Exam Guru 3

Question 1

What labs for pt on olanzepine who says they have gained weight?

Answer 1

Weight, lipid levels, fasting glucose

think metabolic syndrome

Question 2

Single, fixed idea that is wrong but that does not impair function or other areas of his life?

Answer 2

Delusional disorder

Question 3

Cardiomyopathies commonly cause symptoms of what psych disorder?

Answer 3

Panic disorder

Would be anxiety disorder due to another medical condition

Question 4

Why is paroxetine a bad SSRI for pt’s with poor med adherence?

Answer 4

Most likely to cause SSRI discontinuation syndrome

- causes distress

Question 5

Reaction formation is…

Answer 5

anxiety provoking thought is counteracted by asserting an incompatible or opposite thought
(take polar opposite)

Question 6

Splitting is often seen in what PD?

Answer 6

Borderline PD
- see multiple apparent suicide attempts
(often followed by cry for attention)

Question 7

Use motivational interviewing to help with?

Answer 7

Drug and alcohol cessation

Question 8

Predominant signs of ADHD in adults?

Answer 8

Impulsivity & inattentiveness

Question 9

What drug can affect AS drugs, especially olanzapine?

- how?

Answer 9

Nicotine

- induces metabolism of drugs via P450 system

Question 10

Depression can cause what in terms of tests?

Answer 10

Blunted response to:

• dexamethasone suppression test
• infusion of thyrotropin releasing hormone

Question 11

If a patient has a seizure with a positive urine tox screen for alcohol, what is diagnosis?

Answer 11

Alcohol withdrawal

- overactivity of CNS

Question 12

When choose generalized social phobia over avoidant personality disorder?

Answer 12

If see somatic symptoms

- blushing, trembling (panic attacks)

Question 13

Rationalization vs. Intellectualization?

Answer 13

Ration: shift blame w/ alternate explanation (obese and got MI, dad had one so it was genetics and unavoidable).

Intel: avoid emotional and focus on inanimate details; man has MI does extensive research on pathophys of CV rather than address modifiable risk factors

Question 14

Irritable when things don’t go according to plan and when others don’t meet their high expectations. Rigidity + stubbornness?

Answer 14

Obsessive compulsive personality disorder - and pt does not think anything is wrong in their thinking

Question 15

Which is a long-acting BDZ?

• Chlordiazepoxide
• Lorazepam

Answer 15

Chlordiazepoxide = long lasting, slow onset

Lorazepam = rapid acting and intermediate

Question 16

Fastest three BDZ’s?

Answer 16

Midazolam - fast onset, shortest half-life
Diazepam - fast acting
Alprazolam - fast acting

Question 17

Do OCD patients feel a sense of relief when their compulsive actions are completed?

Answer 17

Not really, or only partially

Question 18

Patient sleeping 9 hours a night, tired during the day, at least 3 months. No apnea, appropriate BMI. Naps at desk at work but still not feel rested. What next step?

Answer 18

Modafinil

Primary hypersomnia (sleep hygiene has NO effect)

Question 19

Lamotrigine - safe in preggers?

- SE you want to know?

Answer 19

Safe in preggers=yes

- remember Stevens-Johnson

Question 20

Two times to use assertiveness training?

Answer 20

Avoidant personality disorder

Dependent personality disorder

Question 21

Delusions, hallucinations, incoherent speech
Grossly disorganized behavior
Catatonic behavior
AS A RESULT OF drug use

Answer 21

Substance-induced psychotic disorder

Question 22

Major use for clonidine?

- type of drug?

Answer 22

Acute heroin withdrawal
- alpha-2 selective agonist

**suppresses overall adrenergic activity!
(so deals with diaphoresis, tachycardia, palpitations, emotional hyperarousal)

Question 23

QT prolongation has to do with what channels?

Answer 23

Cardiac potassium channels

Question 24

Haloperidol
Citalopram
Methadone . . . in the elderly?

Answer 24

All can cause QT prolongation

Question 25

What does Carbamazepine do to P450?

Answer 25

Induces

- so reducing active drug levels