Psych forever

Question 1

when does bereavement become MDD

Answer 1

major depressive disorder in these circumstances requires the presence of marked functional impairment, morbid preoccupations with unrealistic guilt or worthlessness, SI, marked psychomotor retardation, and psychotic symptoms

Question 2

How long does healthy bereavement last

Answer 2

2 months

Question 3

1st line rx for mania

Answer 3

valporate- better tolerated vs Li

Question 4

_______________- are generally believed to be the treatments of choice for persistent depressive disorder

Answer 4

Venlafaxine and bupropion

Question 5

Onset 6 months post stroke. This disorder may occur in about 33% of stroke victims.

Answer 5

Post stroke depression

Question 6

____________ is not seen in postpartum blues, but is

common in postpartum depressions.

Answer 6

Anhedonia

Question 7

s/s must be present for _____ time to ddx cyclothymia

Answer 7

2 years

Question 8

The most common complaints after ECT include

Answer 8

HA, nausea, and muscle soreness.

Memory impairment (both retrograde and anterograde) does occur but less frequently

Question 9

Positron emission tomography (PET) scan has

consistently demonstrated _______________ in depressed patient

Answer 9

a decrease in blood flow and metabolism in the frontal lobe

Question 10

In major depressive disorder, the REM sleep latency (the period of time between falling asleep and the
first period of REM sleep) is ___________

Answer 10

shortened

Question 11

characterized by loss of pleasure in all activities (anhedonia), lack of reactivity (nothing can make the
patient feel better), intense guilt, significant weight loss, early morning awakening, and marked psychomotor retardation

Answer 11

Major depressive disorder with melancholic features

TCAs work well here

Question 12

__________ is diagnosed when a major depressive episode develops in a patient with dysthymic disorder

Answer 12

Double depression

Approximately 40% of patients with a major depressive disorder also meet the criteria for persistent depressive disorder (dysthymia).

Question 13

________ are considered to be more effective than other classes of antidepressants in atypical depression

Answer 13

MAOIs

Question 14

four Ds of malpractice:

Answer 14

(1) a duty existed toward the patient on the part of the psychiatrist
(2) a deviation from the standard of practice occurred (3) this deviation bore a direct causal relationship to the untoward outcome
4) damages occurred as a result

Question 15

five elements that make up what is
considered a reasonable standard of care for disclosing information needed to obtain informed
consent are

Answer 15

diagnosis
treatment
consequences
prognosis
alternatives to the proposed treatment (including risks and benefits)

Question 16

The Tarasoff decision was a landmark case in determining that psychotherapists have an obligation to

Answer 16

warn third parties who are in danger

Question 17

__________ is the most common reason for malpractice claims in psychiatry, accounting for 33% of all claims.

Answer 17

Improper treatment

This is followed by attempted/ completed SI, which at 20%

Question 18

The principle of _____________ refers to preventing or removing harm and promoting well-being.

Answer 18

beneficence

Question 19

Tarasoff II stated that once a therapist has reasonably determined that a patient poses a serious danger of violence to others, the therapist must

Answer 19

“bears a duty to exercise reasonable care to protect the foreseeable victim of that danger.”

Tarasoff II

Question 20

Anti- depressents for the elderly

Answer 20

The SSRIs:  
fluoxetine
 paroxetine,
sertraline
 fluvoxamine
citalopram 

unique agents such as bupropion, venlafaxine, nefazodone, and mirtazapine.

Question 21

Name the SSRIs

Answer 21

fluoxetine
paroxetine,
sertraline
fluvoxamine
citalopram

Question 22

citalopram is

Answer 22

SSRI

Question 23

fluvoxamine is

Answer 23

SSRI

Question 24

The tricyclic drugs include

Answer 24

imipramine
desipramine
amitriptyline
nortriptyline.

Question 25

TCAs treat?

Answer 25

They are effective in the treatment of depression;

panic disorder, generalized anxiety disorder, and separation anxiety; enuresis; and ADHD

Question 26

Phenelzine and tranylcypromine are both ______,

Answer 26

MAO inhibitors

major s/e: hypotension

Question 27

tranylcypromine is?

Answer 27

MAOi

Question 28

Clozapine w/ WBC = 2000 to 3000 should cause psychiatrists to

Answer 28

get daily CBCs and stop the clozapine. It may be reinstituted after the WBCs normalize.

Question 29

Clozapine w/ wbc 3000-3500 with or without clinical symptoms should cause the psychiatrist to

Answer 29

monitor the patient closely and institute a minimum of twice-weekly CBC tests with differentials included.

Question 30

With an uncomplicated agranulocytosis (no signs of infection) on clozapine, the patient should be

Answer 30

placed in protective isolation
d/c clozapine
bone marrow specimen to see if progenitor cells are being suppressed.

Clozapine must not be restarted

Question 31

In Li overdose, __________ makes dialysis necessary

Answer 31

Li levels >2.5 nEq/L

Question 32

Ramelteon use and s/e

Answer 32

Ramelteon reduces time to sleep onset

s/es headache.

do not use in severe hepatic impairment, severe sleep apnea, or severe COPD

Question 33

Carbamazepine warnings

Answer 33

can cause aplastic anemia, agranulocytosis, thrombocytopenia, and leukopenia.
risk of hepatotoxicity.

benign rash–> drug should be discontinued if this occurs because progression to a severe rash is unpredictable

Question 34

________ antidepressant is associated with a great tendency to gain weight

Answer 34

Amitriptyline

Question 35

All women of child-bearing potential who must take valproic acid should be given _____ supplementation.

Answer 35

folic acid

Question 36

neuroepileptic dystonia rx in ER

Answer 36

benztropine or diphenhydramine IM in an emergency room setting

Question 37

RX for neuroleptic akathesia

Answer 37

beta-adrenergic receptor antagonists ie propranolol, though benzodiazepines and anticholinergics may also be somewhat effective

Question 38

ECT anesthesia

Answer 38

Methohexital is commonly used for ECT

lower cardiac risks than other barbiturates

Question 39

The only medication approved for shift work

sleep disorder is ________

Answer 39

modafinil

Question 40

disulfiram moa

Answer 40

Acetaldehyde dehydrogenase inhibition

Question 41

_______ is the preferred treatment

for psychotic symptoms in patients with Parkinson disease because?

Answer 41

Quetiapine due to its sedative quality and relative lack of extrapyramidal effects.

Question 42

____________ is considered the safest and the best-tolerated anticonvulsant for patients taking clozapine who experience seizures

Answer 42

Valproate