MOC Exam#2

Question 1

Pregnancy risk of Paroxetine

Answer 1

• cardiac problems (first tri-mester)
• Category D risk
• stop during pregnancy or before

Question 2

Risk of Relapse of MDD after first episode (hospitalized)

Answer 2

• 50% relapse in 5 years
• 70% decreased risk recurrence with med prophylaxis
• 15% with recurrence go on to have chronic recurrence
• 50% after 1st, 75% after 2nd

Question 3

Poor prognostic features of schizophrenia

Answer 3

• blunted affect (negative symptoms)
• younger age onset
• insidious onset
• poor premorbid function

Question 4

Timing criteria for acute stress disorder (ASD) vs. PTSD

Answer 4

• PTSD: sx > 1 month

- ASD: 2wks < sx >= 1 month

Question 5

What are the top 2 diagnoses for people who complete SI (people who die by SI)

Answer 5

• Mood Disorders 35.8%

- Substance Abuse 22.4%

Question 6

Psychiatric diagnosis with the greatest risk of death by suicide

Answer 6

-Eating disorders

Question 7

Conversion Disorder vs. Malingering/Factitious

Answer 7

• in Conversion Disorders symptoms ARE NOT intentionally induced
• M/F Disorders symptoms ARE intentionally induced for secondary gain
• Factitious disorder toward self, secondary gain is internal and not external

Question 8

How long should induced seizure last in ECT?

Answer 8

• 20-40 sec

- at > 180 sec, sz should be terminated

Question 9

Medical complications of anorexia nervosa

Answer 9

• Hypochloremia
• Hypokalemia
• Hyponatremia
• Hypomagnesemia
• Hypocalcemia
• HypoWBC (leukopenia)
• Hypochloremic alkalosis (increased CO3)
• Cardiac arrhythmias/cardiac arrest

Question 10

Rate birth control methods by effectiveness

Answer 10

• high effective: failure rate =< 1%
  
  • Progestin implants, IUD, vasectomy, tubal ligation, RU486
• medium effective: failure rate 6-12%
  
  • diaphragms, cervical cap, OCP’s, vaginal rings, progestin injections & patches
• low effective: failure rate >= 18%
  
  • male/female condoms, withdrawal method, spermicide, contraceptive sponge

Question 11

The most effective antipsychotic for early onset schizophrenia

Answer 11

-CLOZARIL

Question 12

Rates of Alcohol Use Disorder

Answer 12

• Alcohol dependence 3.8% 12 month point prevalence
• life time prevalence dependence 12.5%
• 15% of adults who have tried alcohol will go on to become alcohol dependent

Question 13

The most common side effect of sudden benzodiazepine discontinuation.

Answer 13

Sleep disturbances, including bad dreams

Question 14

%-age of hospitalized, medically ill pts with delirium that will die in 6 months

Answer 14

25%

Question 15

Minimum recommendation duration of methadone maintenance treatment (NIDA)

Answer 15

12 months

Question 16

Risk of seizure in children with autistic spectrum disorder; FDA approved treatment of irritability in ASD

Answer 16

• 25%

- Risperdal

Question 17

Most common way children/adolescents to acquire HIV/AIDS

Answer 17

-born to mothers infected with HIV (blood exposure/breast feeding)

Question 18

Findings found in research on patients with borderline personality disorder

Answer 18

• abnormal TRH stimulation test
• abnormal dexamethasone suppression test
• increased sleep latency
• decreased REM latency
• increased incidence of soft neurological signs

Question 19

opioids from shortest t1/2 to longest

Answer 19

meperidine, morphine, methadone, buprenorphine

MEPMOR METBOOP