PSYCH

Question 1

First line tx for depression

Answer 1

SSRI

Question 2

Antidepressants associated w hypertensive crisis

Answer 2

MAOI

Question 3

Galactorrhea, impotence, menstrual dysfunction, decreased libido

Answer 3

dopamine antagonists

Question 4

17yo girl has left arm paralysis after BF dies in car crash, no medical cause found

Answer 4

conversion disorder

Question 5

Defense mechanism: mother who is angry at her husband yells at kid

Answer 5

displacement

Question 6

Defense mechanism: pedophile enters a monastery

Answer 6

reaction formation

Question 7

Defense mechanism: woman calmly describes a grisly murder

Answer 7

isolation

Question 8

Defense mechanism: hospitalized 10yo begins to wet his bed

Answer 8

regression

Question 9

Life threatening muscle rigiditiy, high fever and rhabdo

Answer 9

NMS

Question 10

amenorrhea, low body weight (<18.5kg), bradycardia, abnormal body image

Answer 10

anorexia

Question 11

35yo man has recurrent episodes of palpitations, diaphoresis and fear of going crazy

Answer 11

panic disorder

Question 12

most serious SFX of clozapine

Answer 12

agranulocytosis

Question 13

21yo M has 3 months of social withdrawal, worsening grades, flattened affect and concrete thinking

Answer 13

schizophreniform disorder (need >6 mo to be schizophrenia)

Question 14

key side fx of atypical antipsychotics

Answer 14

weight gain, QT prolongation, type 2 DM

Question 15

young weight lifter receives IV haloperidol and complains that his eyes are deviated. Diagnosis? Tx?

Answer 15

acute dystonia (oculogyric crisis).  
Tx w benztropine or diphenhydramine

Question 16

Medication to avoid in patients w history of alcohol withdrawal seizures

Answer 16

neuroleptics (or bupropion)

Question 17

13yo M has hx of theft, vandalism, and violence towards family pets

Answer 17

conduct disorder. Not antisocial until adult

Question 18

5mo F has decreased head growth, truncal discoordination, hand wringing and social isolation

Answer 18

Rett’s (look for loss of milestones)

Question 19

Patient hasn’t slept for days, lost $$ gambling, is agitated w pressured speech. Dx? Tx?

Answer 19

Acute mania

Give mood stabilizer

Question 20

After a minor fender bender a man wears a neck brace and requests permanent disability

Answer 20

malingering

Question 21

Nurse presents w severe hypoglycemia, blood analysis reveals no increase in C-Peptide

Answer 21

factitious disorder (Munchausen)

Question 22

Pt continues to use cocaine after being in jail, losing his job and not paying child support

Answer 22

substance abuse

Question 23

Med to avoid in pts w PTSD

Answer 23

Benzodiazepines (which are addictive). Pts w/ PTSD often have hx of substance abuse

Question 24

Violent patient has vertical or horizontal nystagmus

Answer 24

PCP

Question 25

woman who was abused as a child frequently feels outside of detached from her body

Answer 25

depersonalization disorder

Question 26

schizophrenic patient takes haloperidol for 1 year and develops uncontrollable tongue movements. Dx? Tx?

Answer 26

Tardive dyskinesia. decrease or stop the haloperidol and consider another antipsychotic

Question 27

Man w major depressive disorder is counseled to avoid tyriamine rich foods w his new meds

Answer 27

MAOI