Board Vitals Psychiatry

Question 1

Is relapse of depression common after discontinuation of pharmacotherapy?

Answer 1

No

Question 2

Do benefits of psychotherapy for depression persist after discontinuation?

Answer 2

Yes

Question 3

What is the heart rate in patients with anorexia nervosa?

Answer 3

Bradycardia (< 60/min)

Question 4

When feeding is started in a bradycardic anorexia nervosa patient, her heart rate returns to normal.

What is the next step?

Answer 4

Evaluation for refeeding syndrome and impending cardiac compromise (relative tachycardia).

Question 5

What is the first electrolyte abnormality in anorexia nervosa patients with refeeding syndrome?

Answer 5

Hypophosphatemia

Question 6

If patients with anorexia nervosa are in danger of developing refeeding syndrome then what should you do?

Answer 6

Reduce the calorie intake

Question 7

What heart rate is concerning for refeeding syndrome with heart failure in anorexia nervosa patients?

Answer 7

> 70 beats/min

Question 8

What is the minimum criteria to diagnose bipolar type II disorder?

Answer 8

• One hypomanic episode
• Depressive episode

Question 9

What is the minimum criteria to diagnose bipolar type I disorder?

Answer 9

• One manic episode
• Depressive episode

Question 10

An illness in Mexican, Central and South American cultures where it is believed that a frightening event can cause one’s soul to leave one’s body. Symptoms similar to post-traumatic stress disorder.

Terminology?

Answer 10

Susto

Question 11

Entity in Southeast Asia characterized by symptoms of anxiety and depression occurring in the setting of somatic complaints attributed to semen loss.

Terminology?

Answer 11

Dhat syndrome

Question 12

Belief that illness occurs because of destiny.

Terminology?

Answer 12

Fatalismo

Question 13

Ongoing illness caused by challenging life circumstances, including depression, anxiety and somatoform features.

Terminology?

Answer 13

Nervios

Question 14

Belief that illness is a result of long-term social struggle.

Terminology?

Answer 14

Coraje

Question 15

What are residential services for psychiatric patients or those with substance abuse disorders?

Answer 15

Community-based treatments like halfway houses

Question 16

What is the first line management for opioid use disorder?

Answer 16

Medication-assisted treatment (MAT)

Question 17

Which opioid antagonist can prevent the effects of opioid intoxication, thereby reinforcing abstinence?

Answer 17

Naltrexone

Question 18

Which drug is an acetyaldehyde dehydrogenase that is used to manage alcohol use disorder?

Answer 18

Disulfiram

Question 19

Which drug is an acetaldehyde dehydrogenase that is used to manage alcohol use disorder?

Answer 19

Disulfiram

Question 20

Which opioid antagonist is used to rapidly treat acute opioid overdose and should not be used to manage chronic opioid use disorder?

Answer 20

Naloxone

Question 21

What is the mechanism of action of buprenorphine?

Answer 21

Partial mu-opioid agonist

Question 22

Does disulfiram reduce alcohol cravings?

Answer 22

No

Question 23

Is disulfiram a first line treatment for alcohol use disorder?

Answer 23

No

Question 24

Which medication reduces cravings for alcohol?

Answer 24

Naltrexone

Question 25

Which medication reduces cravings for nicotine?

Answer 25

Varenicline (Chantix)

Question 26

What is the first line treatment (medication) for opioid use disorder in a patient who is still using and has withdrawal symptoms?

Answer 26

Buprenorphine

Question 27

Which medications can increase serum lithium levels?

Answer 27

- Diuretics (especially thiazides) - ACE inhibitors - NSAIDs

Question 28

Does fentanyl respond to naloxone?

Answer 28

Not unless very high doses are given.

Question 29

Which drug is responsible for the most overdose deaths?

Answer 29

Fentanyl

Question 30

Can ecstasy cause rhabdomyolysis?

Answer 30

Yes

Question 31

What is benzolecgonine a metabolite of?

Answer 31

Cocaine

Question 32

What is 3-morphine glucuronide a metabolite of?

Answer 32

Morphine

Question 33

What is 6-(mono)acetylmorphine a metabolite of?

Answer 33

Heroin

Question 34

What is 4-aniline-N-phenethyl-4-piperidinone a metabolite of?

Answer 34

Fentanyl analogs

Question 35

What is codeine-6-glucuronide a metabolite of?

Answer 35

Codeine

Question 36

What is the treatment of acute lithium toxicity?

Answer 36

Hemodialysis

Question 37

What is the initial treatment of neuroleptic malignant syndrome?

Answer 37

ICU admission Aggressive supportive care

Question 38

What is the initial medical treatment of neuroleptic malignant syndrome?

Answer 38

Dantrolene

Question 39

Which one involves secondary gain - malingering or factitious disorder?

Answer 39

Malingering

Question 40

What should be tried first for hospital acquired delirium - conservative measures like reorientation or antipsychotics?

Answer 40

Conservative measures

Question 41

What should you do in severe alcohol withdrawal not responding to benzodiazepines?

Answer 41

Use alternative agents: - Phenobarbital - Propofol - Dexmedetomidine

Question 42

Which medication is used to treat generalized anxiety disorder - buspirone or bupropion?

Answer 42

Buspirone

Question 43

Which medication for generalized anxiety disorder does not have sedating or sexual dysfunction adverse effects?

Answer 43

Buspirone

Question 44

Can lithium cause hypothyroidism?

Answer 44

Yes

Question 45

Which medication can treat both opioid and alcohol use disorder?

Answer 45

Naltrexone

Question 46

What adjunct behavioral therapy is useful in bipolar disorder?

Answer 46

Group psychoeducation

Question 47

What is the mechanism of action of N-acetylcysteine (NAC)?

Answer 47

Increases glutathione levels

Question 48

What is a non-stimulant medication for ADHD?

Answer 48

Atomoxetine

Question 49

Should you prescribe stimulants to an ADHD patient who has previously abused stimulants?

Answer 49

No

Question 50

Can phenytoin increase the clearance of methadone?

Answer 50

Yes

Question 51

What is the ocular side effect of thioridazine?

Answer 51

Retinitis pigmentosa

Question 52

What medication is the most common cause of cornea verticillata?

Answer 52

Amiodarone

Question 53

What medication typically causes dyschromatopsia (decrease in color vision)?

Answer 53

Ethambutol

Question 54

What medication typically causes xanthopsia (yellowing of vision)?

Answer 54

Digoxin (toxicity)

Question 55

When a patient is malingering, should you determine motivations for behavior or confront the patient?

Answer 55

Determine motivations for behavior

Question 56

What drugs are first-line for treating generalized anxiety disorder?

Answer 56

SSRIs or SNRIs

Question 57

What class of medications is the best treatment of major depressive disorder with atypical features (depressive episode with emotional reactivity)?

Answer 57

Monoamine oxidase inhibitors