Psychiatry 6%

Question 1

Difference between PTSD and acute stress d/o

Answer 1

PTSD: > 1 month

Acute stress d/o: < 1 month

Question 2

Major depressive disorder: Depressed mood and anhedonia w/ > 5 associated symptoms for most days x ___.

Answer 2

2 weeks

Question 3

Dysthymic d/o

Answer 3

Chronically depressed mood for > 2 years in adults

> 1 year in children

Question 4

MAOI + SSRI =

Answer 4

Serotonin Syndrome = acute AMS, agitation, diaphoresis, tremor, hyperthermia, seizures, coma, death
Dialated pupils (mydriasis)*

Question 5

MAOI + TCA =

Answer 5

Delirium, HTN

Question 6

This psychotherapeutic agent should be avoided in pts w/ long QT syndrome

Answer 6

Citalopram

Question 7

Increased incidence of Serotonin Syndrome if SNRI’s used w/ ____

Answer 7

St. John’s Wort

Question 8

Wide complex tachycardia is a sign of OD of what psychotherapeutic agent

Answer 8

TCA

Question 9

What psychotherapeutic agent should avoid tyramine-containing foods? What happens?

Answer 9

MAOI
Hypertensive crisis

aged cheese, wine, beer, aged foods, smoked meats, chocolates, coffee, tea

Question 10

TCAs inhibit neuronal reuptake of ____

Answer 10

Serotonin, Norephinephrine

Question 11

SNRA inhibit neuronal reuptake of ____

Answer 11

Serotonin, Norephinephrine, Dopamine

Question 12

Bupropion inhibit neuronal reuptake of ____

Answer 12

Dopamine, norephinephrine

Question 13

Cluster A
Cluster B
Cluster C

Answer 13

A: Weird = Schizoid, schizotypal, paranoid
B: Wild = Anti-social, borderline, histrionic, narcissistic
C: Whiny = Avoidant, dependent, Obsessive-compulsive

Question 14

Positive symptoms of schizophrenia (Hallucinations, delusions) is caused by ___

Answer 14

excess dopamine recepotrs in mesolimbic pathway

Question 15

Negative symptoms of schizophrenia (flat emotional affect) is caused by ___

Answer 15

dopamine dysfunction in mesocortical pathway (decreased dopamine)

Question 16

Tx of dystonic reactions (dyskinesia) d/t typical anti-psychotic agent

Answer 16

Diphenhydramine IV +/- anticholinergic (Benztropine)

Dystonic reaction: trismus, protrusions of tongue, facial grimacing, torticollis, difficulty speaking

Question 17

Extrapyramidal sx = (3)

Answer 17

1. Dystonic reactions (Dyskinesia) = trismus, protrusions of tongue, facial grimacing, torticollis, difficulty speaking
2. Tardive dyskinesia
3. Parkinsonism

Question 18

Neurolepitc Malignant Syndrome caused by ____.
Mechanism:
Symptoms:

Tx:

Answer 18

1st generation anti-psychotics
D2 inhibition of basal ganglia

AMS, extreme muscle rigidity, tremor, autonomic instability (tachy, hyperthermia/fever, incontinence)

Dantrolene
Dopamine agonists: Bromocriptine**, Amantadine, Levodopa/Carbidopa

Question 19

Anti-psychotic that causes agranulocytosis

Answer 19

Clozapine

Monitor w/ CBC weekly

Question 20

Anti-psychotic that causes increased prolactin

Answer 20

Benzisoxazoles: Risperidone, Ziprasidone

2nd gen > 1st gen

Question 21

Anti-psychotic that causes DM and marked weight gain

Answer 21

Olanzapine

Question 22

EKG change caused by 2nd gen > 1st gen anti-psychotic

Answer 22

QT prolongation

Question 23

Mental d/o with symptoms suggesting phsyical injury that cannot be explained by medical condition
NOT d/t malingering

Answer 23

Somatoform d/o

Question 24

Chronic condition w/ physical sx involving >1 part of body but no physical cause found.

Answer 24

Somatization d/o

Question 25

Neurological loss of sensory or motor function

Answer 25

Conversion disorder (Functional Neurological d/o)

Question 26

ADHD diagnosed when duration ____, onset age ___

Answer 26

duration > 6 months

onset before 12 y/o

Question 27

Lithium + ___ can cause fatal neurotoxicity

Answer 27

CCB

Question 28

____ may increase serum lithium levels

Answer 28

K+ sparing diuretics
Thiazide diuretics
ACE inhibitors

Question 29

Postural hypotension associated with ____ antipsychotic.

Answer 29

Quetiapine

Question 30

Tx of benzo intoxication

Answer 30

Flumazenil

Question 31

Long term Lithium therapy may cause ___

Answer 31

hypothyroidism

Question 32

hallucinations, parkinsonian features, extrapyramidal, dementia =

Answer 32

Lewy body disease

Loss of cholinergic neurons, dopaminergic neurons