Usmle Easy 2

Question 0

Patient with refractory schizophrenia on clozapine presents with good response but seizures. Management?

Answer 0

Seizures are dose dependent (usually over 400 mg)

#Temporarily stop clozapine and start barbiturates 
#restart clozapine at 1/2 dose and titrating up

Question 1

Repression versus suppression?

Answer 1

Expelling idea from consciousness that causes one to lose goals versus postpone goals

Question 2

Previously-well controlled Bipolar on Valproic acid is not able to sleep and develops mild mania - treatment?

Answer 2

Lack of sleep can cause mania - give long acting benzodiazepine to re-regulate sleep cycle

Question 3

Depressed patient refusing to eat - treatment?

Answer 3

ECT

Question 4

Mechanism of action of amphetamines?

Answer 4

release of monoamines (DA and NE) at synaptic cleft)

Question 5

When to use supportive psychotherapy?

Answer 5

Patient is undergoing acute life crises and is feeing overwhelmed

Question 6

Van Gogh vision? Can also present with?

Answer 6

Digoxin toxicity

Auditory hallucination and atrial fibrillation.

Question 7

Organic causes for acute onset OCD?

Answer 7

Same as anxiety (Hyperparathyroidism, Hyperthyroidism, hypercortisolism)

Question 8

Drug for startle response in PTSD?

Answer 8

Beta-blocker

Question 9

Lesion to where causes euphoria and joking/puns?

Lesion that causes disinhibition, euphoria, and lack of remorse?

Causes depression and uncontrollable crying?

Answer 9

Fornix

Orbitofrontal cortex

Dorsolateral cortex

Question 10

Over-the-counter medication that is contraindicated with MAOIs?

Answer 10

Pseudoephedrine

Question 11

Bipolar patients on lithium experiences depressive symptoms. Treatment?

Answer 11

Stop Li temporarily and start antidepressant temporarily

Question 12

Ramelteon – Indication? Mechanism? Should not be used in patients with?

Answer 12

Sleep aid

High affinity for melatonin receptors

Liver disease, sleep apnea, COPD

Question 13

Social phobia versus avoidant personality disorder?

Answer 13

Specific situations cause distress versus interpersonal contact

Question 14

Bipolar drug that can cause a action tremor?

Answer 14

Lithium

Question 15

Intoxication with this opioid can cause seizures?

Answer 15

Meperidine

Question 16

First choice drug for mild to moderate Alzheimer’s disease?

Answer 16

Donepezil

Question 17

Lesions to the dorsal lateral frontal lobe may cause?

Answer 17

#Deficiencies in planning
#Amotivation, Lack of focus/goal-directedness
#Tendency to linger on trivial thoughts
#Repetition

Question 18

Intoxication of this drug may cause vertical nystagmus?

Answer 18

PCP

Question 19

Patient has one seventh episode of psychosis, warranting a diagnosis of schizophrenia. Since starting medication, patient has been symptom-free. What should be done with her medications?

Answer 19

Lower the dose, and if no symptoms recur, can stop medication

Question 20

Drug that can increase plasma concentration of carbamazepine?

Drugs they can decrease the plasma concentration of carbamazepine?

Answer 20

Erythromycin

Theophylline, cisplatin

Question 21

Most important for side effect of sildenafil?

Answer 21

Myocardial infarction

Question 22

Antidepressant (not bupropion) that is not associated with weight gain?

Answer 22

Setraline

Question 23

Drug that can cause patients to unknowingly sleepwalk, binge eat, have aggressive outbursts and night drive?

Answer 23

Zolpidem

Question 24

OCD symptoms may be caused by which drug?

Answer 24

Cocaine intoxication

Question 25

Will have test necessary before starting the patient on carbamazepine? After beginning therapy?

Answer 25

CBC, reticulocyte count, electrolytes, AST, ALT, pregnancy test

Question 26

Dreams:

1. Manifest content?
2. Hidden latent content?
3. Dream work?
4. Condensation?
5. Primary process?
6. Secondary revision?

Answer 26

1. Images and sensations recalled
2. Impulses, ideas, and feelings acceptable to the conscious mind
3. Process in which the content of the dream is transformed into more acceptable manifest content
4. combination of different concept/feelings into one single image
5. The logical, bizarre, and incoherent images that make up dreams
6. Ego makes manifest content rational and acceptable to the dreamer

Question 27

Non-antidepressant drug can cause impotence?

Answer 27

Beta Blocker

Question 28

Inhalant abuse is associated with what symptoms?

Answer 28

#Hearing loss
#peripheral neuritis and motor impairment
#cerebellar signs

Question 29

Biofeedback is what type of therapy?

Answer 29

Behavior therapy