Sigs Unit 8 Cases 8-15 | Baamboozle - Baamboozle

Describe the clinical presentation of opioid withdrawal. (SIGS 8.7b)

Somatic:piloerection, pupil dilation, yawning, lacrimation, rhinorrhea, flu-like; behavior/mood: dysphoric, anxiety, irritability, restless, agitation, insomnia

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Describe withdrawal seizures. (SIGS 8.7a)

onset 8-48 hours after cessation/reduction alcohol; usually brief, generalized tonic-clonic seizures; often single episode

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Explain the approach to both diagnosis and monitoring of ADHD. Name the two core symptom domains in ADHD and list six examples of each. (Sigs 8.8a)

use valid rating scales; inattention & hyperactivity-impulsivity; careless mistakes, poor organization, losing items, fidgeting, moving, excess talking

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Describe the mechanism of action of buprenorphine for the treatment of opioid use disorder. (SIGS 8.7b)

mu partial agonist, narcotic analgesic, morphine type (synthetic); used to prevent relapse

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Rationalize the use of mannitol in acute TBI. (SIGS 8.5a)

osmotic diuretic-- non-reabsorbable solute filtered by glomerulus causing water retention in PCT & dLoH-> alter Starling forces-> H20 leaves cells->decr ICP

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Describe the mechanism of action of naloxone for opioid overdose. (SIGS 8.7b)

competitive inhibitor of mu opoid receptor-> blocks/reverses action of narcotics; prevent acute withdrawal syndrome (narcotic antagonist)-> restore ventilation

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List the DSM-5 criteria for diagnosing PTSD. (SIGS 8.5b)

traumatic situation-> reliving experience, avoidance, emotional detachment, incr. arousal, decr daily fx, >1 month

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Describe how atypical antipsychotics treat symptoms of schizophrenia AND list adverse effects associated with these medications. (SIGS 8.6b)

transiently occupy D2 recep and rapidly dissociate to allow normal dopamine transmission; 2nd gen less potent D2 antagonists + antagonize 5HT2 recep to decr AE

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Describe neurochemical changes thought to underlie the symptoms of schizophrenia. (SIGS 8.6b)

+ symp: incr subcortical release dopamine-> augments D2 recp activation&nucleus accumben;- symp: reduced D1 recp activation prefrontal cortex & nucleus caudatus

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Describe the four main symptom clusters of PTSD. (SIGS 8.5b)

Criterion B: intrusion symp.; Criterion C: avoidance symp.; Criterion D: negative cognitions & mood; Criterion E: arousal & activity changes

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Discuss the use of imaging in diagnosing head trauma and differentiate subdural from epidural hematoma (Sigs 8.5a)

non-contrast CT 1st; epidural: bright convex disc; subdural: crescent-shaped hemorrhage

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Explain the role of benzodiazepines in the management of alcohol withdrawal. (SIGS 8.7b)

binds "benzodiazepine receptors" between alpha and gamma subunits of GABA-A-> incr freq. of chloride channel opening -> incr inhibitory effect of GABA

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