Psychiatry - UWorld

Question 1

What are the Shared Diagnostic Criteria for a Major Depressive Episode and Postpartum Depression?

Answer 1

≥ 2 weeks of at least 5 of the following 9 symptoms:

• Depressed Mood
• Sleep Disturbance
• Interest Low
• Guilt
• Energy Low
• Concentration Impaired
• Appetite Changes
• Psychomotor Agitation or Retardation
• Suicidal Thoughts

Question 2

What are “Postpartum Blues”?

Answer 2

A milder form of Postpartum Depression that usually resolves in < 2 weeks.

Question 3

What are (10) Suicide Risk Factors?

Answer 3

1. Psychiatric Disorders, Prior Suicide Attempts
2. Hopelessness
3. Never Married, Divorced, Separated
4. Living Alone
5. Elderly White Male
6. Unemployed or Unskilled
7. Physical Illness
8. Family History of Suicide, Family Discord
9. Access to Firearms
10. Substance Abuse, Impulsivity

Question 4

What are (4) Suicide Protective Factors?

Answer 4

1. Social Support/Family Connectedness
2. Pregnancy
3. Parenthood
4. Religion & Participation in Religious Activities

Question 5

What are (6) GOOD Prognostic Factors for Schizophrenia?

Answer 5

1. Later Onset
2. Female Sex
3. Acute Onset with Precipitant
4. Predominantly Positive symptoms
5. No Family History
6. Short Duration of Active symptoms

Question 6

What are (6) POOR Prognostic Factors for Schizophrenia?

Answer 6

1. Onset in Childhood or Adolescence
2. Male Sex
3. Gradual Onset (prodrome), No Precipitant
4. Predominantly Negative symptoms
5. Family History of Psychotic Illness
6. Long Duration of Untreated Psychosis

Question 7

What are (4) possible Characteristics in patients with Stimulant Toxicity?

Answer 7

1. Anxiety
2. Agitation
3. Insomnia
4. Loss of Appetite

Question 8

What are (4) Physical Findings in a patient with suspected Stimulant Toxicity?

Answer 8

1. Tachycardia
2. Hypertension
3. Diaphoresis
4. Mydriasis (pupil dilation)

Question 9

What are (2) possible Complications of Stimulant Toxicity?

Answer 9

1. Psychosis
2. Seizures

Question 10

What are (3) Behaviors associated with Hypomania?

Answer 10

1. Impulsivity
2. Poor Judgement
3. Risky Behavior

Question 11

What (2) Practices by the Physician may help patients with Hypomania avoid making Impulsive Decisions that they may regret later?

Answer 11

1. Early Recognition of Hypomanic States
2. Gentle Exploration of patients Motives

Question 12

What Antipsychotic Medication, even though highly effective, is Reserved for the treatment of REFRACTORY Schizophrenia & Schizoaffective Disorder, and why?

Answer 12

Clozapine: not used as 1st line due to its Side Effect of Neutropenia/Agranulocytosis

Question 13

What (2) Requirements are there for a patient to be prescribed Clozapine?

Answer 13

1. Prescribed through a Central Registry
2. Mandatory Monitoring of Absolute Neutrophil Count:

• Weekly (first 6 months)
• Every other week (second 6 months)
• Every 4 weeks (thereafter)

Question 14

What are (9) Adverse Effects of Clozapine?

Answer 14

1. Neutropenia/Agranulocytosis
2. Weight Gain
3. Metabolic Syndrome
4. Seizures
5. Pulmonary Embolus
6. Myocarditis
7. Excessive Salivation
8. Constipation
9. Ileus

Question 15

What are (3) Treatment Option Categories for patients with Major Depression?

Answer 15

1. Pharmacotherapy
2. Psychotherapy
3. Combination Therapy (Pharmaco- + Psycho-therapy)

Question 16

What are (3) Classes of Antidepressant Medication used as First-Line Pharmacotherapy in the treatment of Moderate-to-Severe Depression or if Psychotherapy is not accessible or available?

Answer 16

1. SSRI’s (eg, escitalopram)
2. SNRI’s (eg, venlafaxine)
3. Atypical Antidepressants (eg, bupropion, mirtazapine)

Question 17

What are (3) Factors used in the Treatment Selection for patients with Major Depression?

Answer 17

1. Severity of Depression
2. Availability of Psychotherapy
3. Patient Preference