Psychiatry

Question 1

Antidepressants a/w hypertensive crisis

Answer 1

MAOIs

Question 2

Galactorrhea, impotence, menstrual dysfcn, and decreased libido

Answer 2

Pt on DA antagonist

Question 3

17 yo F with L arm paralysis after her BF dies in a car crash. No medical cause is found.

Answer 3

Conversion d/o

Question 4

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

Answer 4

Displacement

Question 5

Defense mech: pedophile enters a monastery

Answer 5

Reaction formation

Question 6

Defense mech: F calmly describes a grisly murder

Answer 6

Isolation

Question 7

Defense mech: hospitalized 10 yo begins to wet his bed

Answer 7

Regression

Question 8

Life-threatening m. rigidity, fever, and rhabdo

Answer 8

Neuroleptic malignant syndrome (NMS)

Question 9

Amenorrhea, bradycardia, and abnl body image in a young F

Answer 9

Anorexia

Question 10

35 yo M with recurrent episodes of palpitations, diaphoresis, and fear of going crazy

Answer 10

Panic d/o

Question 11

Most serious SE of clozapine

Answer 11

Agranulocytosis

Question 12

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

Answer 12

Schizophreniform d/o (dx of schizophrenia requires ≥6 mo of sxs)

Question 13

Key SEs of atypical antipsychotics

Answer 13

Wt gain, T2DM, QT prolongation

Question 14

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

Answer 14

Acute dystonia (oculogyric crisis).
-Tx: benztropine or diphenhydramine

Question 15

Medication to avoid if h/o EtOH w/d szs

Answer 15

Neuroleptics

Question 16

13 yo M with h/o theft, vandalism, and violence toward family pets

Answer 16

Conduct d/o

Question 17

5 mo F with decreased head growth, truncal dyscoordination, and decreased social interaction

Answer 17

Rett’s d/o

Question 18

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

Answer 18

Acute mania

-Tx: start a mood stabilizer (ex: lithium)

Question 19

After a minor fender bender, a man wears a neck brace and requests permanent disability

Answer 19

Malingering

Question 20

RN presents with severe hypoglycemia. Labs show no elevation in C-peptide.

Answer 20

Factitious d/o (Munchausen syndrome)

Question 21

Pt continues to use cocaine after being in jail, losing his job, and not paying child support

Answer 21

Substance abuse

Question 22

Violent pt has vertical and horizontal nystagmus

Answer 22

Phencyclidine hydrochloride (PCP) intox

Question 23

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

Answer 23

Depersonalization d/o

Question 24

M has repeated, intense urges to rub his body against unsuspecting passengers on a bus

Answer 24

Frotteurism (a paraphilia)

Question 25

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

Answer 25

Tardive dyskinesia

-Tx: Decrease or d/c haloperidol. Consider another antipsychotic (ex: risperidone, clozapine).

Question 26

M unexpectedly flies across the country, takes a new name, and has no memory of his prior life.

Answer 26

Dissociative fugue

Question 27

1st line pharmacotherapy for depression

Answer 27

SSRIs