UWorld Missed Questions Flashcards
Akathisia treatment
Beta blocker (propranolol) or benzodiazepine (lorazepam)
Parkinsonism treatment
Benztropine or amantidine
Social anxiety disorder definition
Anxiety restricted to social and performance situations (i.e. public speaking), fear of scrutiny and embarrassment. Symptoms may include anxiety, trembling, sweating, chest tightness, or shortness of breath.
Initial treatment of insomnia
Reassurance in elderly. Normal aging may cause early sleepiness, nocturnal awakenings, and afternoon naps. Insomnia that impairs normal functioning is first treated with sleep hygiene and cognitive behavioral therapies.
Psychiatric manifestations of Lupus
Acute and chronic psychiatric problems including psychosis, depression, mania, and anxiety. Specific symptoms may include seizures, headaches, peripheral neuropathy, stroke, and chorea.
TCA overdose symptoms and treatment
Seizures, hyperthermia (102), hypotension (90/60), tachycardia (110), tachypnea (22), Delirium, dilated pupils, flushed, dry skin, reduced bowel sounds, Prolonged QRS complexes.
Wide QRS complexes >100 msec are associated with poor outcomes.
Treatment is sodium bicarb.
Difference between Major depression with psychotic features and schizoaffective disorder?
Psychotic features (hallucinations, etc.) are only present during depression with MDPF, whereas the psychotic symptoms persist after depression (or mania) has resolved in schizoaffective disorder.
Specific phobia treatment
Cognitive behavioral therapy or “behavioral therapy”
Treatment for acute mania (esp. with psychotic and/or aggressive behaviors)
Antipsychotics, either first or second generation
Likely Haldol first (risperidone in this particular question)
Duration of antidepressant treatment for major depressive disorder
1 episode: 4-9 months after symptoms fully resolve
Multiple or severe episodes, family history: 1-3 years
Highly recurrent, severe, and chronic episodes: indefinite treatment
Narcolepsy symptoms and treatment
Excessive daytime sleepiness, hypnagogic hallucinations (on falling asleep), sleep paralysis (unable to move upon awakening, cataplexy (emotionally triggered loss of muscle tone).
Treatment: modafinil (non-amphetamine)
Treatment for acute bipolar depression
Quetiapine, lurasidone (atypicals) or lamotrigine (anticonvulsant)
Antidepressants may be used if they are paired with a mood stabilizer like lithium, valproate, or atypical antipsychotic.
Adjustment disorder definition and treatment
Emotional or behavioral symptoms that develop within 3 months of an identifiable stressor (i.e. relationship breakup). Rarely lasts longer than 6 months. Diagnosis requires significant distress of impairment.
Treatment is psychotherapy. It is not MDD and does not require pharmacotherapy.
Specific treatment for delirium tremens
Lorazepam IV, an intermediate-duration benzodiazepine
Postpartum blues vs postpartum depression
Onset: 2-3 days for blues, within 4 weeks for depression
Symptoms: mild depression, tearfulness, irritability for blues; mod to severe depression, SIGECAPS symptoms for depression
Treatment: Reassurance and monitoring for blues, pharmacotherapy and psychotherapy for depression
