Psych

Question 1

Treatment for ADHD

Answer 1

Methylphenidate

Question 2

Treatment for bulimia nervosa

Answer 2

SSRI (fluoxetine)

Question 3

Ataxia + internuclear opthalmoplegia + confabulation

Answer 3

Wernicke Korsakoff

Question 4

Seizure + bugs crawling on skin + confusion

Answer 4

Delerium tremens

Question 5

Intoxication eye clues:
Mydriasis
Miosis
Horizontal/vertical nystagmus

Answer 5

Mydriasis = LSD, amphetamine, cocaine
Miosis = opioids
Nystagmus = PCP

Question 6

Heavy feeling in arms and legs + increased sleep + weight gain

Answer 6

Atypical depression

Question 7

What are the 2 low potency typical antipsychotics?
“CHeating THeives are LOW”
What is their major side effect?

Answer 7

Chlorpromazine and thioridazine

Anticholinergic and sedation

Question 8

What are the side effects of the high potency typical antipsychotics?

Answer 8

Extrapyramidal (acute dystonia, parkinsonism, akathasia, and tradeoff dyskinesia) and neuroleptic malignant syndrome

Question 9

What is the major side effect of atypical antipsychotics?

Answer 9

Weight gain

Question 10

Indications for typical antipsychotics

Answer 10

Psychosis, acute mania, tourette syndrome (fluphenazine, high potency typical)

Question 11

What are the 4 extrapyramidal side effects and when do they occur?

Answer 11

1. Acute dystonia (days) - spasms
2. Parkinsonism (1 mo) - bradykinesia
3. Akathasia (2 mo) - compulsion to move
4. Tardive dyskinesia (mo-yrs) - lip smacking

Question 12

Delerium + rigidity/myoglobinuria/fever + autonomic instability

Answer 12

Neuroleptic malignant syndrome

Question 13

What are 2 treatments for neuroleptic malignant syndrome?

Answer 13

Dantrolene and bromocriptine (DA agonist)

Question 14

Indications for atypical antipsychotics

Answer 14

Psychosis, bipolar/depression, OCD/anxiety/tourette syndrome

Question 15

What antipsychotic has the strongest association with wright gain?

Answer 15

Olanzapine

Question 16

Which antipsychotic can cause agranulocytosis? How frequently must CBCs be monitored?

Answer 16

Clozapine

Once per week

Question 17

What 3 drug categories are used as mood stabilizers in bipolar disorder?

Answer 17

Li, atypical antipsychotics, and anti-seizures

Question 18

What are 5 side effects for Li?

“LMNOP”

Answer 18

L - Li
M - movement (postural tremor)
N - nephrogenic DI
O - hypOthyroidism, nO heart beat (heart block)
P - pregnancy (ebstein anomaly)

Question 19

Myoclonus/hyperthermia + autonomic instability + flushing/diarrhea + acute mental status changes

Answer 19

Serotonin syndrome

Question 20

Treatment for serotonin syndrome

Answer 20

Cyproheptadine (5HT2 antagonist)

Question 21

What 4 non-antidepressant drugs can contribute to Serotonin syndrome?

Answer 21

Amphetamines, sumatriptan, linezolid, and tryptophan

Question 22

What is the mechanism of:
Citalopram
Duloxetine
Venlafaxine
Doxepin
Amoxapine
Tranylcypromine
Isocarboxazid
Trazodone, nefazodone

Answer 22

Citalopram - SSRI
Duloxetine, venlafaxine - SNRI
Doxepin, amoxapine - TCAs
Tranylcypromine, Isocarboxazid - MAOIs
Trazodone, nefazodone - 5HT modulators (insomnia)

Question 23

What are the 2 indications for SSRIs?

Answer 23

Depression and anxiety disorders

Question 24

What are the 2 indications for SNRIs?

Answer 24

Depression and chronic neuropathic pain (fibromyalgia)

Question 25

What are the 3 effects of TCA OD?

Answer 25

"Tri-Cs" - Cadiotoxicity (arrhythmias), CNS toxicity (coma, seizures), and antiCholinergics Most common cause of death = arrhythmias

Question 26

When is Bupropion contraindicated?

Answer 26

Bulemics - can cause seizures

Question 27

What is the best drug therapy for depression in a little old lady that isn't eating well?

Answer 27

Mirtazapine - can cause weight gain

Question 28

What is the other side effect of Mirtazapine that may actually help depression symptoms?

Answer 28

Sedation - may improve sleep

Question 29

What is the most common use for Trazodone? | What is the most serious side effect?

Answer 29

Insomnia (5HT modulator) | Priapism

Question 30

What antidepressant is used to treat: Fibromyalgia OCD Nocturnal enuresis

Answer 30

Fibromyalgia - amitryptiline OCD - clomipramine Nocturnal enuresis - imipramine

Question 31

Indication for buspirone (5HT agonist) | Indication for bupropion (NDRI)

Answer 31

Generalized anxiety disorder | Smoking cessation

Question 32

What's the difference between GAD and adjustment disorder?

Answer 32

GAD is > 6 mo | Adjustment disorder is

Question 33

What causes narcolepsy?

Answer 33

Decreased orexin (hypocretin) production in the lateral hypothalamus - normally suppresses REM

Question 34

What 2 drugs can be used to treat narcolepsy?

Answer 34

Amphetamines or modafinil (non-amphetamine stimulant)

Question 35

What personality disorder is associated with: Projection Increased suicide rate/self mutilation Splitting

Answer 35

Projection - paranoid | Increased suicide rate, splitting - borderline

Question 36

How can you distinguish Neuroleptic Malignant Syndrome and Serotonin Syndrome?

Answer 36

``` NMS = rigidity SS = myoclonus ```