Psychiatry

Question 1

oppositional defiant disorder. Tx?

Answer 1

family therapy!!

if needed, medicine (risperidone)

Question 2

schizoid personality disorder
schizotypal personality disorder
schizoaffective disorder
schizophreniform disorder

Answer 2

schizoid personality disorder :a disconnection pattern from a social relationship and their emotional range is limited. doesn’t desire close relationships.

schizotypal personality disorder : whereas the ones with STPD are interested in connecting but they cannot foster relationships due to their symptoms. Nevertheless, STPD people seek treatment because their symptoms are more severe than SzPD conditions.

schizoaffective disorder

schizophreniform disorder: Schizophreniform disorder is a type of psychotic illness with symptoms similar to those of schizophrenia, but lasting for less than 6 months.

Question 3

drug for smoking cessation?

for a patient with a history of depression?

Answer 3

verenicline ( Champix) : a nicotine partial agonist

Buproprion effective for smokers with depression, cardiac or respiratory diseases.

Question 4

acute management of bipolar disorder

prevention of future episodes of bipolar disorder?

Answer 4

for acute management that need sedation –> anti-psychotics : risperidone, haloperidol, olanzapine

for acute management without sedation (cooperative patient ) –> Lithium

for prevention –> mood-stabilizers : lithium, atypicial-antipsychotics : valproate

Question 5

duration of treatment in major depression?

Answer 5

6-12 months

3-5 years if

• two depressive episodes within 5 years
• three prior episodes
• severe psychotic depression
• serious suicidal attempt

Question 6

post stroke depression Tx?

Answer 6

Fluoxetine SSRI

Question 7

which antipsychotic has tachycardia as a common adverse reaction?

Answer 7

clozapine

Question 8

Bipolar disorders in pregnant patients. Management?

Answer 8

during pregnancy : lithium

during breastfeeding : valproate

Question 9

agoraphobia tx?

Answer 9

CBT and SSIR

Question 10

Treatment of choice for complicated grief?

Answer 10

psychotherapy

Question 11

Contraindication to use bupropion?

Answer 11

seizure disorder

Question 12

clozapine monitoring for what? how? managent?

Answer 12

WBC count monitoring to detect neutropenia

weekly during the first 6 months
biweekly during the next 6 months
monthly after one year

Management :

• mild (1000-1500) - continue but increase the monitoring frequency to three times a week
• moderate (500-999) - interrupt clozapine, monitor daily until 1000, resume clozapine
• severe <500 - discontinue. rechallange only the benefits outweigh the risks, consult hematology

Question 13

schizophrenia incidence and genetic risk?

Answer 13

1% general population
10% if a parent or sibling has it
~10% if a dizygotic twin has it
50% if a monozygotic twin has it.