Chapter 6 psychiatry

Question 1

How long do the depression symptoms have to last in order for it to be clinical?

Answer 1

Two weeks

Question 2

What mist you one rule out when assessing for depression?

Answer 2

Substance use, recent loss (less than two months ago), underlying medical illness (stroke seizure dementia, coronary heart disease, chronic fatigue syndrome, hypothyroidism, SLE)

Question 3

What physical exam should be done for psychiatric patients?

Answer 3

For physical exam in order to rule out underlying medical illnesses

Question 4

What diagnostic test should be ran for patients who are depressed?

Answer 4

TSH, BMP, vitamin B 12, Urine and blood toxicology screening,
ANA if suspected SLE, HIV testing and VDRL if promiscuous, Dexamethasone suppression test and cosyntropin stimulation test

Question 5

What is a general treatment for patients who exhibit suicide behavior and severe functional impairment?

Answer 5

Admission and ECT

Question 6

What is the pharmacotherapy for depressed patients who exhibit anxiety/insomnia? Who have psychotic symptoms?

Answer 6

SSRI (Fluoxetine) and low-dose lorazepam taper dose for two weeks… Atypical antipsychotics

Question 7

When do you obtain a psychiatric consultation?

Answer 7

If no improvement with pharmacotherapy in 6-8 weeks. In severe suicidal Ideation, substance-abuse disorders or other psychiatric problems

Question 8

We should be the general therapy in depressed patients?

Answer 8

SSRI, medical compliance, regular exercise, patient education