderate symptoms of withdrawal

 

 

2 points

Question 24

 

Choose the correct statement regarding medications used for alcoholism

 

Disulfiram: NMDA receptor antagonist & GABAA agonist

 

Naltrexone: µ-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol

 

Acamprosate: enhances the effect of the inhibitory neurotransmitter gamma-aminobutyric acid on the GABA receptors by binding to a site that is distinct from the GABA binding site in the central nervous system.

 

Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of acetaldehyde

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