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Psychiatry MOC Review > MOC Exam#3 > Flashcards

MOC Exam#3 Flashcards

1
Q

Which medications decrease VALPROIC ACID blood levels/concentrations?

A
  • Carbamzepine
  • Phenytoin
  • Cholestyramine
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2
Q

What does it mean that medication A can reduce, or decrease, blood concentrations of medication B?

A
  • That Drug A increases elimination of Drug B

- That Drug A can decreased absorption of Drug B

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3
Q

Which medication can increase VALPROIC ACID blood concentration?

A

-ASA

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4
Q

How does CHOLESTYRAMINE decrease VALPROIC ACID levels?

A

-By decreasing intestinal absorption

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5
Q

Best approach to treatment of Factitious Disorder Imposed on Self

A

-symptom management and avoiding un-necessary procedures

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6
Q

Percentage of patients with bulimia that are male

A

-10%

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7
Q

Which P450 system metabolizes MODAFANIL?

A

-2D6

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8
Q

Name 2 SSRI inhibitors of 2D6

A
  • Fluoxetine

- Paroxetine

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9
Q

Symptoms of MODAFANIL overdose

A
  • dizziness
  • sedation
  • dry mouth
  • tachycardia
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10
Q

What is the genetics of Rhett syndrome?

A
  • spontaneous mutation on X chromosome gene (MECP2)

- almost exclusively in females (males don’t survive gestation due to only 1 copy of X chromosome

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11
Q

What is the initial presentation of infant with Rhett Syndrome?

A
  • normal prenatal and perinatal development
  • normal psychomotor development for at least the first 5 months
  • normal head circumference at birth
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12
Q

What is the progression of symptoms for infant with Rhett Syndrome?

A
  • decelerating head growth between 5-48 months
  • loss of previously acquired purposeful hand movements and skills
  • sterotyped hand movements (hand wringing)
  • poorly coordinated gait and trunk movememnts
  • severe psychomotor retardation
  • loss of social engagement
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13
Q

Which opioids are also weak SSRI’s?

A
  • meperidine
  • tramadol
  • methadone
  • dextromethorphan
  • propoxyphene
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14
Q

What is the risk of combining meperidine and MAOI?

A
  • serotonin syndrome

- DEATH!!

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15
Q

Name the two age peaks for panic disorder, panic attack, onset

A
  • males late teens to early 20’s

- females mid-30’s to 40’s

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16
Q

What percentage of patients have onset of panic attacks/disorder after age 40 y?

A

~15%

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17
Q

The total prevalence of panic attacks/disorder is the greatest for which age range?

A

15y-24y

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18
Q

What is a proven regimen for maintenance treatment of MDD after completion of course of ECT?

A

Nortriptyline and Lithium

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19
Q

ADHD treated with stimulants does not increase risk of developing substance use disorder in adolescents. TRUE or FALSE

A

TRUE

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20
Q

Which disorders in adolescents increase risk of developing substance use disorders?

A
  • Untreated ADHD
  • Undiagnosed ADHD
  • Conduct Disorder
  • Impulse Control Disorders
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21
Q

What is the clinical triad of Serotonin Syndrome

A
  • Cognitive Effects
  • Somatic Effects
  • Autonomic Effects
22
Q

List the Cognitive Effects of Serotonin Syndrome

A
  • headache
  • confusion
  • agitation
  • hypomania
  • hallucinations
  • coma
23
Q

List the Somatic Effects of Serotonin Syndrome

A
  • Myoclonus
  • muscle twitching
  • hyperreflexia
  • tremor
24
Q

List the Autonomic Effects of Serotonin Syndrome

A

All hypers

  • hypertension
  • tachycardia
  • nausea
  • sweating
25
Q

How often should AIMS testing be done for pt who is not high risk?

A
  • every 6 months for FGAs

- every 12 months for SGAs

26
Q

How often should AIMS testing be done for pts at high risk for dyskinesia

A
  • every 3 months for FGAs

- every 6 months for SGAs

27
Q

Which pts are at increased risk for dyskinesias and Parkinsonism?

A
  • elderly patients

- pts who have experienced acute dystonic reactions or EPS or akathisa

28
Q

The single most predictive factor for successful adoption:

A

-young age of adoptive child

29
Q

Other factors that predict successful adoption:

A
  • short time in foster care
  • older age of adoptive parents
  • child without mental illness
30
Q

Cell body nuclei and major neurotransmitters:

A
  • Raphe nucleus: Serotonin
  • Locus Coeruleus: NE
  • VTA: Dopamine
31
Q

Name the features of schizoid personality disorder

A
  • social distance/withdrawal
  • discomfort with human interaction
  • introversion
  • bland and constricted affect
  • latent fearfulness
32
Q

Best treatment for schizoid personality disorder

A

-supportive psychotherapy

33
Q

Feature that distinguishes serious rash due to lamotrigine from benign rash

A

-lymphadenopathy (suggests systemic rash)

34
Q

Risk of death from ECT

A

1/10,000 - 1/50,000

35
Q

What is the mortality rate for ECT?

A
  • 0.002% per treatment
  • 0.01% per patient
  • safer than child birth
  • safer than getting struck by lightening
36
Q

Annual relapse rate for patients with schizophrenia who are compliant with antipsychotics:

A

30%

37
Q

Define the following cognitive distortions:

  • Mindreading
  • Catastrophizing
  • All or nothing thinking
  • Over inclusion
  • Essentializing
A
  • “jumping to conclusions”
  • assuming the worst possible outcome or that the worst will happen
  • no nuances allowed “it’s either this or that”
  • inability to maintain boundaries between concepts (seen in schizophrenia)
  • inappropriate reduction of complex situation to obvious details
38
Q

Signs and symptoms of Wernicke’s Encephalopathy

A
  • gait ataxia
  • oculomotor abnormalities
  • confusion
  • vestibular dysfunction
39
Q

What is permanent alcohol amnestic syndrome?

A

Korsakoff’s syndrome

40
Q

Findings in patients with pyromania

A
  • lower than average IQ
  • significantly low CSF levels of 5-HIAA and MHPG
  • absent fathers
  • no remorse for actions
  • intense curiosity about effects of fire
41
Q

Most common form of competed suicide by teens in the US

A

FIREARMS

42
Q

Define the following:

  • Efficacy
  • Effectiveness
  • Potency
  • Therapeutic Index
A
  • ability of a drug to treat the condition it is supposed to treat
  • how well a drug works in the real world setting (including ease of use, tolerability)
  • amount of drug needed to produce effect
  • Therapeutic dose/Toxic dose
43
Q

The 2 antipsychotics approved by the FDA for treatment of Tourette’s Disorder

A

HALOPERIDOL & PIMIZODE

44
Q

What is the Flynn Effect?

A
  • increase in average IT test scores since 1936

- 3 IQ points per decade since 1936

45
Q

Risk factors for alcohol use disorder

A
  • white race
  • male gender
  • family history of alcohol use disorder
  • psychiatric disorder (depression/anxiety)
46
Q

Clinical features of Lewy Body Disease

A
  • fluctuating consciousness
  • visual hallucinations
  • Parkinsonism motor symptoms
  • sensitivity to dopamine antagonists (antipsychotic medications)
47
Q

What are the safest and most effective medications for LBD?

A

Cholinesterase inhibitors (90% LBD pts report decrease in visual hallucinations

48
Q

Which antipsychotics should be AVOIDED in pts with LBD?

A
  • Risperdal

- Haloperidol

49
Q

Which antipsychotic is considered safest and most tolerable for parkinsonian sx in pts with LBD?

A

QUETIAPINE

50
Q

What is Charles-Bonnet Syndrome?

A
  • macular degeneration with visual hallucinations

- Diabetes is a risk factor

Psychiatry MOC Review (60 decks)

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