MRCPsych Paper B - Substance Abuse (Questions And
Accurate Solutions)
Most suggestive of PCP intoxication (2) Right Ans - Ataxia and Dysarthria
According to National Treatment Outcomes Research Study (NTORS) most
common crime in those with drug dependence Right Ans - Shoplifting
Most effective way to reduce alcohol related harm Right Ans - Raise
minimum price of alcohol
Heavy use of cannabis detectable in urine for Right Ans - 14-28 days
Cannabis increases relative risk of F20 by Right Ans - 2-fold
A patient using 5mg Methadone keen to have treatment to help him avoid
using opiates Right Ans - Naltrexone (opioid receptor antagonist prevents
pleasurable experience of taking opiates)
Regarding opiate abuse, tolerance does not tend to occur with? (2) Right
Ans - Constipation and Miosis
RCPsych recommendation of safe drinking limits per week Right Ans - Men
21 Women 14 (currently 14/14 on NHS UK site)
LSD remains detectable in urine for Right Ans - 1-3 days
Drugs which interfere with G coupled receptors (3) Right Ans - Opioids,
cannabinoids and GHB
3L wine per day (12% ABV) units? Right Ans - 252 units per week
(12x3x7)
Mechanism of Action of Phencyclidine (PCP/Angel Dust) Right Ans - NMDA
receptor antagonist (similar to ketamine)
Mechanism of Action of Acamprosate Right Ans - Structural analogue of
GABA thought to decrease alcohol intake by affecting calcium channels and
, modifying transmission along GABA and glutamine pathways with no abuse
potential
Highest level of binge drinking occurs in ages Right Ans - 16-24
Best time for pregnant female to undergo opiate detoxification regime
Right Ans - 2nd Trimester
Mechanism of Action of Interference of conversion of aldehyde to acetic acid
Right Ans - Disulfiram
Elevate levels of which markers suggest alcohol abuse and which of those
most reliable indicator of recent alcohol abuse (4) Right Ans - GGT, AST,
MCV, ALT
Which drug of abuse not detectable 24h post ingestion Right Ans - Alcohol
Mechanism of Action Dopamine transport blocker leading to increase
dopamine levels in synaptic cleft Right Ans - Cocaine (is a helluva drug)
Female attends ED complaining of abdominal cramps. Has goosebumps over
skin and dilated pupils. Most likely drug withdrawing from? Right Ans -
Heroin
Most common ocular abnormality found in Wernicke's encephalopathy
Right Ans - Nystagmus
Hypersomnia + Hyperphagia + Irritability. Withdrawing from which
substance? Right Ans - Amphetamines
According to Department of Health UK, what quantity of alcohol considered
safe in pregnancy? Right Ans - No amount!
Legal high Mephedrone similar to which substance? Right Ans - Ecstasy
Excessive yawning, restless and dilated pupils Right Ans - Opiate
withdrawal
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