Quiz Review

Question 1

Lamotrogine

Answer 1

shown to be effective in treating the depressive phase of bipolar disorder
(trade name Lamictal)

Question 2

Fluoxetine

Answer 2

an SSRI (Prozac) and runs the risk of a manic switch in patients with bipolar disorder.

Question 3

Current research investigating the prevention of PTSD involves administration of what medication in close proximity to the experience of trauma?

Answer 3

Propanolol

(Medications that block autonomic arousal have been found in some instances to prevent the onset of PTSD in studies in the US and abroad)

Question 4

First Line Treatments for patients with PTSD without significant comorbid conditions

Answer 4

CBT, and SSRI’s have the most evidence for efficacy in treating PTSD. There is also some evidence for the use of Mirtazepine (Remeron) and autonomic blocking agent. Exposure therapy has efficacy but must be used carefully and skillfully employed to avoid re-traumatizing the patient

Question 5

Disulfiram

Answer 5

inhibits alcohol dehydrogenase resulting in the very unpleasant and potentially lethal “disulfiram” or “Antabuse” reaction in the presence of alcohol ingestion

Question 6

buprenorphine

Answer 6

partial opiate agonist; has a potential role in both maintenance treatment and acute detoxification treatment of opioid dependence and has been combined in a formulation with a low dose of an opiate antagonist to reduce risk of IV drug use

Question 7

Naltrexone

Answer 7

is another maintenance treatment for alcohol dependence thought to reduce alcohol cravings and risk of relapse when combined with appropriate psychosocial interventions.

Question 8

Predictors of good outcome in schizophrenia

Answer 8

later age of onset, family hx of affective illness, normal size ventricles, female gender and good premorbid functioning

Question 9

Predictors of poor outcome in schizophrenia

Answer 9

early age of onset, family history of schizophrenia, enlarged ventricles, and poor premorbid functioning. Males tend to have a poorer course although a female’s course may worsen after menopause.

Question 10

True or False. Auditory hallucinations are a potential presenting symptom in both major depressive disorder and bipolar disorder.

Answer 10

True. Both (unipolar) Major Depressive Disorder and Bipolar Disorder may present with psychotic features, although the nature and content of those hallucinations and delusions may differ in depression and mania (e.g., nihilistic and guilt/punishment themes in depression; expansive themes in mania).

Question 11

comment on the use of antidepressants in bipolar disorder

Answer 11

thought to involve the risk of precipitating a manic episode, mixed manic-depressive symptoms, and/or more frequent mood cycling between mania and depression

Question 12

Gender ratio for Major Depressive Disorder

Answer 12

more common in females

Question 13

risk of having a chronic, unremitting course of MDD

Answer 13

< 20-25%

Question 14

risk of recurrence of depression

Answer 14

increases following each successive episode of depression (50% after first, 70% after second, 90% after third

Question 15

how many adults with major depressive disorder present with comorbid anxiety disorders?

Answer 15

more than half

Question 16

how many adults with major depressive disorder present with predominantly physical symptoms (e.g., loss of appetite, headache, fatigue)?

Answer 16

more than half

Question 17

Bupropion (Wellbutrin) mechanism

Answer 17

thought to inhibit reuptake of norepinephrine and dopamine without appreciable effects on serotonin

Question 18

Mirtazepine (Remeron) mechanism

Answer 18

blockade of the alpha-2 adrenergic, 5-HT2 and 5-HT3 receptors

Question 19

Fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa) and escitalopram (Lexapro) mechanism

Answer 19

inhibition of serotonin reuptake

Question 20

Fluoxetine (Prozac) mechanism

Answer 20

inhibition of serotonin reuptake

Question 21

sertraline (Zoloft) mechanism

Answer 21

inhibition of serotonin reuptake

Question 22

paroxetine (Paxil) mechanism

Answer 22

inhibition of serotonin reuptake

Question 23

citalopram (Celexa) mechanism

Answer 23

inhibition of serotonin reuptake

Question 24

escitalopram (Lexapro) mechanism

Answer 24

inhibition of serotonin reuptake

Question 25

Duloxetine (Cymbalta) and venlafaxine (Effexor) mechanism

Answer 25

inhibition of serotonin and norepinephrine reuptake

Question 26

valproate

Answer 26

one of the FDA approved, first-line pharmacotherapies for bipolar disorder and would be highly unlikely to precipitate mania

Question 27

true or false. Euphoria is a core feature of mania without which the diagnosis of bipolar disorder cannot be validly established

Answer 27

false. Together with other cardinal symptoms of bipolar disorder, euphoria OR intense irritability is necessary to establish the diagnosis.

Question 28

female:male ratio for eating disorders

Answer 28

9:1

Question 29

Peak onset of Anorexia Nervosa is

Answer 29

15-19 years

Question 30

Point prevalence of Bulimia Nervosa is

Answer 30

2-4%

Question 31

True or false. Criteria for Anorexia but not Bulimia include refusal to maintain weight > 85% ideal body weight for age and height

Answer 31

true

Question 32

Well-documented physiological consequences of Anorexia Nervosa include

Answer 32

physiological effects may include low blood pressure, bradycardia, cardiac dysrhythmias, congestive heart failure (on rapid refeeding), low estradiol, low testosterone, “sick thyroid” syndrome, bone marrow suppression, loss of gray matter, and electrolyte disturbances.

Question 33

True or False. BN is associated with comorbid depression and anxiety whereas AN is associated with borderline personality disorder

Answer 33

Both BN and AN are associated with high rates of comorbid depression and anxiety disorders. Although both BN and AN may be associated with Personality Disorders, there is a high rate of BN among individuals with borderline personality disorder as well as among individuals with a h/o severe trauma such as childhood sexual abuse.