Uworld 7/22

Question 1

Akathesia

Answer 1

This should be suspected if you are treating a patient for schizophrenia and they have worsening of symptoms–very restless even though the hallucinations are gone. In these instances, you would want to decrease the antipsychotic medication and give propranolol or benztropine.

Question 2

Difference between serotonin syndrome and neuroleptic malignant syndrome

Answer 2

Serotonin syndrome has more of the neuromuscular irritability such as hyperreflexia and clonus vs neuroleptic malignant syndrome, you see more of the muscle rigidity.

Question 3

characteristic perioral changes are a clue for what?

Answer 3

Inhalent abuse– particularily glue. This is called “glue sniffers dermatitis”. Inhalant abuse is particularly common in boys ages 14-17. It causes mild and transient CNS depression for roughly 15-45 minutes but may be severe enough to cause death.

Question 4

Kleptomania

Answer 4

An impulse control disorder that usually presents in early adolescence but may be present in adulthood as well. It is characterized by intense urges to steel items of little to no monetary value. The urges are relieved after the individual steels the item, but are inevitable followed by intense feelings of guilt and thus, the items are often returned or given away. This is in contrast to that of shoplifters who steel items for personal reasons.

Question 5

What neurotransmitter is the main screwed up one in OCD>

Answer 5

Serotonin. This is why SSRI’s are the first line treatment in OCD. Additionally, the TCA clomipramine can also be used, but is considered a second line medication due to side effects.

Question 6

paradoxical aggitation

Answer 6

seen in elderly patients who are taking a benzodiazepine… this is one of the main reasons that these meds are rarely used in the elderly population, as well as their increased risk for falls and cognitive impairment.

Question 7

Treatment of catatonia?

Answer 7

Benzodiazepines and ECT

Question 8

emaciation

Answer 8

the state of being abnormally thin–used to describe anorexic patients

Question 9

Alcohol hallucinosis

Answer 9

alert sensonurium, visual hallucinations, stable vital signs. Typically presents 12-24 hours after the cessation of alcohol….

Distinguishable from DT’s because the patient has an intact sensonurium and their vital signs are stable.

Question 10

CPK and white blood cell count may be elevated in what disease?

Answer 10

NMS

Question 11

Tx of the different EPS

Answer 11

Acute dystonia: benztropine or diphenhydramine

Akathesia: Tx with a beta blocker or benzodiazepine

Parkinsonism: Tx with benztopine or amantidine

Tardive Dyskinesia: no definitive treatment but clozapine may help.

Question 12

What is the treatment of acute dystonia?

Answer 12

Benztropine or Diphenhydramine

Question 13

What is the treatment of parkinsonism

Answer 13

Benztropine or amantidine