Psychiatry

Question 1

what is the typical treatment of a first episode of major depressive disorder?`

Answer 1

antidepressant medication

Question 2

what is the first line antidepressant medication?

Answer 2

SSRI

Question 3

Once there is remission of symptoms of major depressive disorder what is the next step in management?

Answer 3

Continue antidepressant for approximately 6 months

Question 4

after remission of symptoms and completing 6 months use of antidepressant, what is the next step in management?

Answer 4

gradually taper before eventual discontinual

Question 5

when is it recommended continuing antidepressant indefinitely?

Answer 5

it is recommended in adults who have had more than two previous major depression

Question 6

…………. is the most likely conventional antipsychotics in its ability to cause significant elevations in plasma prolactin levels.

Answer 6

risperidone

Question 7

through which pathway does dopamine inhibit the release of prolactin from the anterior pituitary?

Answer 7

tuberoinfundibular dopamine pathway

Question 8

clinical manifestation of hyperprolactinemia include

Answer 8

breast enlargement and tenderness, galactorrhea, sexual dysfunction, amenorrhea, infertility and weight gain

Question 9

What medication can be used to relieve the autonomic symptoms of heroin withdrawal

Answer 9

Anticholinergic e.g. diphenhydramine

Question 10

What are some of the symptoms lithium intoxication

Answer 10

weakness, unsteady gait, diarrhea, tremor and confusion

Question 11

the use of the antihypertensive agent nifedipine in a patient on lithium with chronic renal insufficiency has what effect ?

Answer 11

it may cause an increase in lithium to toxic levels

Question 12

what is body dysmorphic disorder?

Answer 12

it is the preoccupation with an imagined defect or slight anomaly in appearance. The preoccupation interferes with the individual’s psychosocial functioning

Question 13

what is the treatment of body dysmorphic disorder?

Answer 13

psychotherapy and/or SSRIs

Question 14

what are the side effect of lithium use?

Answer 14

hypothyroidism, nephrotoxicity, nephrogenic diabetes insipidus

Question 15

what the signs and symptoms of hypothyroidism?

Answer 15

weight gain, dry skin, development of a low or “gravelly” voice, hair loss and tiredness e.t.c.

Question 16

neuroleptic malignant syndrome is characterized by

Answer 16

autonomic instability, mental status changes, hyperthermia, muscular rigidity, elevated CPK

Question 17

What is the treatment of choice for patients with bipolar disorder

Answer 17

lithium

Question 18

lithium is contraindicated in what type of patients?

Answer 18

• with signs of renal failure

- pregnant patients

Question 19

when lithium is contraindicated, what is the drug of choice for a bipolar patient?

Answer 19

valproate

Question 20

what is the most serious side effect of lamotrigine

Answer 20

rash

Question 21

what happens when lamotrigine is titrated up too quickly?

Answer 21

the potentially fatal stevens-johnson syndrome can occur.

Question 22

what is gender identity?

Answer 22

gender identity is a person’s sense of maleness or femaleness

Question 23

at what age is gender identity present

Answer 23

3 years

Question 24

define gender role

Answer 24

gender role is the behavior pattern that reflects a person’s gender identity

Question 25

define sexual identity

Answer 25

it refers to one’s biological sexual characteristics

Question 26

define sexual orientation

Answer 26

it is a preference for same sex or opposite sex patners.

Question 27

what is the drug of choice in patients who are depressed and suicidal?

Answer 27

SSRIs

Question 28

what medications are commonly used in the treatment of OCD?

Answer 28

SSRIs - fluoxetine and fluvoxamine

Question 29

describe akathisia

Answer 29

it is a feeling of intense motor restlessness

Question 30

what drugs are useful in decreasing the symptoms of akathisia

Answer 30

benzodiazepines such as lorazepam

Question 31

What is the most frequently used treatment for children with enuresis

Answer 31

Behavioral therapy

Question 32

Delirium is characterized by ………, …………., …………. and ………..

Answer 32

Rapid onset of impaired cognition, altered level of consciousness, disturbances in attention and psychomotor activity and altered sleep-wake cycles

Question 33

What are the common causes of delirium?

Answer 33

Fever, psychological and physical stress, metabolic disturbances, neoplasms, infections, medications, cerebral and cardiovascular diseases, withdrawal from alcohol and/or prescription medications

Question 34

Symptoms of water intoxication includes ………, ……….., …………, ………. and ……..

Answer 34

Polyuria, confusion, diarrhea, vomiting and lethargy

Question 35

tourette disorder is associated with …………….. and …………..in one-third of patients

Answer 35

ADHD and OCD

Question 36

whenever there is lymphadenopathy + oral thrush + cognitive deficits + mood disturbance, what do you think of and what do you do to screen?

Answer 36

HIV infection and order an ELISA

Question 37

Common findings seen in anorexic patients:

Answer 37

• osteoporosis
• elevated cholesterol and carotene levels
• intrauterine growth retardation
• Cardiac Arrhythmias (prolonged QT interval)
• Euthyroid sick syndrome
• Hypothalamic-pituitary axis dysfunction
• Hyponatremia secondary to excess water drinking