Mood/Psychiatric disorders

Question 1

specificity means what?

Answer 1

rules out
ability of the test to rule out the problem

Question 2

sensitivity means what?

Answer 2

rules in
helps identifies the problem

Question 3

what does anhedonia mean?

Answer 3

loss of pleasure

Question 4

why do we screen patients for bipolar disorders before starting them on SSRIs?

Answer 4

because they can precipitate a manic episode

Question 5

what drug is SSRI drug is safe in pregnancy?

Answer 5

lexapro (escitalopram)

Question 6

what are the first line drug choices for depression in older adults aged 65 and older? list three

Answer 6

Cialopram (celexa) , escitalopram (lexapro) , and sertraline (zoloft)

Question 7

what SNRI does not raise blood pressure?

Answer 7

Duloxetine (Cymbalta)

Question 8

what are signs and symptoms of serotonin syndrome?

Answer 8

tachycardia, changes in blood pressure, and temperature, confusion, restlessness, agitation, headache, nausea, vomiting, tremors, shivering

severe symptoms: seizures, high fever, syncope, irregular heart rate

Question 9

what is the recommended process for stopping SSRIs?

Answer 9

taper slowly over 1-2 months (4 to 8 weeks)

Question 10

what is the recommended process for switching SSRIs?

Answer 10

taper, stop, wash out for 5 half lives; start new med

Question 11

Fluoxetine (Prozac)
Fluvoxamine (Faverin)
Paroxetine (Paxil)
Sertraline (zoloft)
Escitalopram (lexapro)
Citalopram (Celexa)
are all what class of medications?

Answer 11

SSRIs

Question 12

Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)
are all what class of medications ?

Answer 12

SNRIs

Question 13

what does the CAGE questionnaire stand for?

Answer 13

Do you feel you need to CUT down from your drinking?
Have people ANNOYED you by criticizing your drinking?
Have you ever felt GUILTY or bad about your drinking?
Have you ever had a drink first thing in the morning? (EYE OPENER) OR Do you need to drink EARLY in the morning?

Question 14

what drugs should not be given to a patient with glaucoma?

Answer 14

venlafaxine (Effexor) and Duloxetine (Cymbalta) which are SNRIs because it can precipitate acute narrow angel closure glaucoma

Question 15

Abrupt discontinuation may of SSRIs may precipitate what symptoms?

Answer 15

dysphoria, fatigue, chills, myalgias, headache, dizziness, gastrointestinal distress.

Question 16

How many days should you avoid SSRIs if a patient is taking a MAOI?

Answer 16

14 days within taking a MAOI

Question 17

SRRIs can induce mania with bipolar patients, true or false?

Answer 17

True

Question 18

what is the SAD CUB mnemonic for remembering anticholinergic side effects?

Answer 18

Sedation
Anorexia
Dry mouth
Confusion and constipation
Urinary retention
BPH

Question 19

kava-kava and/or valerian root are both complementary therapies used for what?

Answer 19

anxiety and insomnia
DO NOT mix with benzos, hypnotics, or CNS depressants

Question 20

what exam asks patients to spell the word “WORLD” backwards?

Answer 20

Mini-mental state exam (MMSE)

Question 21

what is Korsakoff’s syndrome related to?

Answer 21

alcohol use disorder and it is caused by thiamine deficiency

Neurologic disorder with symptoms that include hypotension, visual impairment, mental confusion, ataxia, stupor, and hypotension.

Question 22

Can patients some on nicotine patches?

Answer 22

NO they will overdose on nicotine.
Nicotine overdoses can cause acute MI, hypertension, and agitation in susceptible patients.

Question 23

what is the gold standard test for sleep apnea?

Answer 23

polysomnography, after diagnosis refer to otolaryngologist

Question 24

what is Munchausen syndrome?

Answer 24

“factitious disorder imposed on self”
patient falsifies symptoms of factitious disorders and/or injuries self and seeks medical treatment

Question 25

of all the SSRIs, which is most likely to cause erectile dysfunction?

Answer 25

Paxil (paroxetine)