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ADEPT Test / CSAM – Questions With Solutions (100%)
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ADEPT Test / CSAM – Questions With Solutions (100%)A 50 year old male presents to a primary care clinic with his wife after a
completion of three day inpatient admission for treatment of alcohol
withdrawal disorder. He states that he felt very depressed prior to his
admission and he still has some depression and insomnia symptoms, but that
he is feeling better now. Which of the following is true regarding the
treatment of patients with co-occurring depression and alcohol use disorder?
Wait for 30 days of abstinence from alcohol before evaluating for treatment of
depression
Treatment of depression with concurrent alcohol use disorder have no benefit
Patient is feeling better, so no need for evaluation of depression
Depression was part of alcohol withdrawal symptoms, need to continue to
treatwithdrawal symptoms
Evaluate for depression at admission to detoxification, as well as at the time of
discharge,regardless of days of sobriety days Right Ans - Evaluate for
depression at admission to detoxification, as well as at the time of discharge,
regardless of days of sobriety days
Evidence has been limited on the use of antidepressant medications in
patients with co-occuring depression and alcohol use disorder (AUD).
However, meta-analysis study has shown that antidepressants outperformed
placebo in the treatment of depression in patients with AUD (Iovineo).
Another study also showed that among patients with depression and AUD,
those who were not given antidepressant medication at the time of discharge,
100% resumed alcohol use in 4 months (Greenfield). Another study showed
that medication treatment for depression with AUD has significant benefit
(Nuens) * Iovineo, Antidepressants for major depressive disorder and
dysthymic disorder in patients with comorbid AUD:
A first time user of oxycodone reports a sudden rush of euphoria and energy.
Which of the following neurological pathways is primarily responsible for this
effect?
,Dorsal raphe nucleus projections to nucleus accumbens
Nucleus accumbens projections to ventral tegmental area
Ventral tegmental area projections to dorsal raphe nucleus
Ventral tegmental area projections to nucleus accumbens Right Ans -
Ventral tegmental area projections to nucleus accumbens
The positive reinforcing effects of substances and pleasurable behaviors due
to dopaminergic projections from the ventral tegmental area (VTA) to the
nucleus accumbens (NAcc) represents the neural mechanism most
consistently implicated in the development of addiction, especially in early
stages. The NAcc along with the olfactory tubule are located in the ventral
striatum. The dorsal raphe nucleus is a midbrain cluster of serotonergic
neurons, which may be relevant for the effects of certain substances such as
hallucinogens and MDMA, but is not as universally implicated in substance
and behavioral positive reinforcement.
1. As part of a research study, volunteers with severe opioid use disorder
receive monetary vouchers for providing opioid-negative urine samples.
Which of the following best describes this behavioral treatment strategy?
twelve-step facilitation
contingency management
cognitive behavioral therapy
community reinforcement
motivational enhancement Right Ans - contingency management
2. A 28-year-old male is brought to the ED by his roommate for agitation after
a prolonged cocaine binge. His BP is 160/90 and HR is 125. The most
appropriate medication would be:
IV haloperidol
IV lorazepam
IV labetalol
IV chlorpromazine
sublingual clonidine Right Ans - IV lorazepam
3. You are treating a 17-year-old for acne and depression. During one of the
visits, the patient mentions that he occasionally "dabs" with his friends using a
,vape device. His mother asks you about a recent news article that she read
regarding vaping related lung injury. Which of the following is thought to be
one of the causative agents in electronic vaping use associated lung injury
(EVALI)?
vitamin D acetate in THC containing vape devices
fentanyl adulteration in nicotine liquid for vape devices
vitamin E acetate in THC containing vape devices
cannabis resin
caffeine adulteration in nicotine liquid for vape devices Right Ans - vitamin
E acetate in THC containing vape devices
4. A patient presents to you in the emergency room with an overdose from IV
heroin/fentanyl. She is treated with naloxone and now demanding to leave.
You see that she has been to the ER 5x in the last 6 months with a similar
presentation. After discussing the efficacy of buprenorphine and methadone,
she remains uninterested. Your next strategy to minimize risk for overdose
and death is:
referral to needle exchange program
referral to methadone OTP
next day appointment in addiction clinic
provide naloxone kit
rive first dose of buprenorphine prior to discharging from the ER Right Ans
- provide naloxone kit
5. A 50-year-old male presents to a primary care clinic with his wife for his
annual physical exam. He reports that he recently completed an inpatient
detoxification and rehabilitation program for severe alcohol use disorder. He
states that he felt very depressed prior to his admission, but that he feels no
symptoms of depression currently. Which of the following is true regarding
the treatment of patients with co-occurring depression and alcohol use
disorder?
wait for 30 days of sobriety before evaluating for depression
wait for 60 days of sobriety before evaluating for depression
wait for 7 days of sobriety before evaluating for depression
evaluate for depression at admission to detoxification, regardless of sobriety
days
evaluate for depression after completion of detoxification, regardless of
sobriety days Right Ans - evaluate for depression at admission to
detoxification, regardless of sobriety days
, You assess a 51-year-old female who has tobacco use disorder. You have
assessed her motivation for smoking cessation several times over the years
and she has continued to have low motivation for quitting. Today you decide
to:
assess her motivation for change and avoid giving advice related to quitting
since this is ineffective without motivation
counsel her on improved health behaviors in general but avoid directly
mentioning smoking cessation since she is not ready to quit
provide her with a prescription for bupropion with instructions related to
side effects and avoid having another conversation about smoking cessation
as you risk damaging rapport
provide clear advice to quit smoking along with a brief intervention related to
the risks of continued smoking. You do this at each visit Right Ans - provide
clear advice to quit smoking along with a brief intervention related to the
risks of continued smoking. You do this at each visit
7. A dental hygienist is in early recovery from addiction to methamphetamine.
She has reduced her work schedule to devote more time to attend Narcotics
Anonymous meetings and counseling sessions for her intensive outpatient
program. Her supervisor informs her that she will be dismissed from her job if
she continues taking time off, even after the hygienist provides a note from
the intensive outpatient program physician. This patient in recovery is
protected in terms of time off necessary to attend treatment by which of the
following federal laws?
Affordable Care Act
Americans with Disabilities Act
Comprehensive Addiction Recovery Act
Drug Abuse Treatment Act of 2000
Fair Labor Standards Act Right Ans - Americans with Disabilities Act
8. Which is an example of a secondary prevention activity for alcohol use
disorder?
increasing the tax on alcoholic beverages
decreasing hours of operation for liquor stores
offering counselling to teens after a first DUI
liver transplantation for a patient with alcoholic cirrhosis
warning labels in bars about the dangers of alcohol in pregnancy Right Ans
- offering counselling to teens after a first DUI
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