Psych

Question 1

What is anhedonia? Apathy?

Answer 1

• Decreased ability to experience pleasure
• Lack of interest

Question 2

What score of PHQ indicates depression?

Answer 2

5 or higher

Question 3

What herb used for depression? Contraindications?

Answer 3

• St. John’s Wort
• Contraindicated: Serotonin syndrome with SSRI/SNRI

Question 4

Symptoms of serotonin syndrome

Answer 4

• S’s: shivering, seizures, shaking (tremors)
• Tachycardia, agitation, coma

Question 5

What neuro med increases risk for serotonin syndrome?

Answer 5

Triptans - med class is serotonin agonist

Question 6

Highest population for suicide?

Answer 6

White elderly males

Question 7

SSRI’s first line treatment for what? (3)

Answer 7

• OCD, PTSD, depression

Question 8

What SSRI is bad for the elderly? Good?

Answer 8

• Bad: Prozac d/t long half-life, can male you jittery and cause falls
• Good: Zoloft or Lexapro

Question 9

Most sedating SSRI?

Answer 9

• Paxil

Question 10

SSRI most likely to cause anxiety?

Answer 10

• Prozac (jitteriness can also cause falls)

Question 11

What med can help eliminate sexual side effects?

Answer 11

Wellbutrin

Question 12

SSRI good for bulimia?

Answer 12

• Prozac

Question 13

What SSRI helps with menopause and PMS?

Answer 13

Paxil

Question 14

SSRI highest change for weight gain?

Answer 14

Paxil

Question 15

First line OCD treatment

Answer 15

Paxil

Question 16

Best SSRI for GAD?

Answer 16

Lexapro - works quickly 2-6 weeks

Question 17

SSRI good for pregnant patients?

Answer 17

Zoloft

Question 18

SNRI good for neuropathic pain?

Answer 18

Cymbalta

Question 19

Contraindication of SNRI/Effexor?

Answer 19

Uncontrolled HTN

Question 20

Very easy to OD on which med?

Answer 20

• TCA – amitriptyline, Nortriptyline

Question 21

Side effects atypical antipsychotics?

Answer 21

• Weight gain, HLD, anticholinergic effects, hyperglycemia
• Tardive Dyskinesia, galactorrhea

Question 22

What to get before starting atypical antipsychotics?

Answer 22

• EKG for adults > 50 or hx cardiac issues d/t qt prolongation

Question 23

Which meds are MAOIs? Don’t give with what?

Answer 23

• Rasagiline, Selegiline
• Other antidepressants

Question 24

Avoid what with MAOIs?

Answer 24

• Foods high in tyramine: aged cheese, sausages, cured meats, yogurt, fermented foods (beer, kombucha)
• No grapefruit juice

Question 25

Lithium therapeutic range? Signs of toxicity? Avoid what?

Answer 25

- 0.6-1.2 - Weakness, tremors, ataxia, blurred vision, vomiting - Grapefruit juice

Question 26

Long term effects of lithium?

Answer 26

- Hypothyroidism - Kidney damage - Low Na

Question 27

Enzyme responsible for serotonin syndrome?

Answer 27

- CYP3A4

Question 28

Enzyme responsible for pain meds not working for Asians?

Answer 28

- CYP2C19

Question 29

Questionnaire for ETOH abuse?

Answer 29

CAGE

Question 30

Rehab programs for alcoholics family and friends

Answer 30

- Al-Anon (adults) and Alateen (teens)

Question 31

Avoid Beta Blockers with what?

Answer 31

Asthma

Question 32

Erikson Stages mnemonic

Answer 32

- Trust the Auto In Industry, Identify with intimate geniuses with integrity

Question 33

What psych medication lowers seizure threshold? Also avoid in who?

Answer 33

- Wellbutrin - Recent head injury, active eating disorder

Question 34

SNRI approved for treatment in fibromyalgia?

Answer 34

Cymbalta

Question 35

What lab can be affected in adults taking SSRIs?

Answer 35

Low Na

Question 36

Can TCAs cause weight gain?

Answer 36

Yes

Question 37

Side effects Haldol? Med class?

Answer 37

- First gen antipsychotic - TD, QT prolong, weight gain, metabolic syndrome

Question 38

First line SSRI treatment for PTSD?

Answer 38

- Zoloft - Paxil but no more than 20mg