Vignettes

Question 1

what are absolute contraindications to ECT?

Answer 1

NONE

Question 2

What is the length of time for seizure in ECT to be effective?

Answer 2

25 sec

Question 3

what meds have to be tapered for ECT?

Answer 3

Benzos
Lithium - postictal delirium
Bupropion - late appearing seizures
Clozapine - late appearing seizures

Question 4

can you use propofol for anesthesia for ECT?

Answer 4

no - raises seizure threshold

Question 5

what med conditions associated with mania?

Answer 5

glioma
cushing’s dz
MS

Question 6

what % of patients with bipolar d/o have co-occurring substance d/o?

Answer 6

60%

Question 7

actus reus definition in legalese

Answer 7

voluntary conduct

Question 8

mens rea in legalese

Answer 8

evil intent

Question 9

M’Naghten rule

Answer 9

did the defendant understand the nature of the act and the difference of right and wrong? if mentally ill, then not guilty

Question 10

glossolalia

Answer 10

unintelligible jargon that has meaning to the speaker (made up words)

Question 11

laconic speech

Answer 11

reduction in quality of spontaneous speech

Question 12

mesocortical pathway responsible for

Answer 12

negative symptoms of schizophrenia

Question 13

mesocortical pathway goes from what to what

Answer 13

VTA –> frontal lobe

Question 14

transient global amnesia – do people typically retain personal information and identity?

Answer 14

yes

Question 15

transient global amnesia demographics

Answer 15

affects men>women
over 50 y/o

Question 16

transient global amnesia prognosis

Answer 16

benign - no work up needed
lasts a few hours - 12 hrs

Question 17

average survival expectancy range from initial onset of Alzheimer’s dz

Answer 17

5-10 years (8 avg)

Question 18

gender ratio of DID

Answer 18

female 5-10: male 1

Question 19

what % of DID patients meet criteria for somatization disorder?

Answer 19

40-60%

Question 20

therapy modalities that may be helpful for DID

Answer 20

supportive, dynamic, CBT, hypnotherapy

Question 21

Is HTN a risk factor for delirium?

Answer 21

no

Question 22

is smoking a risk factor for delirium?

Answer 22

yes

Question 23

what area of the brain implicated in delirium?

Answer 23

reticular formation - arousal

Question 24

triphasic waves associated with

Answer 24

hepatic encephalopathy

Question 25

psychodynamic explanation of body dysmorphic disorder

Answer 25

displacement of sexual or emotional conflict onto nonrelated body parts

Question 26

body dysmorphic disorder has high comorbidity with

Answer 26

MDD

Question 27

biological contributors to somatic symptom disorder

Answer 27

• heritable in first degree female relatives
• decreased activity in frontal lonbe and nondom hemisphere (bad attention to detail)
• abnormal cytokine regulation

Question 28

lifetime prevalence of somatic symptom disorder

Answer 28

1-2%

Question 29

what age does somatic symptom disorder usually begin

Answer 29

adolescence

Question 30

somatic symptom disorder prognosis

Answer 30

chronic, undulating, relapsing disorder

rarely remits, poor prognosis

Question 31

best treatment for somatic symptom disorder

Answer 31

individual or group psychotherapy

Question 32

how much time do you have to be off of alcohol before starting disulfiram?

Answer 32

12 hours

Question 33

dosing of disulfiram

Answer 33

500 mg daily for first 1-2 weeks, then 250 mg daily thereafter

Question 34

how would phenytoin affect methadone level?

Answer 34

decreases it

Question 35

how would dextromethorphan affect methadone levels?

Answer 35

decreases it

Question 36

how would cocaine affect methadone levels?

Answer 36

decreases it

Question 37

how would tobacco affect methadone levels?

Answer 37

decreases it