Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

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Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

Psychological disorders

Bipolar and related disorders

Bipolar disorder

Feeding and eating disorders

Anorexia nervosa

Bulimia nervosa

Medication-induced movement disorders and other adverse effects of medication

Neuroleptic malignant syndrome

Serotonin syndrome

Somatic symptom and related disorders

Factitious disorder

Somatic symptom disorder

Trauma and stressor-related disorders; Abuse

Physical and sexual abuse

Post-traumatic stress disorder


Drug misuse, intoxication and withdrawal: Stimulants: Pathology review

USMLE® Step 1 questions

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USMLE® Step 1 style questions USMLE

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A 1-day old boy is evaluated in the neonatal ICU for preterm birth and low birth weight. The patient was born via uncomplicated spontaneous vaginal delivery to a 35-year-old woman at 34 weeks gestation. The neonate has passed urine and is breastfeeding. He has not passed stool. The mother had a normal pregnancy with regular antenatal care. During her pregnancy, she had two upper respiratory tract infections and a urinary tract infection that was treated. She did not use illicit drugs or consume alcohol during her pregnancy. She did consume caffeinated energy drinks and smoked a pack of cigarettes on the weekends throughout her pregnancy. Temperature is 37.2°C (99°F), blood pressure is 70/30 mmHg, pulse is 120/min, and respiratory rate is 55/min. His weight, length and head circumference are at the 40th percentile for gestational age. Birth weight was 1500g. Abdomen is soft and nontender. Normal heart sounds are heard on cardiovascular auscultation. Which of the following intrauterine processes is most likely responsible for this patient’s clinical findings?


In the middle of the night, a 25 year old female, named Sylvie, comes to the emergency department complaining of retrosternal chest pain that began a couple of hours ago. Earlier that night, she was at a party, where she and her friends consumed alcohol.

Upon further questioning, Sylvie reveals that she also consumed an illicit drug. She is otherwise healthy, has no history of cardiac disease, and does not take any medications.

On physical examination, Sylvie is sweating profusely. In addition, her pupils are dilated, and the nasal septum is atrophic.

Vital signs reveal a temperature of 100 degrees Fahrenheit or 37.7 degrees Celsius, a heart rate of 110 beats per minute, and a blood pressure of 160 over 90 millimeters of mercury.

Some days later, you meet a 36 year old male, named Hunter, who comes in due to recurrent headaches associated with trouble concentrating and irritability.

Hunter adds that he feels like he can’t stop eating, and as a consequence, he’s gained about 3 kilograms, or about 7 pounds, over the last two weeks.

When you ask about his habits, Hunter admits to smoking 2 packs of cigarettes daily for the last 10 years, but stopped smoking about two weeks ago.

Based on the initial presentation, both Sylvie and Hunter seem to have a form of stimulant intoxication or withdrawal.

Stimulants are a group of substances that, when consumed, typically lead to increased activity in the body and brain.

Stimulants include legal substances like caffeine, nicotine, and some amphetamines that can be prescribed for medical treatment; as well as illegal substances, such as cocaine and other amphetamines like MDMA.


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