Notes

Question 1

Grief vs MDD (timeframe)

Answer 1

If > 2 mo then MDD

Question 2

Abnormal grief (6 items)

Answer 2

GUILT NOT directly related to E.O.L
SI NOT "better off dead"
Preoccupation with WORTHLESSNESS
PMR
Prolonged functional IMPAIRMENT
HALLUCINATIONS (beyond voice image of deceased)

Question 3

Hypomania becomes mania when …

Answer 3

last MORE than 7 days OR
patient hospitalized OR
accompanied by psychosis

Question 4

Erickson (7 stages)

Answer 4

0-18 mo: trust vs mistrust
3-5: initiative vs guilt (autonomy to explore)
5-13: industry vs inferiority (sense of self through creation)
13-18: identity vs role confusion
Young Adult: intimacy vs isolation
40-60: generativity vs stagnation (view of role in society)
Late life: ego integrity vs despair (place in life cycle vs unfulfilled desire

Question 5

SSRI longest half life, how long, out of system in?

Answer 5

fluoxetine, 54 hours, 9 days

Question 6

SSRI highest rate of QTc prolongation, at dose?

Answer 6

citalopram, at >40mg

Question 7

Most associated with discontinuation syndrome and ADR?

Answer 7

paroxetine

Question 8

SSRI with starting dose 20 mg (3)?

Answer 8

fluoxetine, citalopram, paroxetine

Question 9

SSRI with starting dose 50 mg (2)?

Answer 9

sertraline, fluvoxamine

Question 10

SSRI with starting dose 10 mg (1)?

Answer 10

escitalopram

Question 11

SSRI shortest half life?

Answer 11

fluvoxamine 18 hours

Question 12

SSRI not on $4 list?

Answer 12

escitalopram

Question 13

Adequate SSRI trial?

Answer 13

6-8 weeks at treatment dose

Question 14

OCD dosing for SSRIs? (3)

Answer 14

fluoxetine 60-80 mg
sertraline 250-300 mg
If refractory then high dose fluvoxamine

Question 15

First gen anti psychotics (4)

Answer 15

haloperidol, chlopromazine, perphenazine, fluphenazine

Question 16

FGA side effects (3)

Answer 16

tremors, tardive dyskinesia, dystonia

Question 17

SGA side effects (4)

Answer 17

weight gain, increased lipids, DM risk, increased appetite

Question 18

Antipsychotic with breast formation

Answer 18

risperidone (due to incr. PRL)

Question 19

Antipsychotic with QTc prolongation but less weight gan

Answer 19

ziprasidone

Question 20

Antipsychotics with highest weight gain, DM risk, and sedation

Answer 20

Olanzapine (more weight gain) and quetiapine (more sedating)

Question 21

Weight neutral antipsychotic

Answer 21

Aripiprazole (can gain or lose weight)

Question 22

Effect of clozpaine of Schizo suicide rate

Answer 22

10% –> 2-3%

Question 23

Cigarettes affect metabolism via?

Answer 23

CYP1A2 (40% drop in clozapine and others metbaolized by 1A2)

Question 24

Clozapine side effects (3)

Answer 24

Agranulocytosis (0.8%, 0.4% on other anti-psychotics)
Myocarditis (rate as above)
Metabolic effects

Question 25

GAD drugs

Answer 25

SSRI, TCA, Buspar, benzos

Question 26

Panic drugs

Answer 26

SSRI, TCA, benzos, MAOi

Question 27

Hyperarousal drugs

Answer 27

a1-antag, b-blocker, a2-agonist

Question 28

Hyperarousal center in brain?

Answer 28

Locus ceruleus

Question 29

Hypothalmic stimulates appetite

Answer 29

lateral

Question 30

Hypothalmic suppresses appetite

Answer 30

ventromedial

Question 31

Hypothalmic controls arousal

Answer 31

posterior

Question 32

Hypothalmic sexual behavior

Answer 32

anterior

Question 33

Hypothalmic makes ADH

Answer 33

supraoptic

Question 34

Schizophrenia prevalence in kids, siblings, parents

Answer 34

Kids 12.8% Siblings 10% Parents 5.9% RISK FOR FIRST DEGREE RELATIVES IS ELEVATED BY 0.9%

Question 35

ADHD with bedwetting drug?

Answer 35

imipramine

Question 36

ADHD with tics drug?

Answer 36

clonidine

Question 37

LItihum onset of action?

Answer 37

7-14 days

Question 38

Hyperarousal center?

Answer 38

Locus ceruleus

Question 39

kid refusing to eat 7,8,9 not to do with fat

Answer 39

ARFID

Question 40

Confusion with neck rash

Answer 40

Niacin or thiamine

Question 41

somatization complaints

Answer 41

4 pain, 2 GI, 1 sexual and 1 pseudo neuro

Question 42

4 (hypo)manic in 12 mo =

Answer 42

rapid cycling

Question 43

4 Ds of malpractice

Answer 43

DUTY to patient DEVIATION from standard of care DIRECT CAUSAL relationship to bad outcome DAMAGES occurred

Question 44

DSM AXES

Answer 44

``` 1 - psych disorders 2 - personality disorders 3 - medical probs 4 - preceding events 5 - fucntioning ```

Question 45

How to tell epileptic seizures from non

Answer 45

incr PRL in epi, and EEG activity

Question 46

How long do you have after seizure to check PRL?

Answer 46

20 min

Question 47

RLS three comorbidities?

Answer 47

Pregancy, renal failure, metabolic disorders

Question 48

2 high/med/low potency antispcyhotics

Answer 48

High: haldol, fluphenazine Med: Perphenezine, molidone Low: Chlorpromazine, thioridazine

Question 49

ADRS with low potency

Answer 49

Anti-cholinergic

Question 50

Carbamazepine ADRs

Answer 50

aplastic anemia, steven johnson

Question 51

Tourettes drugs

Answer 51

Haldol (& anti-psyhcotics), a2-agonists, CCBs

Question 52

5 classes of drugs that cause depression

Answer 52

``` corticosteroids OCPs Thyroid meds HTN meds Parkinson meds ```

Question 53

Med for opiate withdrawal

Answer 53

clonidine

Question 54

Shortest acting benzo & 2 long acting

Answer 54

fluorazepam vs lorazepam and oxazepam

Question 55

Dysphoric mania means ...

Answer 55

mixed state

Question 56

Stable self theorist?

Answer 56

Kohut

Question 57

Bupropion has higher or lower risk than SSRI to induce mania?

Answer 57

Lower!

Question 58

Cyclothymia and dysthymia timeframe?

Answer 58

2 years