UWorld 7/19

Question 1

dissociative amnisia

Answer 1

isolated impairment in autobiographical memory. the dissociative fugue subtype is characterized by seamingly pourposeful travel or wondering off in the dissociative state.

Question 2

What is a unique med that can be used in GAD?

Answer 2

Buspirone. However, this is still second to SSRI’s.

Question 3

be careful on questions that ask whether or not you should admit the patient…

Answer 3

In a patient that denies suicidal or homicidal ideations, you would think that you would not need to admit them, but if they also appeared disheveled and grossly unkempt as well as if they have COMMAND HALLUCINATIONS these are indications for hospitalization, even if against the patients will.

Question 4

difference between NMS and serotonin syndrome?

Answer 4

in serotonin syndrome you typically see hyperreflexia and myoclonus but you do not see lead-pipe rigidity like you do in NMS. Also look at the history… if they try to trick you by giving you a patient that is on a lot of medications, look to see if they have a 2 week washout period before starting an SSRI from an MAOI…. if they did and they are on an antipsychotic, then suspect NMS more…

Question 5

Patients with one major depressive episode and is now feeling better… when should you discontinue antidepressants?

Answer 5

In patients who have only had 1 MDD episode and that have responded well to their medication, should still remain on the medication for another 4-9 months due to the risk for relapse. Patients with severe depression, multiple, recurrent or persistent should remain on medications for 1-3 years or indefinitely.

Question 6

rapid eye movement sleep disorder

Answer 6

may be a sign of neurodegeneration in older individuals.