Psych- UWORLD

Question 1

124- Q2. person believes that she has “six sense” and “always listen to her body”: is this delusion?

Answer 1

no.

delusion is something that is persistent belief DESPITE the facts. (like talking to alien) Although this sounds like delusion, it is more like MAGICAL THINKING seen in SCHIZOTYPAL personality disorder

Question 2

124- Q2. Apart from magical thinking or eccentric appearance, what other phenotype will be seen in schizotypal personality disorder

Answer 2

interpersonal awkwardness

• this is not same with negative symptoms (affective flattening or asociality)

Question 3

124- Q 7. Naloxone, opioid antagonist, has greatest affinity to what opioid receptor?

Answer 3

u (mu) receptor

• it binds to all kinds of opioid receptors (mu, delta, kappa)

Question 4

124- Q 13. What is the most effective treatment for specific phobia?

Answer 4

exposed based behavioral therapy

: desensitization to trigger of fear by exposing to it

Question 5

124- Q22. How many words should baby of age 2 be able to speak to be considered as normal development? how many words sentence?

Answer 5

200 words

2 words sentences

Question 6

124- Q 33. Is hallucination considered as abnormal grief?

Answer 6

No. WITH ABSENCE OF OTHER psych symptoms,
HALLUCINATION is considered as NORMAL GRIEF

• think like this: hallucination is sort of way to deal with sad situation (ex: grandmother appearing after death of her). so it is part of normal grief

Question 7

124- Q 37. Rat poison (rodenticides): what toxicity? how to treat it?

Answer 7

warfarin like toxicity

treated as if warfarin toxicity: FFP, followed by vitamin K

Question 8

125- Q 2. What medication can be used to reduce craving of alcohol?

Answer 8

naltrexone
=> inhibit reward effect of alcohol by blocking u opioid receptor

• I picked disulfiram. Disulfiram does NOT change craving. Rather, it helps maintain abstinence via aversive mechanism of action

Question 9

125- Q3. what is trichotillomania?

Answer 9

hair pulling disorder

: patient pulls off hair to stop behavior

Question 10

125- Q7. After pt takes some psych medication, she developed weight gain, loss of hair, constipation, and dry skin. What med is this?

Answer 10

lithium

• remember, hypothyroidism can result in dry skin and hair loss (coarse, brittle hair)

Question 11

125- Q8. What medication can be used to treat refractory schizophrenia?

Answer 11

clozapine

• clozapine: remember two things
  1. agranulocytosis
  2. refractory schizophrenia

Question 12

125- Q9. Why antidepressants are contraindicated in biploar disorder?

Answer 12

all antidepressants can induce mania

• this kinda makes sense: serotonin is happy molecule. with high serotonin, you get so happy and thus manic (kinda..)

Question 13

125- Q 11. What is key difference between schizophrenia vs. major depression with psychotic features

Answer 13

• schizophrenia: CO-OCCURRANCE of psychotic features (positive symptoms- hallucination, delusion, disorganized thoughts) and depressive symptoms (negative symptoms- asociality, avolition[ loss of motivation], anhedonia)
• major depression with psychotic features: psychotic features and depressive symptoms occur EXCLUSIVELY
• BOTTOM LINE: co-occurring? or exclusively occurring?

Question 14

125- Q18. Nitroprusside (direct NO releaser) may cause cyanide toxicity as a side effect. thiosulfate is used as an antidote (after nitrite). what is MOA of thiosulfate?

Answer 14

thiosulfate: SULFUR group donor

cyanide -> thiocyanide (detoxified)

Question 15

125- Q 25. SSRI: serotonin syndrome vs. sexual dysfunction. what side effect should I worried about more?

Answer 15

sexual dysfunction

• serotonin syndrome is uncommon with mono-drug therapy

Question 16

127- Q2. what drug can be used during initiation of SSRI if there is significant increase in insomnia?

Answer 16

short or intermediate acting BDZ

• lorazepam is intermediate acting BDZ

Question 17

126- Q 1. Other than cataplexy and sudden daytime sleep, what another phenotype may be seen in nacrolepsy?

Answer 17

hypnagogic (before going to sleep) or hynopompic (after awakening from sleep) hallucination

Question 18

126- Q 7. what medication is used for acute panic disorder? what is first line for panic disorder in general?

Answer 18

• acute setting: BDZ

- first line: SSRI

Question 19

126- Q 8. methylphenidate

• what drug class?
• side effects

Answer 19

• CNS stimulant (like amphetamine)
• weight loss and deceased appetite
• remember cocaine withdrawal is eat a lot sleep alot?

Question 20

126- Q 14. Treatment option for atypical depression?

Answer 20

MOAI (phenelzine)

Question 21

126- Q 20. What drug is the most common cause of overdose death?

Answer 21

heroin (or opioid)

death due to excessive respiratory suppression

Question 22

126- Q28. which drug can be used in treating both epilepsy and bipolar disorder?

Answer 22

valproate