Psychiatry

Question 1

How do we best define generalized anxiety disorder and criteria?

Answer 1

Chronic, insidious low level anxiety all the time

Constant state of worry for at least 6 months and at least 3 somatic changes (sleep, weight, concentration)

Question 2

Best treatment for GAD?

Treatment for a panic attack, not the disorder?

Answer 2

Psychotherapy much more effective than meds, but if you do get to meds, SSRIs.
Benzo

Question 3

What to use for a panic attack acutely to abort it?

What to use for chronic panic disorder?

Answer 3

Benzo

SSRI +- CBT

Question 4

Best treatment for phobias?

Answer 4

CBT - desensitization under benzo

Question 5

What med to give for public speaking social phobia?

Answer 5

Non selective beta blocker

Question 6

Best treatment for depression?

Next?

Answer 6

ECT

SSRI and therapy

Question 7

When would you hospitalize a pt for suicide?

Answer 7

Idea and plan

Question 8

First line treatment for mania/bi polar type 1?
Second?
Third?

Answer 8

Lithium
Valproic acid
Carbamazepine

Question 9

Stages of sleep and what they show on EEG?

1,2,3 and REM

Answer 9

1: theta waves
2: K complexes
3: Delta waves
Rem: awake brain Rapid eye movements and Antonia

Question 10

Define sleep latency?

REM latency?

Answer 10

Bed to stage 1

Stage 1 to REM

Question 11

Increase serotonin has what affect on sleep?
Increase Ach has what affect on sleep?
NE and Dopamine has affect on sleep?
GABA has what affect on sleep?

Answer 11

Increase sleep
Increase dreaming
Increase arousal and awake
Decrease sleep latency

Question 12

3 6s of depression treatment?

Answer 12

Try drug for 6 weeks
Treat for 6 months
Wash out for 6 weeks

Question 13

Side effect for SSRIs to know?

Answer 13

Sexual dysfunction

Question 14

What are the 3 c’s of TCAs?

Answer 14

Convulsions (seizures), cardio toxicity, and coma

Question 15

What is another indication of TCAs besides antidepressants?

Answer 15

Neuropathic pain, especially diabetic neuropathy

Question 16

When to only use selegiline or phenylzine?

Answer 16

Hypertensive crisis

Question 17

2 first line mood disorder drugs?

2 second line mood disorder drugs?

Answer 17

Lithium and valproate

Quetiopine and lamotrigine

Question 18

Positive psychotics symptoms are what receptor?

Negative psychotic symptoms are what receptor?

Answer 18

Dopamine 2 mesolimbic

Serotonin

Question 19

Very potent first generation med usually used in hospital?

Answer 19

Haloperidol

Question 20

Side effect for quetiapine second generation?
Side effect for clonzapine second generation?
Side effect for risperidone second generation?

Answer 20

Sleepiness, so treat insomnia
Weight gain and diabetes
EPS

Question 21

What second generation is the best but why don’t we use it?

Answer 21

Clozapine

Agranulocytosis

Question 22

What is the best, most effective contraception?

Answer 22

LARC
Non IUD
IUD, hormone or copper

Question 23

Triad for DVT Risk involving contraception?

Answer 23

Estrogen, smoking and over 35

Question 24

What contraception form has the highest risk for DVT?

Answer 24

Patches

Question 25

What med to give for hot flashes of menopause? Vaginal atrophy? What to screen menopause women for, 2 things?

Answer 25

Venlafaxine Estrogen cream heart disease, so check LDL and put on statin Osteoporosis, do dexa screen at 65, bisphosphonates, vitamin d and calcium

Question 26

2 ways to diagnose PCOS with the history already there?

Answer 26

LH to FSH ratio | US the ovaries and see all the cysts

Question 27

What med to give for PCOS to help her ovulate?

Answer 27

Clomiphene

Question 28

How to treat CAH?

Answer 28

Give her cortisol and

Question 29

What kind of bleeding has previa with it during 3rd trimester? What about not previa diseases?

Answer 29

Painless, that is coming from the placenta that is baby’s blood Painful that is coming from moms blood from uterus

Question 30

When does placenta previa present? | How to treat?

Answer 30

3rd trimester with painless bleeding. Basically when contractions start and cervical dilates it tears placenta and baby’s blood comes out. C section

Question 31

In what 2 settings do we have uterine rupture? Clinical identifier? Treatment?

Answer 31

Attempting to deliver vaginally after previous c section Oxytocin Painful bleeding and loss of fetal station Crash section, get it out

Question 32

3 causes of placenta abruption?

Answer 32

HTN, cocaine use, MVA

Question 33

How to diagnose diabetes in pregnancy? | Treatment?

Answer 33

``` Do a 1 hour glucose tolerance and if its over 140 do a 3 hour If 1 hour over 180 2 hour over 155 3 hour over 140 Fasting over 90 Insulin ```

Question 34

When do you screen for pregnancy anemia? How to diagnose? Cause? Treat?

Answer 34

28 weeks HgB less than 10, hct less than 30 Iron deficiency Give iron