First Aid for the Wards Pearls

Question 1

Symptoms of Depression

Answer 1

SIG E CAPS

Sleep changes
Interest loss
Guilt/worthlessness
Energy loss
Concentration disturbed
Appetite disturbance
Psychomotor agitation
Suicidality

Need 5 symptoms, one of which must be depressed mood or anhedonia for at least 2 weeks.

Question 2

Why should SSRI’s be discontinued 5 weeks before MAOIs?

Answer 2

To avoid serotonin syndrome.

Question 3

3 C’s of TCA toxicity

Answer 3

Convulsions, coma, cardiac arrhythmias

Question 4

Symptoms of Mania

Answer 4

DIG FAST

Distractibility
Insomnia
Grandiosity
Flight of Ideas
Agitation/Goal directed activity
Speech pressured
Thoughtlessly pursuing pleasure (shopping, hypersexual behavior)

At least 3 needed for 1 week (less if hospitalization is required). 4 if key mood is irritable.

Question 5

Can antidepressants precipitate mania?

Answer 5

Yes if used without mood stabilizers to treat bipolar.

Question 6

Prevalence of schizophrenia worldwide?

Answer 6

1%

Question 7

Diagnosing schizophrenia

Answer 7

At least 2 of the following for at least 6 months:
Unusual thoughts, behaviors, or perceptions (hallucinations, delusions, disordered thinking).
Negative symptoms: Flat affect, poverty of thought/speech, anhedonia, catatonia

Question 8

How to treat acute dystonia from neuroleptics?

Answer 8

Treat with IM Benadryl, benztropine (cogentin), or trihexylphenadyl (artane).

Question 9

Neuroleptic malignant syndrome

Answer 9

Fever, rigidity, autonomic instability, rhabdomyolysis, myoglobinuria.

Question 10

Delusional disorder vs schizophrenia

Answer 10

Delusions in delusional disorder are nonbizarre (plausible).
Also hallucinations, disorganized speech, disorganized behavior cannot be present.

Question 11

Is buspar effective in panic disorder?

Answer 11

No. Takes too long to work. Useful in GAD in patients with a history of drug use or in combination with a benzo before SSRI treatment takes effect.