Psychiatry

Question 1

1st line pharmacotherapy for depression

Answer 1

SSRIs

Question 2

Antidepressants a/w hypertensive crisis

Answer 2

MAOIs

Question 3

Galactorrhea, impotence, menstrual dysfxn, and decreased libido

Answer 3

Dopamine antagonists

Question 4

17 y/o girl has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.

Answer 4

Conversion disorder

Question 5

Name the defense mechanism: A mother who is angry at her husband yells at her child

Answer 5

Displacement

Question 6

Name the defense mechanism: A pedophile enters a monastery

Answer 6

Reaction formation

Question 7

Name the defense mechanism: A woman calmly describes a grisly murder

Answer 7

Isolation

Question 8

Name the defense mechanism: A hospitalized 10 y/o begins to wet his bed

Answer 8

Regression

Question 9

Life-threatening muscle rigidity, high fever, and rhabdomyolysis

Answer 9

Neuroleptic malignant syndrome

Question 10

Amenorrhea, low body weight (

Answer 10

Anorexia

Question 11

35 y/o man has recurrent episodes of palpitations, diaphoresis, and fear of going crazy

Answer 11

Panic disorder

Question 12

Most serious side effect of clozapine

Answer 12

Agranulocytosis

Question 13

21 y/o man has 3 months social withdrawal, worsening grades, flattened affect and concrete thinking

Answer 13

Schizophreniform disorder (dx of schizophrenia requires a >/= mo of sx)

Question 14

Key side effects of atypical antipsychotics

Answer 14

Weight gain, type 2 DM, QT-segment prolongation

Question 15

Young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Dx? Tx?

Answer 15

Acute dystonia (oculogyric crisis). Tx w/ benztropine or diphenhydramine.

Question 16

Medication to avoid in pts w/ hx of alcohol withdrawal seizures

Answer 16

Neuroleptics

Question 17

13 y/o boy has a hx of theft, vandalism, and violence towards family pets

Answer 17

Conduct disorder. A/w antisocial personality do in adults

Question 18

5 mo girl has decreased head growth, truncal discoordination, and decreased social interaction

Answer 18

Rett’s do. Loss of milestones is commonly described.

Question 19

Patient hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Dx? Tx?

Answer 19

Acute mania. Start a mood stabilizer (eg lithium)

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 elevation in C-peptide

Answer 21

Factitious disorder (Munchausen syndrome)

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

Medication to avoid in pts w/ PTSD

Answer 23

Benzodiazepines (have high addiction potential.) Patients commonly have a hx of substance abuse

Question 24

Violent pt has vertical and horizontal nystagmus

Answer 24

Phencyclidine hydrochloride (PCP) intoxication

Question 25

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

Answer 25

Depersonalization disorder

Question 26

Schizophrenic pt takes haloperidol for 1 year and develops uncontrollable tongue movements. Dx? Tx?

Answer 26

Tardive dyskinesia. Decrease or d/c haloperidol and consider another antipsychotic (eg, risperidone, clozapine)

Question 27

Man w/ major depressive do is counseled to avoid tyramine-rich foods w/ his new medications

Answer 27

MAOIs