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A 44-year-old man comes in for a preventive health visit. He denies having any medical problems, and he is not on any medications. He denies smoking, but he drinks ―socially.‖ He denies having any alcohol-related problems.
For this patient, which of the following is the next step in screening for alcohol-related problems?
A. Inquire about the type, frequency, and quantity of alcohol use
B. Administer a standardized questionnaire to detect alcohol problems
C. Administer laboratory tests to detect alcohol-related medical problems
D. Inquire about criteria that meet definitions of alcohol abuse,
dependence, and alcoholism
A 45-year-old woman presents with complaints of back pain. She requests "something strong" for pain and states that various NSAIDs and nonnarcotic pain medications do not help her when she has pain.
A review of her medical record shows a pattern of various musculoskeletal complaints, for which she has been given opiate-derivative pain medications on several occasions. She requests morphine for her back pain.
For this patient, which of the following statements is false?
A. Opiates can cause addiction
B. Opiates can cause dependence
C. Opiates function by blocking norepinephrine reuptake
D. Pharmacologic therapy is available for treatment of opiate addiction
A 49-year-old woman presents for follow-up of depression. She has been treated with fluoxetine for the past 12 weeks. She started on 20 mg a day and had only a minimal response. At 6 weeks her dose was raised to 40 mg. She reports that her fatigue has improved, and she is no longer suicidal. She still has marked anhedonia and problems with concentration. She reports that she has not been missing doses
of her medication.
Which of the following would you recommend for this patient?
A. Stop fluoxetine; begin paroxetine
B. Stop fluoxetine; begin psychotherapy
C. Stop fluoxetine; refer for ECT
D. Add lithium to current regimen
E. Add buspirone to current regimen
A 47-year-old man presents with cold symptoms. In giving his social history, the patient reports drinking six beers nightly to relieve stress. He admits to having been arrested once for driving while under the influence of alcohol, but he denies that there is any evidence of alcohol withdrawal or tolerance. He also denies having any thoughts of controlling his drinking or that he spends a great deal of time obtaining alcohol, using alcohol, or recovering from his drinking. He further denies having any psychological or physical problems related to his drinking.
Which of the following statements regarding this patient is false?
A. This patient meets the criteria for alcohol abuse
B. This patient does not meet the criteria for alcohol dependence
C. This patient displays moderate drinking
D. This patient displays at-risk drinking
A 47-year-old man presents with cold symptoms. In giving his social history, the patient reports drinking six beers nightly to relieve stress. He admits to having been arrested once for driving while under the influence of alcohol, but he denies that there is any evidence of alcohol withdrawal or tolerance. He also denies having any thoughts of controlling his drinking or that he spends a great deal of time obtaining alcohol, using alcohol, or recovering from his drinking. He further denies having any psychological or physical problems related to his drinking.
Which of the following statements regarding this patient is false?
A. This patient meets the criteria for alcohol abuse
B. This patient does not meet the criteria for alcohol dependence
C. This patient displays moderate drinking
D. This patient displays at-risk drinking
A 54-year-old man presents with symptoms of alcohol withdrawal. He has hypertension, fever, diaphoresis, and agitation. He reports a recent episode of binge drinking, with his last drink having been consumed 8 hours ago. He is unsure of the quantity of alcohol that he consumed during this episode ofbinge drinking.
Which of the following pharmacologic therapies is the most appropriate to administer first?
A. Disulfiram
B. Benzodiazepine
C. Barbiturates
D. Carbamazepine
A 49-year-old man presents to your primary care clinic with his wife. His wife is concerned that her husband is ―addicted‖ to alcohol. She wants him to be evaluated and treated because his father was an alcoholic. Over the past few months, he has been drinking alcohol more often, has received a traffic citation for driving under the influence of alcohol, and has missed days of work.
Which of the following statements regarding the Diagnostic and Statistical Manual of Mental Disorders—Text Revision (DSM-IVTR) definition of dependence is false?
A. Tolerance and withdrawal are criteria for dependence
B. Dependence disorders encompass psychiatric states that resemble
primary psychiatric syndromes but that occur only during periods
of intoxication or withdrawal from a substance
C. The inability to cut back when needed is a criterion
D. Continued use of a substance despite problems is a criterion
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