Psych

Question 1

Generalized anxiety disorder

Answer 1

Anxiety > 6 months + 3 or more somatic symptoms (fatigue, restlessness, sleep disturbance, muscle tension, irritability)

Short term: BNZPs (also panic disorder)

Long term: education, SSRI, buspirone

Question 2

BNZP intoxication: therapy

Answer 2

Give Flumazenil

Question 3

ADHD

Answer 3

> 7 years old
inattention, short attention span, hyperactivity at least in to scenarios

Tx: Methylphenidato > insomnia, headaches

Atomoxetine> 2nd line but tested

Question 4

Tourette disorder

Answer 4

Motor tics + vocal tics

give antypsychotics: risperidone

Question 5

Major depression

Answer 5

>2 weeks
Depressed mood +
weight changes, 
sleep changes, 
fatigue, 
poor concentration, thoughts of death & worthlessness 

SSRI

Question 6

Depression + neuropathic pain

Answer 6

desvenlafaxine

Question 7

Depression + fearful of weight gain and sexual side effects

Answer 7

Bupropion (⬇️Seizures threshold)

Question 8

Bipolar mania treatment

Answer 8

Acute: if severe give antipsychotics > if mild give stabilizers!
Maintenance: mood stabilizers (1ST lithium, valproate > 2nd quetiapine, lamotrigine)

Question 9

Bipolar depression treatment

Answer 9

Start stabilizer, add antidepressant

Question 10

Lithium

Answer 10

First line mood stabilizer!

Diabetes insipidus (Don’t use in renal failure), tremor, weight gain, hypothyroidism

Question 11

Lithium toxicity

Answer 11

> 1.5 mEq
ataxia, dysarthria, delirium, acute renal failure

HTZ use ⬆️risk

Question 12

Carbamazepine

Answer 12

2nd line mood stabilizer

Nausea, leukopenia, AV block

Question 13

Schizophrenia + DMII

Answer 13

Aripiprazole

Ziprasidone preferred

Question 14

Olanzapine

Answer 14

Atypical antypsych

OBESITY

Question 15

cLOZAPINE

Answer 15

Atypical antypsych

Agranulositosis

Question 16

Risperidone

Answer 16

Hyperprolactinemia

Question 17

Delusional disorder

Answer 17

> 1 month

Non bizarre delusions

Question 18

Alprazolam

Answer 18

Short half life BZPs

Panic disorder

The shorter the half life, the greater risk of severe withdrawal reactions .

Question 19

Somatization disorder

Answer 19

multiple system symptoms

Question 20

Conversion disorder

Answer 20

Voluntary motor or sensory function complaints&raquo_space; associated with psychological factors

Question 21

Delirium tremens

Answer 21

> 48 H after ALCOHOL 🍾 withdrawal

confusion, agitation, fever, tachycardia, htn, diaphoresis, halucinations

<48 h&raquo_space;> Think in Alcoholic hallucinosis (oriented, no autonomic compromise)

Question 22

Opioid withdrawal

Answer 22

Lasting 3-5 days

Like amphetamine intoxication symptoms (dysphoria, anorexia, myalgias, diaphoresis, dilated pupils, diarrhea)

Question 23

Amphetamine

intoxication

Answer 23

Psychomotor agitation, impaired judgment, mydriasis, delusions, seizures, hallucinations.

Tx: Haloperidol

Question 24

Cocaine withdrawal

Answer 24

Depression, fatigue, hypersomnia, increased dreaming, hyperphagia, impaired concentration

Question 25

Body dysmorphic disorder

Answer 25

Preoccupation with >1 physical defect
Distress

Tx: antidepressant, cog beh therapy

No response to reassurance

Question 26

Conversion disorder

Answer 26

Neurologic symptoms incompatible with any disease

Distress

Question 27

Illness anxiety disorder

Answer 27

Fear of having a serious disease with NO symptoms

Question 28

Neuroleptic malignant syndrome

Answer 28

Fever, mental status changes, rigidity, autonomic symptoms

Tx»🚫Meds, supportive care&raquo_space;> Dopa agonist (Bromocruptine or amantadine)