USMLE Easy 1

Question 0

Drugs that cause schizophrenia-like symptoms?

Answer 0

PCP
Amphetamines
LSD

Question 1

Patient in clozapine. Lowering WBC count. Next step (depending on count)?

Answer 1

If 3000-3500, continue clozapine and institute 2x weekly CBCs

If 2000-3000, stop clozapine and restart when WBCs normalize

If agranulocytosis, stop clozapine and place on protective isolation

Question 2

Four character traits?

Answer 2

#harm avoidance (uncertain, shy worriers)
#novelty seeking (impulsive, curious, easily bored)
#reward dependence (socially dependent, sociable)
#persistence (hard-working, ambitious overachievers)

Question 3

Social phobia - longest lasting treatment?

Answer 3

CBT

Question 4

Treatment for narcissism?

Answer 4

Psychodynamic psychotherapy

Question 5

Abnormal neurotransmitter in OCD?

Answer 5

Serotonin

Question 6

Patient with cataplexy. Drugs to suppress REM sleep?

Answer 6

Antidepressants (SSRI, TCA, and MAOI)

Question 7

Seizure with postictal hypertension and tachycardia – suspect?

Answer 7

Alcohol withdrawal

Question 8

Tarasoff I versus Tarasoff II?

Answer 8

Duty to warn 3rd parties who are in danger from patient versus duty to protect victim from danger

Question 9

Hormone that is sometimes used in the adjuvant treatment of depression?

Answer 9

Levothyroxine

Question 10

Patient with benzodiazepine overdose is given flumazenil. Shortly after, patient has seizure – cause of seizure?

Answer 10

Pre-existing seizure disorder (Flumazenil precipitates seizures in patients with seizure disorder)

Question 11

Initial therapy for panic attacks? Why?

Answer 11

Hyperventilate

Hypocapnia/respiratory alkalosis is reversed, leading to normal cerebral blood flow and normalization of serum calcium

Question 12

Herbal treatments for depression?

Answer 12

St. John’s wort (antidepressant, sedative, and anxiolytic)

Ginseng (mood elevator)

Question 13

Melancholic depression?

Answer 13

Variant of major depressive disorder

#Anhedonia
#Lack of reactivity (nothing makes the patient feel better)
#And neurovegetative symptoms

Question 14

Double depression? Importance?

Answer 14

Major depressive episode in a patient with dysthymic disorder

#Higher risk for suicide
#more severe depressive symptoms
#more treatment resistance

Question 15

Bereavement versus adjustment disorder?

Answer 15

Death of a loved one versus other event

Question 16

Signs/symptoms that suggests major depressive disorder instead of bereavement?

Answer 16

#Persistace beyond two months
#Worthlessness
#Suicidal ideation
#Psychomotor retardation 
#psychosis

Question 17

Most common cause of delirium in old age?

In children?

Answer 17

Multiple medications

Accidental poisoning or hypoxia (from drowning)

Question 18

Hereditary Alzheimer disease – genes? Chromosomes? Occurs at what ages?

Answer 18

Presinilin 1/2; Apo E

14; 21

40s (Ps1) versus 50s (PS2) versus over 50 (Apo E)

Question 19

Majority of Alzheimer’s disease is caused by which gene?

Answer 19

Presilin 1 (70-80%)

Question 20

Huntington’s disease affects which brain region?

Answer 20

Caudate Nucleus

Question 21

Brain changes in a patient with schizophrenia?

Answer 21

#PET scan – increase in D2 receptors and caudate nucleus
#Eye movement Dysfunction
#Enlarged lateral and third ventricles (reduction in cortical )
#Decreased alpha waves on EEG, increased Delta and Theta waves

Question 22

Drug to treat psychosis in delirium?

Answer 22

Haloperidol

Question 23

Erotomanic delusions?

Answer 23

Belief that someone (usually of higher status, such as a TV star) is in love with you

Question 24

Undoing?

Answer 24

A compulsive act to negate the consequences of a obsessive fantasized action

Question 25

Psychotic patient with orthostatic hypotension - best medication?

Answer 25

Haloperidol or fluphenazine (low Anticholinergics side effects and less postural hypotension)

Question 26

Drugs well tolerated in the elderly?

Answer 26

SSRIs
Bupropion
Venlafaxine
Nefazadone
Mirtazapine

Question 27

Bereavement vs depression. Signs suggestive of depression?

Answer 27

#guilt over actions taken by the survivor
#thoughts of death OTHER THAN "I would be better off dead"
#worthlessness 
#psychomotor retardation
#hallucinations OTHER THAN hearing the voice of loved one

Question 28

Yearly tests for patients on Li?

Answer 28

EKG (when 50+)

Cr

Question 29

Antipsychotic for patient with Parkinson’s?

Answer 29

Clozapine