Random Facts

Question 1

Demographic population w/ highest rate of successful suicide

Answer 1

White elderly males

Question 2

Monozygotic twin concordance of scz

Answer 2

50%

-suggesting high genetic component

Question 3

Common prodrome to scz psychotic break

Answer 3

Social withdrawal

Question 4

Common dx for pt exhibiting post-partum depression w/ psychosis

Answer 4

Bipolar d/o

Question 5

Name the acronym used for the characteristics of borderline personality d/o

Answer 5

Borderline personality d/o: IMPULSIVE

I: impulsive
M: moodiness/mood changes
P: paranoid when under stress
U: unstable self-esteem
L: labile and intense relationships
S: suicidal gestures
I: inappropriate anger
V: vulnerability to abandonment
E: emptiness (feelings of)

Question 6

Describe a possible explanation for a jobless, homeless scz pt

Answer 6

Downward drift hypothesis- states that the chronic mental illness itself (and not medication side effects or stress of a chronic d/o) accounts for the progressive SES decline of scz pts

Question 7

What sleep disturbance is most consistently linked w/ major depression?

Answer 7

Early morning awakening

Question 8

2 universal indications for ECT in a depressed pt

Answer 8

• refractory to medications/history of poor response

- need for quick anti-depressant action (ex: pt at immediate risk such as suicidal behavior)

Question 9

Name 3 features of catatonia

Answer 9

• negativism: doing the opposite of what you’re told
• hypomotorism: motoric, waxy flexibility
• echolalia w/ echopraxia: repeats words and phrases, crudely mimic movements

Question 10

Biochemical profile of depression, describe the levels of

(a) catecholamine activity
(b) cortisol secretion
(c) immune fxn
(d) sex hormone activity

Answer 10

In depression

(a) Catecholamine (ex: NE) activity is low
(b) Cortisol (stress hormone) secretion is high
(c) Decreased immune fxn
(d) Decreased sex hormone activity

Question 11

Which major psychiatric illness has (probably) the strongest genetic link?

Answer 11

Bipolar disorder

-1st degree relatives of pt w/ bipolar d/o have 25% risk of any mood d/o

Question 12

Which typical antipsychotic is approved for use in pediatric population?

Answer 12

Chlorpromazine = Thorazine

-approved in pediatrics population b/c such low potency

Question 13

Which atypical antipsychotic must be taken w/ food?

Answer 13

Ziprasidone (Geodon)

Question 14

Which atypical antipsychotic can also be used as a sleep aid?

Answer 14

Quetipaine (Seroquel)

Question 15

Serum lithium level

(a) therapeutic
(b) toxic

Answer 15

Serum lithium levels

(a) very narrow therapeutic window: 0.7-1.2
(b) Toxic > 1.2

Question 16

Clinical signs of lithium toxicitiy

Answer 16

• N/V/D
• tremor, ataxia, MS changes
• renal failure
• convulsions, coma

Question 17

Name 2 dangerous side effects of lithium

Answer 17

• renal involvement: nephrogenic diabetes insipidus, renal impairment
• thyroid dysfunction

Question 18

Common side effects of lithium

Answer 18

• polyuria, polydipsia
• sedation
• tremor

Question 19

Common side effects of valproic acid

Answer 19

• sedation
• weight gain
• alopecia

Question 20

2 Dangerous side effects of valproic acid

Answer 20

• hepatotoxicity

- thrombocytopenia (low platelet count)

Question 21

Name 2 drug-drug interactions of lithium

Answer 21

• diuretics (especially thiazides)

- NSAIDs

Question 22

Blood draws to monitor in pts on valproate

Answer 22

• serum levels of valproate
• platelet count
• LFTs

Question 23

Cotard syndrome

Answer 23

Common type of delusion

-nihilistic, “I am dead” “there is no world”

Question 24

Capgras syndrome

Answer 24

Common type of delusion

-family members are replaced by imposters

Question 25

Folie a deux

Answer 25

Shared delusion

Question 26

Receptor responsible for orthostatic hypotension

Answer 26

alpha-1

Question 27

Antipsychotic that requires sublingual administration

Answer 27

Lurasidone