Psych

Question 1

IQ 55-70

Answer 1

Mild

Question 2

IQ 40-55

Answer 2

Moderate

Question 3

IQ 25-40

Answer 3

Severe

Question 4

IQ< 25

Answer 4

Profound

Question 5

Treatment for ADHD

Answer 5

first line: stimulants- methylphenidate and dextroamphetamine

Second line: Atomoxetine (non-stimulant) norepinephrine reuptake inhibitor

Question 6

Depression treatment for patient with neuropathic pain

Answer 6

Duloxetine

Question 7

Depression treatment in patient with fear of weight gain and sexual side effects

Answer 7

Buproprion

Question 8

TCA toxicity

Answer 8

Antihistaminic: sedation
Antiadernergic: hypotensions, dizziness, reflex tachycardia, widening of QT interval
Antimuscarinic: dry mouth, constipation, urinary retention, blurred vision
Weight gain
Seizures
Sexual SE

Question 9

MAOI (phenelzine, isocarboxazid, tranylcypromine) toxicity

Answer 9

Hypertensive crisis in tyramine rich foods

Question 10

SSRI toxicity

Answer 10

Sexual dysfunction 
GI disturbances: Nausea and vomiting 
insomina
Weight changes 
HA 
seizure

Question 11

SNRI (venlafaxine, duloxetine, desvenlafaxine) toxicity

Answer 11

HTN

Same side effects as SSRI

Question 12

Buproprion toxicity

Answer 12

Increased risk of seizures

Question 13

Trazadone toxicity

Answer 13

Sedation

Priaprism

Question 14

Mirtazapine toxicity

Answer 14

Weight gain

Sedation

Question 15

Lithium toxicity

Answer 15

Toxicity: Altered mental status, coarse tremor, convulsions, death

Regularly monitor thyroid and kidney function

Nephrogenic DI
Hypothyroid
teratogenic - ebstein’s anomoly
leukocytosis - benign

Question 16

Valproic acid

Answer 16

Tremors
weight gain
alopecia
hepatotoxic

Monitor: toxicity causes hyponatremia, coma, death

Question 17

Serotonin syndrome

Answer 17

Cognitive: agitation, confusion, hallucinations, hypomania

Autonomic: sweating, hyperthermia, tachycardia

Somatic: tremor, myoclonus

May treat with Cyproheptadine (serotonin antagonist)

Question 18

IM atypical antipsychotics

Answer 18

olanzapine and ziprazidone

Question 19

Long acting atypical antipsychotic

Answer 19

risperidone

Question 20

When to use clozapine?

Answer 20

When patient fail to respond

Never as first line treatment

Question 21

Olanzapine AE

Answer 21

Increased metabolic syndrome and diabetes

Question 22

Risperidone AE

Answer 22

Greater incidence of movement disorders

orthostatic hypotension and reflex tachycardia

Question 23

Quietiapine AE

Answer 23

Less incidence of movement disorders

Sedation and orthostatic hypotension

Question 24

Ziprazidone AE

Answer 24

Prolong QT

Weight gain

Question 25

Apiprazole AE

Answer 25

Less weight gain and sedation

Question 26

Clozapine AE

Answer 26

More efficacious Agranulocytosis- monitor CBC Myocarditis

Question 27

Acute dystonia

Answer 27

Hours to days Muscle spasm- torticolis, laryngeal spasm, occulogyric spasm Treat: Benzotropine, trihexyphenidyl, diphenhydramine

Question 28

Akathisia

Answer 28

weeks Generalized restlessness Tx: reduce dose of med, beta blocker, switch to atypical

Question 29

Tardive dyskinesia

Answer 29

At least 6mo Abnormal involuntary movements especially of mouth Tx: Switch to atypical, clozapine is the least likely to cause

Question 30

Benzodiazepines AE

Answer 30

``` Sedation Confusion Memory Deficits Respiratory depression Addiction potential ```

Question 31

Buspirone AE

Answer 31

Headache Nausea Diziness

Question 32

Loreazepam indication

Answer 32

Emergency situations can be given IM

Question 33

Clonazepam indication

Answer 33

Mitigate addiction because longer half live

Question 34

Chordiazepoxide, oxazepam, lorazepam indication

Answer 34

Alcohol withdrawal

Question 35

Alprazolam indication

Answer 35

panic disorder

Question 36

Benzodiazepine overdose

Answer 36

Treat with Flumazenil if: | overdose is acute and you are sure there is no chronic dependance (causes seizures)