Psychiatry

Question 1

Bipolar Disorder: DIGFAST

Answer 1

Distractibility
Impulsivity
Grandiosity
Flight of ideas
Increased Activity
Sleep deficit
Talkativeness

Question 2

Lythium toxicity

Answer 2

Fatigues, constipation, myalgias bradycardia
Thyroid abnormalities 25% hypothyroidism
Renal dysfunction

Question 3

ADHD best treatment

Answer 3

Stimulants: Amphetamines, methylphenidate
Warning: potential misuse or addiction

CBT when medication isn’t fully efective

Question 4

ADHD w/ risk of misuse/addiction

Answer 4

NONSTIMULANTS:

ATOMEXETINE : norepinephrine reuptake inhibitor

Question 5

Maniac episode definition

Answer 5

> = 1 week of elevated/irritable mood and increased energy/activity + DIGFAST (at least 3).

Question 6

Schizophrenia first line pharmacological treatment

Answer 6

Risperidone

Clozapine in treatment-resistant cases.

Question 7

Acute Dystonia :: FGA (haloperidol)

Answer 7

Benztropine (anticholinergic)

Question 8

Binge Eating Disorder features

Answer 8

No compensating behaviors

Treat with SSRI, CBT is best

Question 9

SSRIs features

Answer 9

Fluoxetine, Sertraline, Escitalopram, Paroxetine

Question 10

Seasonal Affective Disorder

Answer 10

Major depression disorder with seasonal pattern

Fall-Winter initiation, spring-summer remission

Atypical symptoms: HI sleep, HI appetite, weight gain, carb craving

Tte: bright light, 10.000 lux @ awakening

Question 11

Conduct Disorder Features

Answer 11

At least 12 months
Aggression/cruelty to others/animals
Lying
Fighting

Over 18 y/o, antisocial personality disorder

Question 12

Alcohol Use Disorder tte

Answer 12

Goal: reduce craving and relapse

Naltrexone: mu-opioid receptor, reduce craving

Acamprosate: glutamate modulator, reduce relapse risk

Disulfiram: second line

Question 13

Tricyclic antidepressant overdose

Answer 13

Mental status change
Seizures
Prolonged PR/QRS/QT
Anticholinergic syndrome

Give NaHCO3 to counteract EKG alterations

Question 14

Parkinson Disease psychotic symptoms treatment

Answer 14

Reduce antidopaminergics

Add low dose antipsychotics: quetiapine

• High dose: haloperidol, risperidone

Question 15

Brief Psychotic Disorder

Answer 15

> 1 day, < 1 month
Full return to function

Often in relation to a stressor

Question 16

Schizophreniform disorder

Answer 16

> 1 month, < 6 months

Question 17

Schizoaffective disorder

Answer 17

Mood episode with concurrent active-phase symptoms of schizophrenia

+

> 2 weeks of delusions/hallucinations in the absence of prominent mood symptoms

Question 18

Delusional disorder

Answer 18

> 1 delusions & > 1 month, no other psychotic symptoms, normal functioning apart from direct impact of delusions

Question 19

First Line treatment for OCD

Answer 19

SSRI