PSYCHIATRY

Question 1

DSM Axis I:

Answer 1

Psychiatric d/o, substance dependence/abuse

Question 2

DSM Axis II:

Answer 2

Personality d/o and mental retardation

Question 3

DSM Axis III:

Answer 3

Physical and medical problems

Question 4

DSM Axis IV:

Answer 4

Social and environmental problems/stressors

Question 5

DSM Axis V:

Answer 5

GAF (current and highest from past year)

Question 6

2 features that distinguish MDD from Bereavement

Answer 6

1. S/S last >2 mos

2. Excessive depressive Sx are present (suicidal ideation, excessive guilt, worthlessness)

Question 7

Diagnosis of MDD

Answer 7

5/9 S/S of SIGECAPS (1 must be anhedonia or depressed mood) lasting at least 2 weeks

Question 8

Major S/E of Trazodone

Answer 8

Priapism

Question 9

Major S/E of Bupropion

Answer 9

Decreased seizure threshold

Question 10

Major S/E of Mirtazapine

Answer 10

Weight gain

Question 11

Serotonin Syndrome S/S

Answer 11

restlessness, confusion, hyperthermia, muscle rigidity, CV collapse, death

Question 12

Major S/E of TCAs

Answer 12

prolonged QRS, lethal in OD

Question 13

Major S/E of MAOIs

Answer 13

Hypertensive crisis if taken w/ high-tyramine foods

Question 14

Serotonin Syndrome

Answer 14

SSRI + MAOI + SNRI can all lead to serotonin syndrome

Question 15

Serotonin Syndrome Prevention

Answer 15

D/C SSRI 5 weeks before starting MAOI

Question 16

Which SSRIs have fewer drug interactions?

Answer 16

Sertraline and Citalopram

Question 17

Which SSRIs are helpful for anxiety associated w/ depression?

Answer 17

Sertraline and Citalopram

Question 18

SSRIs take _____ to have an effect

Answer 18

2-3 weeks

Question 19

Major reason for non-compliance of SSRIs?

Answer 19

Sexual dysfunction

Question 20

Medication for bedwetting?

Answer 20

Imipramine

Question 21

Medication for depression and OCD?

Answer 21

Clomipramine

Question 22

3 C’s of TCA OD

Answer 22

convulsions, coma, cardiac arrhythmias

Question 23

Evolution of EPS

Answer 23

4hrs - Acute Dystonia
4d - Akinesia
4wks - Akathisia
4mos - Tardive dyskinesia

Question 24

Tx of acute dystonia

Answer 24

(IM anticholinergics) Benztropine, Diphenhydramine, or Trihexyphenidyl

Question 25

Tx of akathisia

Answer 25

B-blocker (propanolol) or Benzodiazepine (clonazepam, diazepam)

Question 26

Tx of parkinsonism

Answer 26

(oral anticholinergics) amantadine (DA-releasing agent)

Question 27

Serotonin Syndrome Tx

Answer 27

5-HT2 antagonist (Cyproheptadine)

Question 28

Tx for TCA OD

Answer 28

Bicarb