FA Psychiatry

Question 1

Signs of physical abuse

Answer 1

Spiral fractures*
Burns
Subdural hematomas
Patterned marks and bruising
Rib fractures
Retinal hemorrhage or detachment

Question 2

Neuro findings in ADHD

Answer 2

Decreased frontal lobe volume/metabolism

Question 3

NT change: Alzheimer

Answer 3

Decreased ACh

Question 4

NT change: Depression

Answer 4

Decreased NE, 5HT and DA

Question 5

NT change: HD

Answer 5

Decreased GABA
Decreased ACh
Increased DA

Question 6

NT change: PD

Answer 6

Decreased DA
Increased 5-HT
Increased ACh

Question 7

NT change: Schizophrenia

Answer 7

Increased DA

Question 8

NT change: Anxiety

Answer 8

Increased NE

Decreased 5HT and GABA

Question 9

Destroyed in Korsakoff amnesia?

Answer 9

Mamillary bodies

Question 10

What diagnostic test will be abnormal in delirium?

Answer 10

EEG (vs. normal in dementia)

Question 11

Formication is seen in…?

Answer 11

Cocaine use and OH withdrawal

Question 12

Decreased dendritic branching is seen with what disorder?

Answer 12

Schizophrenia

Question 13

Sleep changes in depression

Answer 13

EMA
Decreased slow-wave sleep
Decreased REM latency
Increased REM early in sleep 
Increased total REM
Repeated nighttime awakenings

Question 14

Postpartum blues timeline

Answer 14

Starts 2-3 days after delivery
Resolves within ten days
(seen in 50-85%)

Question 15

Postpartum depression timeline

Answer 15

Starts within 4 weeks of delivery

Lasts 2 weeks to a year or more

Question 16

What are the ABC cluster personality traits?

Answer 16

A = awkward
Paranoid
Schizoid
Schizotypal

B = B movies (dramatic)
Histrionic
Borderline
Antisocial
Narcissistic

C = Cowardly
Avoidant
Obsessive-compulsive
Dependent

Question 17

Cause of narcolepsy

Answer 17

Decreased orexin production in lateral hypothalamus

Question 18

Treatment of narcolepsy

Answer 18

Daytime stimulants (amphetamines, modafinil)
Nigh-time sodium oxybate (GHB)

Question 19

Treatment of restless leg syndrome?

Answer 19

DA agonists (pramipexole)

Question 20

Mechanisms of antipsychotics

Answer 20

Block D2 and increased cAMP

Question 21

Evolution of EPS symptoms (4’s)

Answer 21

4 hours acute dystonia
4 days akathisia
4 weeks parkinsonism
4 years TD

Question 22

Treatment NMS

Answer 22

Bromocriptine (DA agonist) or dantrolene

Question 23

High potency typical antipsychotics

Answer 23

Trifluoperazine
Fluphenazine
Haloperidol
*EPS symptoms

Question 24

Low potency typical antipsychotics

Answer 24

Chlorpromazine
Thioridazine
*anticholinergic, antihistamine and alpha1 blockade

Question 25

Chlorpromazine vs. thioridazine eye effects

Answer 25

Chlorpromazine - corneal deposits | Thioridazine - retinal deposits

Question 26

Clozapine SE

Answer 26

WG Seizures Agranulocytosis Wet pillow syndrome

Question 27

Buspirone MOA

Answer 27

5HT1a (partial agonist)

Question 28

Lithium toxicity effects

Answer 28

``` Tremor Sedation Edema Heart block Hypothyroidism Polyuria (ADH antagonist) ```

Question 29

Mirtazapine: MOA, effects (aside from decreasing depression)

Answer 29

alpha 2 antagonist (increased release of NE and 5HT) Potent 5HT2/3 antagonism Sedation and increased app/WG

Question 30

Trazadone: MOA and SE

Answer 30

``` Blocks 5HT2 (autoreceptor) and alpha1 adrenergic receptors SE: priapism, sedation and postural hypotension ```

Question 31

Treatment of serotonin syndrome

Answer 31

cyproheptadine

Question 32

SNRIs and indications/SE

Answer 32

Venlafaxine - GAD and panic disorder Duloxetine - diabetic neuropathy SE - increased BP

Question 33

SSRIs

Answer 33

Citalopram Sertraline Fluoxetine Paroxetine

Question 34

MAOIs

Answer 34

Tranyylcypromine Phenelzine Isocarboxazid Selegiline

Question 35

TCAs

Answer 35

``` Amitriptyline Nortriptyline Imipramine Desipramine Clomipramine Doxepin Amoxapine ```

Question 36

TCA MOA

Answer 36

Block reuptake of 5HT and NE

Question 37

Amitriptyline (tertiary) vs. nortriptyline (secondary) - which has more anticholinergic effects

Answer 37

Amitrptyline

Question 38

Treatment of TCA toxicity (cardio)

Answer 38

NaHCO3