Problems of Addiction

(questions are worded poorly, be sure to bring it to the profs attention so that the class can get the free point)
1. What is the definition of addiction?
a. use of any drug, usually by self-administration
b. the repeated use of a drug or chemical substance, with or without physical dependence
c. a reversible syndrome caused by a specific substance
d. neurochemical or neurophysiologic changes in the body that result from the repeated
administration of a drug

2. Which of the following state markers are useful in screening for alcoholism?
a. GGT
b. MCV
c. uric acid
d. triglycerides
e. all of the above

3. Which his the most often drug that is used in delirium tremens
a. chlordiazepoxide
b. olanzapine
c. acamprosat
d. diazepam
e. haloperidol

4. What statement is incorrect?

a. males are significantly more likely to use alcohol than females
b. the age group that consumes the most alcohol is the group in ages ___
c. alcohol-related disorders are more often present in high socioeconomic classes
d. antisocial personality disorder is very often in comorbidity (dual diagnosis with alcohol-
related disorders)
e. prevalence of suicide among alcohol-related disordered patients range ____

5. Please circle the correct statement

a. cocaine is the strongest natural stimulant
b. physiological effects of cocaine can be stroke or heart attack

c. paranoia and auditory hallucinations are often seen as a __

d. neuroadaptation is a defensive reaction toward cocaine
e. all of the above is correct

6. Typical symptom of alcohol dependence is NOT

a. craving for alcohol
b. ability to reduce or stop alcohol consumption
c. withdrawal symptoms upon stopping
d. increased tolerance of alcohol
e. auditory hallucinations

7. Which of the following symptoms are NOT associated with the short-term effects of
benzodiazepines?
a. confusion
b. dizziness
c. relaxation
d. auditory hallucinations
e. mood swings

8. For disulfiram (Antabuse) the following state is NOT correct

a. it is useful temporarily to help establish a long-term pattern of abstinence
b. when even small amounts of alcohol are taken it leads to ____
c. disulfiram stimulate aldehyde dehydrogenase
d. its usual dosage is 250 mg/day
e. life-threatening complications, although uncommon, can ____

9. The statement which is NOT true, for consuming marijuana

a. illusions and hallucinations occur often
 b. appetite is increased
c. there is increased risk for various lung diseases
d. immune system is often reduced
e. reduces mental abilities when using for a long time

10. What is INCORRECT about Wernicke encephalopathy?

a. is an acute syndrome caused by thiamine deficiency
b. ataxia is not very often seen in this syndrome
c. it is treated with 100-300 mg of thiamine per day
d. magnesium can be very useful in treatment of this syndrome
e. the syndrome may progress to Korsakoff syndrome

11. Diagnostic criteria for amphetamine intoxication is NOT

a. tachycardia
b. bradycardia
c. nausea
d. psychomotor agitation
e. weight gain

12. In opioid-related disorder

a. heroin is the most widely used opiate in persons with opioid dependence
b. the most common and most serious adverse effect is the potential transmission of hepatitis
and HIV
c. naloxone is an opiate antagonist
d. A+C are corredct
e. all of the above are correct

13. Opioid withdrawal does not include

a. rhinorrhea
b. severe muscle cramps and bone aches
c. hypotension
d. piloerection or gooseflesh cold turkey
e. irritability

14. Scientifically proven treatments for smoking is NOT

a. nicotine patch
b. nicotine inhaler
c. atypical antipsychotic in small dosages
d. buproprion
e. behavior therapy

15. Which statement for flumazenil is correct?

a. it is a benzodiazepine antagonist used to reverse the effects of benzodiazepine receptor
agonist in overdose
b. it is used in clinical situations such as sedation or anesthesia
c. the usual regimen is to give 0.2mg IV over 30 sec
d. its duration is from 1-5 hr
e. all of the above is correct

16. Which of the following statement for delirium tremens is incorrect?

a. it occurs after 5-15 years of heavy drinking
b. it can start with epileptic seizure
c. diazepam is used for pharmacotherapy
d. hallucinations does not occur in delirium tremens
e. patients can harm themselves or others

17. Which of the following scales is commonly used in detecting alcoholism?

a. CAGE
b. PANISS
c. MADRS
d. HAM-D
e. None of the above

18. Primary insomnia is treated with

a. lorazepam
b. SSRIs
c. zolpidam (for a short period of time)
d. diazepam
e. promazine

19. Which of the following drugs are often used in the treatment of delirium tremens
a. benzodiazepines
b. vitamins
c. antihypertensive agents
 d. A+B+C are correct
e. nothing is correct

20. All of the statements regarding factors influencing drug use and dependence are true except
a. Some psycho formulations relate substance use and substance dependence to inability to
deal with reality (disturbed ego function)
b. Association with genes affecting dopamine production has been postulated in substance
abuse and substance dependence
c. person with a completely normal endogenous opioid receptor functions and
neurotransmitter concentration is believed not to be susceptible to development of
opioid dependence
d. major neurotransmitters thought to be involved in development of substance abuse and
substance development are the opioid, catecholamine, and GABA systems
e. Learning and conditioning phenomena in substance dependence can be superimposed on
preexisting psychopathology, but preexisting difficulties are not required for the
development of powerfully reinforced substance seeking behavior

21. Of the following statements regarding epidemiology of alcohol-related disorders, which is false?
a. men are much more likely than women to be heavy drinkers and binge drinkers
b. binge alcohol use rates are similar across all different levels of education
c. alcohol-related disorders appear among persons of all socioeconomic classes
d. about 70% of adults with college degrees are current drinkers, compared to 40% of adults
with less than a high school education
e. none of the above

22. How many hours after cessation of drinking does tremulousness as a part of the alcohol withdrawal
syndrome usually develop?
a. 1 to 2 hrs
b. 6 to 8 hrs
c. 12 to 24 hrs
d. after 24 hrs
e. immediately within the first few minutes after drinking cessation

23. The following medications have not been used to control symptoms of alcohol withdrawal
a. benzodiazepines
b. clonidine
c. antidepressants
d. carbamazepine
e. beta adrenergic receptor antagonists

24. Which of the following statements s true about alcohol withdrawal delirium?
a. In the treatment of delirium tremens antipsychotic medication should be avoided
b. alcohol widthrawal delirium can result in significant morbidity, but usually has low mortality of
about 5% for untreated delirium tremens
c. Withdrawal seizures never precede the withdrawal delirium
d. unlike visual hallucinations, tactile hallucinations are not very common
e. symptoms of alcohol intoxication delirium include autonomic hypoactivity and psychomotor
lethargy

25. Treatment of opioid related disorders does not include

a. opioid agents for treatment of opioid withdrawal
b. opioid antagonists
c. mood stabilizers for treatment of opioid intoxication
d. psychotherapeutic approaches
e. therapeutic communities

26. opioid withdrawal symptoms include the following

a. severe muscle cramps and bone aches
b. papillary constriction
c. profuse diarrhea
d. A+C
e. A+B+C

27. Which of the following is not caused by cannabis use?

a. respiratory disease and lung cancer
b. respiratory center inhibition
c. anxiety
d. cognitive impairment
e. paranoid ideation

28. Which of the following statements is true regarding cocaine use?

a. cocaines primary pharmacodynamic action related to its behavioral effects is blockade of
serotonin transporters reuptake function
b. cocaine abuse is not associated with seizures
c. almost all cardiac abnormalities, except myocardial infarction, can be seen as a result of
 cocaine use
d. the behavioral effects of cocaine are felt after 30 minutes and can last for up to several
hours
e. in case of cocaine withdrawal, no pharmacological agents reliably reduce the
intensity of withdrawal symptoms

29. Which of the following statements regarding nicotine use is false?

a. Nicotine is believed to produce its positive reinforcing and addictive properties by activating
dopaminergic pathways
b. in contrast to its stimulatory CNS effect, nicotine also acts as a skeletal muscle relaxant
c. along with other effects, nicotine use is associated with a decrease in REM sleep

d. all nicotine replacement therapies double cessation rates

e. none of the above

30. According to the DSM-IV-TR which of the following is not a Caffeine-Related Disorder:
a. caffeine-induced anxiety disorder
b. caffeine-induced sleep disorder
c. caffeine-induced psychotic disorder
d. caffeine intoxication
e. all of the above are Caffeine- Related Disorders

31. For the Inhalant-Related Disorders it is NOT true

a. there is a high use of inhalants among poor people
b. inhalants act as a central nervous system (CNS) depressants
c. withdrawal symptoms are not classified as a disorder in DSN-IV-TR
d. sedative drugs are used in every day practice as a first line agent in treatment
intoxication
e. for the adolescents with combined substance dependence, day treatment and residential
programs are often very useful
32. Which of the statements is correct for Phencyclidine (PCP)?
a. PCP is an antagonist of the NMDA subtype glutamate receptors
b. PCP is an agonist of the NMDA subtype glutamate receptors
c. it does not affect NMDA subtype glutamate recptors
d. PCP deactivates the dopaminergic neurons of the ventral tegmental area (VTA)
e. because of PCPs action on CNS receptors, physical dependence occurs very often

33. Which of the statements is INCORRECT for the use of anxiolytic or sedation-hypnotic drugs
a. sedatives and anxiolytics produce sleep in smaller dosages
b. hypnotics in lower doses can produce daytime sedation
c. the age group with hightest lifetime prevalence of sedative use is ages 26-34
d. anxiolytics, sedatives, and hypnotics induce tolerance and physical dependence
e. females use the drugs more often than men

34. Which of the following is not connected with the sedative, hypnotic, or anxiolytic withdrawal
a. increased hand tremor
b. anxiety
c. depression
d. grand mal seizures
e. transient hallucinations or illusions

35. What can we see shortly after hallucinogen use? (this question was taken out b/c by the book it
would be A+B)
a. depersonalization
b. tachycardia
c. bradycardia
d. A+C is correct
e. all of the above

36. Which is correct for the epidemiology of amphetamine use?

a. amphetamine use occurs in higher socioeconomic groups
b. amphetamine use occurs in lower socioecomonic groups
c. amphetamine use occurs in all socioeconomic groups
d. the highest rates of the amphetamine groups is amont 25-35 year olds
e. the lifetime prevalence of the amphetamine dependence and buse is 3%

37. In the treatment of the amphetamine (or amphetamine-like) related disorders in everyday practice
we use:
a. group psychotherapy
b. antipsychotics (especially in first few days)
c. anxiolytics
d. if the patient has a comorbid condition, depression, the use of antidepressants can be useful
e. all of the above
38. Which of the following substances can be related with the substance-related disorders
a. anabolic steroids
b. nitrous oxide
c. nitrite inhalants
d. none of the above
e. all of the above