Rapid Review: Psychiatry

Question 1

First-line pharmacotherapy for depressions

Answer 1

SSRIs

Question 2

Antidepressants associated with hypertensive crisis

Answer 2

MAOIs

Question 3

Galactorrhea, impotence, menstrual dysfunction, and decreased libido

Answer 3

Dopamine antagonists (due to hyperprolactinemia)

Question 4

A 17 year old girl has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found

Answer 4

Conversion disorder

Question 5

Name the defense mechanism: 1. A mother who is angry at her husband yells at her child. 2. A pedophile enters a monastery. 3. A woman calmly describes a grisly murder. 4. A hospitalized 10 year old begins to wet his bed.

Answer 5

1. Displacement. 2. Reaction formation. 3. Isolation. 4. Regression.

Question 6

Life-threatening muscle rigidity, high fever, and rhabdomyolysis

Answer 6

Neuroleptic malignant syndrome

Question 7

Amenorrhea, low body weight (

Answer 7

Anorexia

Question 8

a 35 year old man has recurrent episodes of palpitations, diaphoresis, and fear of going crazy

Answer 8

Panic disorder

Question 9

The most serious side effect of clozapine

Answer 9

Agranulocytosis

Question 10

A 21 year old man has 3 months of social withdrawal, worsening grades, flatten affect, and concrete thinking

Answer 10

Schizophreniform disorder

Question 11

Key side effects of atypical antipsychotics

Answer 11

Weight gain, type 2 DM, QT segment prolongation

Question 12

A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?

Answer 12

Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

Question 13

Medication to avoid in patients with a history of alcohol withdrawal seizures

Answer 13

Neuroleptics

Question 14

A 13 year old boy has a history of theft, vandalism, and violence toward family pets

Answer 14

Conduct disorder. Associated with antisocial personality disorder in adults

Question 15

A 5 month old girl has decreased head growth, truncal discoordination, and decreased social interaction

Answer 15

Rett’s disorder. Loss of milestones is commonly described.

Question 16

A patient hasn’t slept for days, lost 20K gambling, is agitated, and has pressured speech. Diagnosis? Treatment?

Answer 16

Acute mania. Start a mood stabilizer

Question 17

After a minor “fender bender,” a man wears a neck brace and requests permanent disability

Answer 17

Malingering

Question 18

A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C-peptide

Answer 18

Factitious disorder (Munchausen syndrome)

Question 19

A patient continues to use cocaine after being in jail, losing his job, and not paying child support

Answer 19

Substance abuse

Question 20

Medication to avoid in patients with PTSD

Answer 20

Benzodiazepines (have high addiction potential). Patients commonly have a history of substance abuse.

Question 21

A violent patient has vertical and horizontal nystagmus

Answer 21

Phencyclidine hydrochloride (PCP) intoxication

Question 22

A woman who was abused as a child frequently feels outside of or detached from her body

Answer 22

Depersonalization disorder

Question 23

A schizophrenic patient takes haloperidol for 1 year and develops uncontrollable tongue movements. Diagnosis? Treatment?

Answer 23

Tardive dyskinesia. Decrease or discontinue haloperidol and consider a different antipsychotic.

Question 24

A man with major depressive disorder is counseled to avoid tyramine-rich foods with his new medication

Answer 24

MAOI