Psych

Question 1

1.Which medication is good for ETOH abuse in highly motivated patients who are not drinking?

2. Which medication is good for ETOH abuse in patients who need more control and still drinking.

Answer 1

1. Disulfiram (causes nausea and vomitting)
2. Naltrexone

Question 2

Elderly patient with normal mini mental exam, with changes in sleep and poor oral intake with ELEVATED MCV and LFTs should prompt what consideration?

Answer 2

ETOH use disorder

Question 3

Which Second Generation Antipsychotic is associated with Less Weight Gain and Metabolic Syndrome?

Answer 3

Aripiprazole

Question 4

Which Antipsychotic causes Agranulocytosis?

Answer 4

Cloazapine

Question 5

Which anti-depressant is associated with Less Weight gain and Less exual dysfunction?

Answer 5

Bupropion (Avoid in hx of seizure)

Question 6

Medication that treats Acute dystonia and Parkinsomnism?

Answer 6

Benztropine (Anticholinergic)

Question 7

After receiving dopamine agonist pt develops AMS, Fever (very high 103,) Generalized Muscle Rigidity, Autonomic instability. Dx? Rx?

Answer 7

Neuroleptic Malignant Syndrome.

Discontinue causative agent.

Supportive care with aggressive Cooling, Antipyretics, IVF, Tylenol

Dantrolene is used if no improvement.

Question 8

Rare Genetic disorder when patient develops Muscle rigidity and Hyperthermia after Volatile Anesthetics or Succinylcholine?

Answer 8

Malignant Hyperthemia

Question 9

Pt develops Fever, AMS, Hyperrefleixa, and Myoclonus, Nausea, Vomiting and Diarrhea after drug interactions

Answer 9

Serotonin Syndrome

Question 10

What is the Strongest risk factor for Functional Decline in the eEderly?

Answer 10

Loneliness

Question 11

1. Medications causes Inability to sit still and restlessness? Rx?
2. Develops after a few days Sudden onset distressing involuntary contraction of neck, mouth, tongue and eye muscles.

Answer 11

1. Akathisia seen in patients on 1st or 2nd generation antipsychoticsRx: Treat with betablocker or benzo
2. Tardive dyskinesia

Question 12

Rx for Bulimia Nervosa?

Answer 12

Fluoxetine

Question 13

Insomnia, Impaired Concentration, Emotional detachment, Avoidance within 4 weeks after Stressful event?

Dx?

Rx?

Answer 13

Acute Stress Disorder

CBT

Question 14

First line treatment for Major Depression with Psychotic features?

Answer 14

ECT

Question 15

Management of Anorexia Nervosa?

What if they present with unstable vitals and abnormal electrolytes?

Answer 15

1. Psychotherapy and Nutritional rehabilitation
   Olanzapine (Help with WEIOGHT GAIN)
2. Hospitalization

Question 16

Preoccupation with >1 unexplained Somatic Symptom?

Answer 16

Somatic Symptom Disorder

Question 17

Preoccupation with having a serious Undiagnosed Specific Disease?

Answer 17

Illness Anxiety Disorder (Hypochondriac)

Question 18

First line treatment for Social Anxiety Disorder?

Answer 18

1. SSRI or SNRI and CBT

Question 19

Pt is a 36 yo who prefers Working From home, Does not like Socializing, Stuck in Routines, Very Restricted Interest and Behavioral Rigidity.

Dx?

Answer 19

Autism Spectrum Disorder (Delayed Diagnosis in Adulthood)

Question 20

Which medications can Decrease Excretion of Lithium which is common in the Elderly due to Decrease GFR?

Answer 20

Anti-hypertensives that work on the kidney (ACE, ARB, Thiazides, Diuretics.)

Question 21

1. Which medications are associated with the Greatest Metabolic effects (Weight gain, Hyperlipidemia, Hyperglycemia)
2. Which bipolar medication as effects on thyroid function
3. Which medications can lead to QT Prolongation?
4. Which Second-Generation Antipsychotic has less weight gain side effects?

Answer 21

1. Olanzapine and Clozapine ( Check fasting glucose and lipids)
2. Lithium
3. Citalopram, Ziprasidone
4. Aripiprazole

Question 22

First line medication for Severe Major Depression in Pregnant Patients

Answer 22

Setraline

Question 23

Treatment for TCA overdose?

Answer 23

Sodium Bicarbonate