Psychiatry

Question 1

First-line pharmacotherapy for depression

Answer 1

SSRIs

Question 2

Antidepressants associated with hypertensive crisis

Answer 2

MAOIs

Question 3

Galactorrhea, impotence, menstrual dysfunction, and decreased libido

Answer 3

Dopamine antagonists

Question 4

17yo F has L arm paralysis after boyfriend dies in a car crash. No medical cause is found.

Answer 4

Conversion disorder

Question 5

Defense mech: mother who is angry at husband yells at child

Answer 5

Displacement

Question 6

Defense mech: pedophile enters monastery

Answer 6

Reaction formation

Question 7

Defense mech: woman calmly describes a grisly murder

Answer 7

Isolation

Question 8

Defense mech: hospitalized 10yo begis to wet his bed

Answer 8

Regression

Question 9

Life-threatening muscle rigidity, high fever, rhabdomyolysis

Answer 9

Neuroleptic malignant syndrome

Question 10

Amenorrhea, low body weight (

Answer 10

Anorexia

Question 11

35yo M has recurrent episodes of palpitations, diaphoresis, & fear of going crazy

Answer 11

Panic disorder

Question 12

Most serious side effect of clozapine

Answer 12

Agranulocytosis

Question 13

21yo M w/ 3mo of social withdrawal, worsening grades, flattened affect, and concrete thinking

Answer 13

Schizophreniform (schizophrenia requires >6mo of Sxs)

Question 14

Key side effects of atypical antipsychotics

Answer 14

weight gain, type 2 DM, QT prolongation

Question 15

Young man receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis & treatment?

Answer 15

Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

Question 16

Medication to avoid in patients with a h/o alcohol withdrawal seizures

Answer 16

Neuroleptics

Question 17

13yo M w/ h/o theft, vandalism, violence towards family pets

Answer 17

Conduct DO. Ass. w/ antisocial personality DO in adults

Question 18

5mo F has decreased head growth, tunnel discoordination, and decreased social interaction

Answer 18

Rett’s disorder; loss of milestones is commonly described

Question 19

Pt hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis and treatment?

Answer 19

Acute mania. Start a mood stabilizer (lithium)

Question 20

After minor “fender bender,” a man weras a neck brace and requests permanent disability

Answer 20

Malingering

Question 21

A 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 patients w/ PTSD

Answer 23

Benzodiazepines (have high addiction potential). Puts commonly have a history of substance abuse

Question 24

A violent Pt has vertical and horizontal nystagmus

Answer 24

Phencyclidine hydrochloride (PCP) intoxication

Question 25

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

Answer 25

Depersonalization DO

Question 26

A schizophrenic patient takes haloperidol for 1 year and develops uncontrollable tongue movements. Diagnosis and treatment?

Answer 26

Tardive dyskinesia. Decrease or DC haloperidol and consider another antipsychotic (risperidone, clozapine)

Question 27

A man w/ MDD is counseled to avoid tyramine-rich foods with his new medication

Answer 27

MAOIs

Question 28

Antipsychotics can cause hyperprolactinemia via…

Answer 28

blocking dopamine activity in tuberoinfundibular pathway