Cannabis-Related Disorders — MCQs
A 55-year-old drug addict from California presents with euphoria, altered time perception, and conjunctival injection, along with impairment of judgment. The most likely cause of this is addiction to which substance?
What is the role of Anandamide in the human body?
What is the primary role of marijuana in the management of AIDS-related cachexia?
Management of a violent patient in psychiatry includes all except:
Symptomatic treatment is only required in withdrawal syndrome caused by:
What is the classification of intelligence corresponding to an IQ score of 90-109?
A mother reports that her daughter ingested a substance in an unknown dose. The girl presents with hypertension, tachycardia, mydriasis, and hyperthermia. What is the most likely substance?
Match the following: A) Caplan syndrome- 1) Found first in coal worker B) Asbestosis- 2) Upper lobe predominance C) Mesothelioma- 3) Involves lower lobe D) Sarcoidosis- 4) Pleural effusion is seen
Following pathogenetic mechanisms operate in septic shock except -
Warm periphery is noticed in which type of shock:
Cannabis-Related Disorders Indian Medical PG Practice Questions and MCQs
Question 1: A 55-year-old drug addict from California presents with euphoria, altered time perception, and conjunctival injection, along with impairment of judgment. The most likely cause of this is addiction to which substance?
- A. Marijuana (Correct Answer)
- B. Cocaine
- C. Phencyclidine
- D. Benzodiazepine
Explanation: ***Marijuana*** - **Euphoria**, altered time perception, and **conjunctival injection** are classic symptoms associated with marijuana use. - Impairment of judgment and coordination are also common effects of **cannabis intoxication**. *Cocaine* - Cocaine intoxication typically presents with **psychomotor agitation**, **tachycardia**, **hypertension**, and **dilated pupils**, not conjunctival injection. - While it causes euphoria and altered perception, the specific combination of symptoms points away from cocaine. *Phencyclidine* - **Phencyclidine (PCP)** often causes **nystagmus**, violence, and **dissociative symptoms** like derealization and depersonalization, which are not described. - It can also lead to severe agitation and unpredictable behavior, distinct from the patient's presentation. *Benzodiazepine* - Benzodiazepine intoxication or abuse typically leads to **sedation**, ataxia, and **respiratory depression**, rather than euphoria and conjunctival injection. - The effects are more consistent with central nervous system depression.
Question 2: What is the role of Anandamide in the human body?
- A. Opioid
- B. D2 blocker
- C. Cannabinoid neurotransmitter (Correct Answer)
- D. CCK1 antagonist
Explanation: ***Cannabinoid neurotransmitter*** - **Anandamide** is an **endogenous cannabinoid neurotransmitter** that binds to **CB1** and **CB2 receptors**. - It plays a role in **pain modulation**, **appetite stimulation**, and **memory regulation**. *Opioid* - **Opioids** bind to **opioid receptors** (mu, delta, kappa) and are known for their **analgesic** and **euphoric effects**. - Examples include **morphine** and **endorphins**, which are chemically distinct from anandamide and have different receptor targets. *CK 1 antagonist* - This option refers to a **cholecystokinin 1 (CCK1) receptor antagonist**, which would block the effects of **CCK**. - **CCK** is a hormone involved in **digestion** and **satiety**, and its role is unrelated to anandamide. *D2 blocker* - A **D2 blocker** is an agent that antagonizes the **dopamine D2 receptor**. - These are typically **antipsychotic medications** that modulate **dopamine pathways** in the brain, unrelated to the function of anandamide.
Question 3: What is the primary role of marijuana in the management of AIDS-related cachexia?
- A. Produces euphoric effects
- B. Acts as a psycho-stimulant
- C. Stimulates appetite (Correct Answer)
- D. Reduces nausea
Explanation: ***Stimulates appetite*** - Marijuana, particularly through its cannabinoid components like THC, is well-known for its **appetite-stimulating effects**, often referred to as "the munchies." - For patients with AIDS-related cachexia (wasting syndrome), increasing appetite can help in **gaining weight** and improving nutritional status, which is crucial for overall health. *Produces euphoric effects* - While marijuana can produce euphoric effects, this is a **side effect** and not the primary therapeutic role sought for managing **cachexia**. - The euphoria might temporarily improve mood but does not directly address the physiological wasting. *Acts as a psycho-stimulant* - Marijuana is generally considered a **depressant** or **hallucinogen**, not a psycho-stimulant. - Psycho-stimulants increase alertness and focus, which is not the desired action for treating AIDS-related cachexia. *Reduces nausea* - While marijuana can effectively **reduce nausea** and vomiting, particularly in chemotherapy patients, this is a secondary benefit in the context of cachexia. - The primary goal in cachexia is to increase food intake and weight, which the appetite stimulation directly addresses.
Question 4: Management of a violent patient in psychiatry includes all except:
- A. CBT (Correct Answer)
- B. Haloperidol
- C. ECT
- D. BZD
Explanation: ***CBT*** - **Cognitive Behavioral Therapy (CBT)** is a long-term psychological intervention aimed at changing maladaptive thought patterns and behaviors. It is **not suitable for immediate management** of an acutely violent patient. - While CBT can be beneficial for aggression management in a stable patient, it requires patient cooperation, cognitive engagement, and time, which are not available during a **violent psychiatric emergency**. *Haloperidol* - **Haloperidol** is a potent typical antipsychotic frequently used in acute settings for rapid tranquilization of violent or severely agitated patients. - It is effective in reducing **psychosis-related agitation** and can be administered **intramuscularly** for quick onset of action. - Often used in combination with benzodiazepines for optimal control of acute violence. *ECT* - **Electroconvulsive Therapy (ECT)** may be considered in **severe, treatment-resistant cases** of violence associated with conditions like uncontrolled mania, catatonic excitement, or psychotic depression when pharmacological interventions have failed. - While not used for immediate acute management due to logistical requirements (consent, anesthesia, specialized setup), it can be an effective option for severe psychiatric conditions with persistent violence. - It works by inducing a brief controlled seizure, which can rapidly alleviate severe symptoms. *BZD* - **Benzodiazepines (BZDs)** like lorazepam or diazepam are **first-line agents** in the acute management of violent or agitated patients due to their rapid anxiolytic, sedative, and muscle relaxant properties. - They are particularly useful for **calming acute agitation** and are often combined with antipsychotics for rapid tranquilization. - Can be administered intramuscularly or intravenously for quick action in psychiatric emergencies.
Question 5: Symptomatic treatment is only required in withdrawal syndrome caused by:
- A. Alcohol
- B. Cocaine
- C. Morphine
- D. Cannabis (Correct Answer)
Explanation: ***Cannabis*** - **Cannabis withdrawal syndrome** is generally mild and non-life-threatening, **requiring only symptomatic management** for symptoms such as irritability, anxiety, sleep disturbances, and cravings. - Unlike withdrawal from opioids or alcohol, cannabis withdrawal does not present with severe physiological complications, seizures, or significant psychological distress requiring pharmacotherapy. - **Supportive care alone is sufficient** with reassurance, hydration, and rest. *Morphine* - **Opioid withdrawal** (e.g., from morphine) can be very distressing and painful, involving severe gastrointestinal symptoms, myalgia, and intense cravings. - **Requires pharmacological intervention** with medications like **methadone**, **buprenorphine**, or **clonidine** for symptom control and to prevent relapse. - Not merely symptomatic treatment. *Alcohol* - **Alcohol withdrawal syndrome** can be severe and life-threatening, potentially progressing to **delirium tremens** and seizures. - **Necessitates pharmacological treatment** with **benzodiazepines** (e.g., lorazepam, diazepam) to prevent serious complications. - Symptomatic treatment alone is inadequate and dangerous. *Cocaine* - **Cocaine withdrawal** is characterized by **dysphoria**, fatigue, hypersomnia, and intense cravings with high relapse risk. - While primarily managed with supportive care, **severe cases often require pharmacological intervention** for depression (antidepressants) and intense cravings. - Unlike cannabis, the psychological severity often necessitates more than just symptomatic management.
Question 6: What is the classification of intelligence corresponding to an IQ score of 90-109?
- A. Below average
- B. Average (Correct Answer)
- C. Slightly below average
- D. Above average
Explanation: ***Average*** - An **IQ score** range of **90-109** is traditionally classified as **Average** intelligence. - This range represents the **mean** and surrounding **standard deviation** of IQ scores in the general population. *Below average* - This classification usually corresponds to IQ scores in the range of **70-79** or **80-89**, depending on the specific scale. - It does not represent the central tendency of the population's intelligence. *Slightly below average* - This category typically corresponds to IQ scores in the range of **80-89**. - It falls just below the average range but is not as low as the "below average" classification. *Above average* - This classification is typically assigned to IQ scores that are in the range of **110-119** or higher. - It signifies cognitive abilities that are greater than the majority of the population.
Question 7: A mother reports that her daughter ingested a substance in an unknown dose. The girl presents with hypertension, tachycardia, mydriasis, and hyperthermia. What is the most likely substance?
- A. Heroin
- B. Morphine
- C. Cocaine (Correct Answer)
- D. Chlorpheniramine
- E. Organophosphate
Explanation: ***Cocaine*** - The presented symptoms of **hypertension, tachycardia, mydriasis, and hyperthermia** are characteristic of a **sympathomimetic toxidrome**, frequently caused by cocaine overdose. - Cocaine acts as a **norepinephrine-dopamine-serotonin reuptake inhibitor**, leading to excessive stimulation of the central and peripheral nervous systems. *Heroin* - Heroin is an **opioid**, and overdose generally presents with **respiratory depression, bradycardia, miosis (pinpoint pupils)**, and hypotension, which are contrary to the patient's symptoms. - Patients typically exhibit central nervous system **depression**, rather than the hyperactive state seen here. *Morphine* - Similar to heroin, morphine is an **opioid** and causes symptoms like **respiratory depression, bradycardia, miosis**, and hypotension. - These effects are the opposite of the **sympathomimetic** signs observed in the patient. *Chlorpheniramine* - Chlorpheniramine is an **antihistamine** with significant **anticholinergic effects**. An overdose might cause **mydriasis and tachycardia**, but not typically severe hypertension or hyperthermia as the primary features. - Other anticholinergic signs such as **dry mucous membranes, urinary retention, and altered mental status (delirium)** would also be expected. *Organophosphate* - Organophosphate poisoning causes a **cholinergic toxidrome** due to **acetylcholinesterase inhibition**, resulting in excessive cholinergic stimulation. - Classic presentation includes **SLUDGE syndrome** (Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis) along with **miosis (pinpoint pupils), bradycardia, bronchospasm**, and muscle fasciculations. - These findings are the **opposite** of the sympathomimetic signs seen in this patient.
Question 8: Match the following: A) Caplan syndrome- 1) Found first in coal worker B) Asbestosis- 2) Upper lobe predominance C) Mesothelioma- 3) Involves lower lobe D) Sarcoidosis- 4) Pleural effusion is seen
- A. A-3, B-4, C-2, D-1
- B. A-1, B-4, C-3, D-2 (Correct Answer)
- C. A-4, B-2, C-3, D-1
- D. A-2, B-4, C-3, D-1
Explanation: **A-1, B-4, C-3, D-2** - **Caplan syndrome** was first described in **coal workers** with **rheumatoid arthritis** and progressive massive fibrosis. - **Asbestosis** is often associated with **pleural effusion**, which can be benign or malignant. - **Mesothelioma** typically involves the **lower lobes** of the lungs, specifically the pleura, and is strongly linked to asbestos exposure. - **Sarcoidosis** is characterized by **non-caseating granulomas**, which have a predilection for the **upper lobes** of the lungs. *A-3, B-4, C-2, D-1* - This option incorrectly states that Caplan syndrome involves the lower lobe; **Caplan syndrome** is defined by the presence of large nodules in the lungs of coal workers with rheumatoid arthritis, and their specific lobar distribution is not a defining characteristic. - This option incorrectly states that Mesothelioma has an upper lobe predominance; **Mesothelioma** is a pleural malignancy and typically involves the **lower lobes**, extending along the pleura. *A-4, B-2, C-3, D-1* - This option incorrectly associates Caplan syndrome with pleural effusion; **Caplan syndrome** manifests as rheumatoid nodules in the lungs, not primarily pleural effusion. - This option incorrectly states that Asbestosis has an upper lobe predominance; **Asbestosis** predominantly affects the **lower lobes** of the lungs, causing interstitial fibrosis. *A-2, B-4, C-3, D-1* - This option incorrectly states that Caplan syndrome has an upper lobe predominance; the defining feature of **Caplan syndrome** is the combination of rheumatoid arthritis and pneumoconiosis, not specific lobar involvement. - This option correctly identifies pleural effusion with asbestosis and lower lobe involvement with mesothelioma, but **Caplan syndrome** is not characterized by upper lobe predominance.
Question 9: Following pathogenetic mechanisms operate in septic shock except -
- A. Direct toxic endothelial injury
- B. Veno constriction
- C. Increased peripheral vascular resistance (Correct Answer)
- D. Activation of complement
Explanation: Following pathogenetic mechanisms operate in septic shock except - ***Increased peripheral vascular resistance*** - Septic shock is characterized by profound **vasodilation** and a subsequent **decrease in systemic vascular resistance (SVR)**, leading to hypoperfusion. - The body's compensatory mechanisms attempt to increase cardiac output rather than constrict peripheral vessels, making increased PVR an unlikely finding in established septic shock. [1] *Direct toxic endothelial injury* - **Bacterial products** (e.g., endotoxins from Gram-negative bacteria) and inflammatory mediators directly damage the **endothelium**, leading to capillary leak and microvascular dysfunction. - This endothelial damage contributes significantly to the widespread organ damage seen in sepsis. *Veno constriction* - While initial compensatory mechanisms might involve elements of vasoconstriction to maintain blood pressure, the hallmark of septic shock is widespread **vasodilation**, which includes both arterial and venous beds. - Early, fleeting venoconstriction is overshadowed by the profound venodilation and loss of venous tone that ultimately contributes to reduced preload and distributive shock. *Activation of complement* - The innate immune response in sepsis triggers the **complement cascade**, leading to the generation of potent inflammatory mediators. - Complement activation contributes to endothelial damage, leukocyte recruitment, and further amplification of the systemic inflammatory response.
Question 10: Warm periphery is noticed in which type of shock:
- A. Traumatic shock
- B. Cardiogenic shock
- C. Septic shock (Correct Answer)
- D. Hemorrhagic shock
Explanation: Septic shock - In septic shock, the severe systemic inflammation and widespread **vasodilation** lead to an initial phase of warm, flushed extremities, known as **warm shock**. - This is due to the body's inability to adequately vasoconstrict peripheral vessels despite hypotension. *Traumatic shock* - Traumatic shock often involves **hemorrhage** and systemic inflammatory responses, typically presenting with **cool, clammy skin** due to vasoconstriction. - The body attempts to centralize blood flow to vital organs, reducing perfusion to the periphery. *Cardiogenic shock* - Characterized by severe **pump failure** of the heart, leading to reduced cardiac output and poor peripheral perfusion [1]. - Patients typically present with **cool, clammy extremities** as the body tries to compensate by vasoconstriction. *Hemorrhagic shock* - Caused by significant **blood loss**, which triggers a compensatory response of **vasoconstriction** in the periphery to maintain central blood pressure. - This results in **cool, pale, and clammy skin** as blood is shunted away from non-essential areas.
Want unlimited practice?
Get full access to all questions, explanations, and performance tracking.
Start For Free