Report from Dr. Weaver Chair ASAM exam cmt.

1
Report from Dr. WeaverChair ASAM exam cmt.

• All questions are multiple choice-1 Choice
• Study the Basics. Exam not testing trivia
• Principles of Addiction Medicine is core
  knowledge base, but questions may come from
  current journal literature
  
• Many of the questions are based on brief clinical
  vignettesusually only 1 question
  

2
List of areas that the Exam Cmt. has identified
where past examinees have had difficulty

• Basic science-metabolism, receptors,
  neurotransmitters
  
• Basic statistical methodsodds ratios, predictive
  values, prevalence rates
  
• Designer drugs
• Newer pharmacotherapies to treat addiction
• Computer Based Exam

3
Sample Questions
4
Which of the following best describes mechanism
of action of rimonabant?

• Selective CB1 antagonist
• Stress lowers endocannabinoid activity
• Mice, lacking the CB1 receptor gain weight
• The CB1 receptor acts only centrally
• Intestinal anadamide levels decrease with
  overfeeding

5
Which of the following is the most appropriate
aspect of behavioral treatment for an adolescent
with severe drug use?

• Stimulus control
• Imprisonment
• Probation
• Response gratification
• Psychotherapy

6
14yo boy tells you he switched from smoking
cigarettes to using smokeless tobacco to avoid
lung cancer. Which cancer is he know at increased
risk?

• Colon
• Rectum
• Gallbladder
• Stomach
• Esophagus

7
Which of the following drugs has highest
continuous abstinence rate among motivated
smokers?

• Nicotine patch
• Bupropion
• Varenicline
• Rimonabant
• Cytisine

8
Bupropion most likely inhibits which of the
following receptors?

• 5HT Glutamate
• Dopamine NE
• GABA Glutamate
• Acetylcholine Epineprine
• 5HT NE

9
? Mechanism of acamprosate

• Increases renal clearance of EtOH
• Blocks ADH
• Modulates glutamate and GABA neurotransmitter
  systems
  
• Acts as a partial agonist/antagonist of the mu
  opioid receptor

10
Mechanism of action of varenicline

• ?answer

11
Distinguish a patient getting opioids for chronic
pain vs. an addicted patient getting into
difficulty?

• Development of tolerance
• Symptoms of withdrawal with discontinuation
• Drug craving
• Increased analgesic dose for increased pain

12
?Currently approved for EtOH?

• Bupropion
• Depot naltrexone
• Naloxone
• Varenicline
• Carbamazepine

13
12th step of AA, Having had a spiritual
awakening as a result of these steps, we tried to
carry this message to other alcoholics, and to
practice these principles in all our affairs, is
an example of which pairs of defense mechanisms?

• Suppression and repression
• Sublimation and altruism
• Projection and denial
• Reaction formation and displacement

14
Suggestions

• Study subject areas outside of your usual
  clinical work
  
• Skim the Principles in areas you are proficient
• Read other general reviews.
  e.g.Goodman Gilman, opioids, EtOH,
  sedative/hypnotics
  
• ? Get tapes in weaker areas.
• Relax, Youll Do Well