Psychiatry

Question 1

DIGFAST is for…

Answer 1

mania

Question 2

DIGFAST stands for…

Answer 2

D - distractability
I - irritable mood/insomnia
G - grandiosity
F - flight of ideas
A - agitation/increase in goal-directed activity
S - speedy thoughts/speech
T - thoughtlessness (seek pleasure w/out regard to consequences)

Question 3

SAD PERSONS is for…

Answer 3

suicide risk

Question 4

SAD PERSONS stands for…

Answer 4

S - sex (male)
A - >60 years
D - depression
P - previous attempt
E - ethanol/drug abuse
R - rational thinking loss
S - suicide in family
O - organized plan/access
N - no support
S - sickness

Question 5

SIGECAPS is for…

Answer 5

depression

Question 6

SIGECAPS stands for…

Answer 6

S - sleep
I - interest
G - guilt
E - energy
C - concentration
A - appetite
P - psychomotor changes
S - suicidal ideation

Question 7

Delirium Tremens - timeframe

Answer 7

2-4 days post cessation of EtOH

Question 8

Delirium Tremens - symptoms

Answer 8

delirium, agitation, fever, autonomic hyperactivity, auditory and visual hallucinations

Question 9

Delirium Tremens - treatment

Answer 9

benzodiazepines, hydration

Question 10

Neuroleptic Malignant Syndrome - symptoms

Answer 10

fever, rigidity, autonomic instability, clouding of consciousness, elevated WBC/CPK

Question 11

Neuroleptic Malignant Syndrome - treatment

Answer 11

withhold neuroleptics, hydrate, consider dantrolene/bromocriptine

Question 12

Serotonin Syndrome - pathophys.

Answer 12

precipitated by use of 2+ with serotonin-enhancing properties (MAOI + SSRI)

Question 13

Serotonin Syndrome - symptoms

Answer 13

AMS, fever, agitation, tremor, myoclonus, hyperreflexia, ataxia, incoordination, diaphoresis, shivering, diarrhea

Question 14

Serotonin Syndrome - treatment

Answer 14

d/c offending agents, consider cyproheptadine

Question 15

Tyramine Reaction/Hypertensive Crisis - pathophys.

Answer 15

precipitated by ingestion of tyramine containing foods while on MAOIs

Question 16

Tyramine Reaction/Hypertensive Crisis - symptoms

Answer 16

HTN, HA, neck stiffness, sweating, N/V, visual problems, stroke, death

Question 17

Tyramine Reaction/Hypertensive Crisis - treatment

Answer 17

nitroprusside or phentolamine!!!

Question 18

Acute Dystonia - symptoms

Answer 18

early, sudden onset of muscle spasm: eyes, tongue, jaw, neck

Question 19

Acute Dystonia - treatment

Answer 19

benztropine or diphenhydramine

Question 20

Lithium Toxicity - symptoms

Answer 20

N/V, slurred speech, ataxia, incoordination, myoclonus, hyperreflexia, seizures, nephrogenic diabetes insipidus, delirium, coma

Question 21

Lithium Toxicity - treatment

Answer 21

d/c Li, hydrate aggressively, consider hemodialysis

Question 22

Tricyclic Antidepressant Toxicity - symptoms

Answer 22

anticholinergic effects, cardiac conduction disturbances, hypotension, respiratory depression, agitation, hallucinations, CNS stimulation, depression, seizures

Question 23

Tricyclic Antidepressant Toxicity - treatment

Answer 23

monitor EKG, activated charcoal, cathartics, supportive treatment

Question 24

Fixed, false beliefs that are not shared by the person’s culture and cannot be changed by reasoning; bizarre or nonbizarre

Answer 24

delusions

Question 25

persistent, irrational fear

Answer 25

phobia

Question 26

repetitive, intrusive thought

Answer 26

obsession

Question 27

repetitive behavior

Answer 27

compulsion

Question 28

sensory perceptions that occur in the absence of an actual stimulus

Answer 28

hallucinations

Question 29

inaccurate perception of existing sensory stimuli

Answer 29

illusion

Question 30

experience of feeling detached from one's surroundings/mental processes

Answer 30

derealization/depersonalization

Question 31

hallucinations (usually auditory) during or just after heavy alcohol consumption; patients are aware that they are not real

Answer 31

alcoholic hallucinosis

Question 32

teenager's aggression with father is redirected to perform well in sports...

Answer 32

sublimation (mature defense)

Question 33

a patient with sexual thoughts enters a monastery...

Answer 33

reaction formation (immature)

Question 34

3 available FDA-approved first-line pharmacological treatments for smoking cessation

Answer 34

1. nicotine replacement therapy 2. varenicline 3. bupropion

Question 35

Contraindications for using bupropion for smoking cessation

Answer 35

1. patients with seizures | 2. patients with history of bulimia

Question 36

Tx for smoking cessation

Answer 36

nicotine replacement therapy + counseling + supportive therapy

Question 37

Most effective Rx for pediatric depression

Answer 37

SSRI (fluoxetine)

Question 38

There is some evidence that in patient < ____ y/o, there can be an ______ in suicidal thoughts when starting

Answer 38

25, increase

Question 39

Selective Mutism - Definition

Answer 39

refusal to speak in a specific social situation in contrast to normal communication in situations in which they feel comfortable (school vs. home)

Question 40

Selective Mutism - Treatment

Answer 40

CBT, SSRIs

Question 41

Psych symptoms + Neuro Symptoms + abnormal liver function tests in a child think...

Answer 41

Wilson Disease

Question 42

Neuro findings in Wilson Disease

Answer 42

slurred speech, drooling, hand tremor

Question 43

Characterized by abnormal social development and extreme behavioral rigidity; usually diagnosed in early development but can be masked by intelligence

Answer 43

ASD (autism spectrum disorder)

Question 44

Non-stimulant treatment for ADHD

Answer 44

atamoxetine

Question 45

A diagnosis of ______ should be considered in a patient who demonstrates symptoms of inattention, impulsivity, and hyperactivity in >2 settings.

Answer 45

ADHD

Question 46

redirection of emotions/impulses to a neutral person

Answer 46

displacement (immature defense); teacher gets yelled at by principal, teacher then yells at husband for dinner choices

Question 47

Cluster A, B, C

Answer 47

Weird, Wild, Worried

Question 48

Timeline: Depression

Answer 48

> 2 weeks

Question 49

Timeline: Adjustment D/O

Answer 49

w/in 3 months

Question 50

Timeline: Acute Stress D/O

Answer 50

b/w 3 days - 1 month

Question 51

Timeline: PTSD

Answer 51

>1 month

Question 52

Greatest Risk for Completed Homicide

Answer 52

Firearm in the house

Question 53

First step in treatment for PP psychosis

Answer 53

Hospitalization

Question 54

Patients with >3 lifetime depressive episodes, severe episodes, or episodes lasting for >2 years should have...

Answer 54

indefinite antidepressant therapy

Question 55

High yield therapy interventions in schizophrenia

Answer 55

family therapy and psychoeducation

Question 56

Lose semen through urine

Answer 56

Dhat Syndrome -- ask them what they think is wrong

Question 57

SSRI that is bad for patients with recent MI

Answer 57

citalopram

Question 58

Class of antidepressant that is bad for patient with cardiac history

Answer 58

TCAs

Question 59

Brief psychotic disorder is schizo sx that last for...

Answer 59

1 day - 1 month

Question 60

Mood stabilizer for patient's with kidney disease...

Answer 60

Valproate

Question 61

2nd line Rx for alcohol cessation; causes unpleasant s/e when patient drinks

Answer 61

disulfiram

Question 62

Fatigue, constipation, myalgias, hypotension with mood stabilizer...

Answer 62

lithium induced hypothyroidism

Question 63

Vomit induced (bulimia) metabolic disturbance and lab finding...

Answer 63

metabolic alkalosis and hypokalemia

Question 64

Anticholinergic S/E

Answer 64

``` Mad as a hatter Blind as a bat Red as a beet Hot as a hare Dry as a bone ```

Question 65

OD + QT interval changes think...

Answer 65

TCAs

Question 66

SSRI of choice for pediatric patients

Answer 66

fluoxetine

Question 67

1st line for Tourette's

Answer 67

a2 adrenergic -- guanfacine

Question 68

Prior to lithium therapy, check (labs)...

Answer 68

thyroid and renal function

Question 69

Mood stabilizer associated with elevated LFTs

Answer 69

valproate

Question 70

Rx treatments (2) for patients with suicidal intentions

Answer 70

lithium, clozapine

Question 71

Adjustment disorder tx...

Answer 71

psychotherapy

Question 72

Despiramine

Answer 72

TCA; 2nd line for cataplexy

Question 73

Phenylzine

Answer 73

MAOI

Question 74

NMS is caused by...

Answer 74

antipsychotics

Question 75

Increased amylase levels think...

Answer 75

bulimia

Question 76

Fentanyl can cause...

Answer 76

Parkinsonism

Question 77

Location: acetylcholine

Answer 77

nucleus basalis of Meynert

Question 78

Location: dopamine

Answer 78

substantia nigra

Question 79

Location: GABA

Answer 79

nucleus accumbens

Question 80

Location: norepinephrine

Answer 80

locus ceruleus

Question 81

Location: serotonin

Answer 81

Raphe nucleus

Question 82

Bipolar: depressed

Answer 82

quetiapene/lamotrigene; olazapene + fluoxetine

Question 83

Bipolar: mania

Answer 83

valproic acid

Question 84

1st line for Panic D/O

Answer 84

SSRI + CBT

Question 85

Tx: acute dystonia

Answer 85

benztropine, diphenhydramine (4 hours)

Question 86

Tx: akathisia

Answer 86

benztropine, benzos, beta blockers (4 days)

Question 87

Tx: Parkinsonism by Rx

Answer 87

benztropine, amantidine (4 weeks)

Question 88

Tx: Tardive Dyskinesia

Answer 88

valbenazine (4 years)