UWORLD

Question 1

anxiety, insomnia, perceptual disturbances, tachycardia, seizures, psychosis - withdrawal from what?

Answer 1

benzos

Question 2

agitation, tremors, tachycardia, HTN, possible progression to seizure and DT - withdrawal from what?

give what three things?

Answer 2

alcohol withdrawal

benzos, anticonvulsants, thiamine

Question 3

Diagnosis of ADHD requires what:

Answer 3

presence of symptoms before age of TWELVE and SIX or more inattentive or hyperactive symptoms.

Question 4

Dx of adjustment disorder with depressed mood.

Answer 4

Within 3 months of identifiable stressor with significant functional impairment and marked distress (v. normal sadness)

Question 5

Time frame for GAD.

Answer 5

6 or more months

Question 6

unstable and intense relationships, anger, self-destructive behavior - what personality disorder?

Answer 6

borderline PD

Question 7

hypomania ad major depression

Answer 7

bipolar 2

Question 8

dx/criteria od MDD

Answer 8

5+ sx for 2+ weeks: SIG E CAPS - depressed mood, sleep disorder, interst deficient (anhedonia), guilt, eergy-less,

Question 9

hypotension, tachycardia, dry skin, menstrual irregularities, hypokalemia, elevated pancreatic enzymes

Answer 9

Bulemia Nervosa

Question 10

tx for AN and BN

Answer 10

CBT, fluoxetine (SSRI), nutritional rehab

Question 11

prominent mood symptoms and mania

Answer 11

Bipolar 1

Question 12

treatment of treatment-resistant schizophrenia

Answer 12

clozapine

Question 13

MOA of PCP

Answer 13

NMDA receptor antagonist, leading to excess release of excitatory neurotransmitters. (hallucinogen)

Question 14

delusions or halllucinations for more than 2 weeks in absence of major depressive or manic episodes. Mood sx preset for majority of illness.

Answer 14

schizoaffective disorder

schizophrenia has absence of mood sx for most of illness

Question 15

difference bw schiphrenia and schizoaffective

Answer 15

schizophrenia has NO mood symptoms at any point (no mania or depression)

Question 16

psychosis and mood together v. delusions and hallucinations WITHOUT mood

Answer 16

bipolar and MAD (w/ mood sx) v. schizoaffective disorder (w/o mood sx for at least 2 weeks - only schizo hallucinations during this time, NO MOOD)

Question 17

tx of GAD

Answer 17

SSRI (NOT benzos)

Question 18

define schizophrenia criteria for dx

Answer 18

2 or more sx for 1 or more months (w/o tx) and more than one sx (delusions, hallucinations, disorganized speech)

continual disturbance for 6+ mo

Question 19

two drugs to slow demenita

Answer 19

donepezil (AChE inhibitor) and memantine (NMDA inhibitor)

Question 20

Never give elderly what type of drug?

Answer 20

Avoid anticholinergic medications which can impair cognitive function, ESPECIALLY in ELDERLY, (i.e. Benadryl , hydroxyzine***)

Question 21

Black box warning for what antipsychotics (for dementia + psychosis)

Answer 21

olanzapine (Zyprexa), aripiprazole (Abilify), risperidone (Risperdal), or quetiapine - double risk of death!

Question 22

Medication examples for tx of med addiction in elderly.

Answer 22

• Naltrexone –opiate antagonist to reduce cravings

- Buprenorphine, Benzodiazepines (i.e. valium/Diazepam taper)

Question 23

Hill’s DoC for geriatric depression

Answer 23

nortryptaline

Question 24

CHASE

Answer 24

dysthymia (progressive depressive disorder)

Concentration
Hopelessness
Appetite
SELF ESTEEM
Energy

more than 2 years with no more than 2 mo WITHOUT symptoms

Question 25

SIG E CAPS

Answer 25

Major Depressive Episode
Sleep
I…INTEREST LOSS
Guilt

Energy

Concentration
Appetite
P… PSYCHOMOTOR RETARDATION/AGITATION
Suicide

Episode = more than 2 weeks of 5/9 characteristics

Question 26

DIG FAST

Answer 26

Mania:

Distractibility
Irresponsibility
Grandiosity - inflamed self esteem

Flight of ideas
Activity
Sleepless
Talkativeness - pressured speech

Episode = 1 or more weeks (BP1 is manic only, BP2 is hypomanic and Major Depressive Episode)

Question 27

define cyclothymia

Answer 27

greater than two years of mild depression and hypomania sporadically (essentially dysthymia with intermittent hypomania)

Question 28

tx for OCD (and 2nd line for BN)

Answer 28

fluvoxamine

Question 29

tx for BN (1st line)

Answer 29

fluoxetine

Question 30

give what three things for opioid withdrawal (intox = pinpoint pupils)?

Answer 30

buprenorphine, naltrexone, methadone.

Question 31

Give what three thigns for alcohol addiction?

Answer 31

Naltrexone, acamprosate, disulfram

Question 32

What drug intoxication is this: illusions, hyperacusis, sensitivity of touch, taste/ smell altered, “oneness with the world”, tearfulness, euphoria, panic, paranoia, impairment judgment

Answer 32

MDMA

Teeth grinding

Question 33

MDMA - what receptor does it target?

Answer 33

5HT2 receptor agonist

Question 34

What drug intoxication is this:
 Dissociative anesthetic
 Similar to Ketamine used in anesthesia
 Intoxication: severe dissociative reactions – paranoid delusions, hallucinations, can become very agitated/ violent with decreased awareness of pain.
 Cerebellar symptoms - ataxia, dysarthria, nystagmus (vertical and horizontal)
 With severe OD - mute, catatonic, muscle rigidity, HTN, hyperthermia, rhabdomyolsis, seizures, coma and death

Answer 34

PCP

Question 35

PCP - what receptor does it target and what is the overdose treatment?

What is its withdrawal like?

Answer 35

NMDA receptor

benzos or antipsychotics

No tolerance or withdrawal!!!

Question 36

BMI for AN

Answer 36

less than 18.5

Question 37

Manic v. hypomanic - defining difference

Answer 37

manic has psychotic features, 1 week

hypomanic does not have psychotic features, greater than four days