A 39-year-old school teacher presents at the urging of her peers. The patient says that she was sent here because she “just likes things a little cleaner” than her colleagues do. In the school restaurant, she brings her own utensils because she’s seen the kitchen crew grasp all of the forks with their bare hands. When she gets home, she must wash her hands and dry them using only a clean towel without touching the fingers of her other hand. She repeats this washing process at least 5 times before she can stop. Because of the patient’s belief that the world is dirty, she has stopped going to shows or the movies, which she once enjoyed immensely, according to her friends. What is the next step in management of this patient?

A 52-year-old male with a history of alcohol use disorder, hypertension, and cirrhosis presents to the ER requesting a detox admission. The patient has been drinking 12 beers daily for the past 2 weeks. He has experienced withdrawal seizures when attempting to detox at home from alcohol. His initial lab work demonstrates a GFR >60, an AST of 210, and an ALT of 152. He is admitted for a medically managed detox. Which of the following agents would be the best choice to use for this patient’s alcohol detox?

A 45-year-old man with a 20-year history of alcohol and stimulant use disorders presents after a relapse triggered by cue exposure. Neuroimaging research performed during a university addiction study demonstrates reduced basal dopamine release in the ventral striatum, upregulated glutamatergic input from the prefrontal cortex to the nucleus accumbens, and elevated expression of ΔFosB in D1 receptor–expressing medium spiny neurons. Clinically, he reports intense craving, automatic “habit-like” drug-seeking behaviors, and difficulty inhibiting responses despite strong motivation to abstain. Based on these findings, which neurobiological process best explains the patient’s persistent vulnerability to relapse, even after periods of abstinence?

#27 – 31) Match the term with the correct definition listed below. 28) Air Quality  

____ pollutants are chemicals or particles that are directly emitted from identifiable sources.  

The primary sources of the acidity in acid rain are the gases ________.  

The best way to address outdoor air pollution is to ________.  

Complete removal of the forest canopy is ________.  

10 – 14) Match each term with its definition listed below. 11) Greenhouse Effect      

Which of the following health problems associated with UV exposure is also associated with thinning of Earth’s ozone layer?