Psych Case File and U world

Question 1

This neurotransmitter is most often altered in OCD

Answer 1

Serotonin

Question 2

This type of medication is the first line treatment of OCD

Answer 2

SSRI

Clomipramine, fluvoxamine, fluoxetine, paroxetine, sertraline

Question 3

What two conditions commonly occur with touretts?

Answer 3

OCD and ADHD

Question 4

Drug to give to a depressed smoker?

Answer 4

Buproprion

Question 5

What is the only antipsychotic that has been shown to be effective in treatment resistent schizophrenia especially in cases associated with suicidality?

Answer 5

Clozapine

Question 6

First line drug class for depression?

What is the next step when the first line does not work?

Answer 6

SSRI (Citalopram, Sertraline, fluoxetine, paroxatine)

When SSRI does not work then the next step would be to try a drug of the same class (e.g. sertraline not working switch to citalopram)

Question 7

Patient newly on haloperidol has torticolis. Tx?

Answer 7

Benztropine or diphenhydramine

Question 8

Buproprion should never be used in a patient with a hisotry of this…

Answer 8

Seizures

Question 9

Signs common in patients with anorexia nervosa

Answer 9

• Osteoporosis
• Euthyroid sick syndrome
• Hyponatremia (water excess)
• Cardiac arrythmia

Question 10

Anxiety medication that if discontinued abruptly can cause seizures

Answer 10

Alprazolam (xanax)

Question 11

Fever, rigidity, AMS and automic instability…

Answer 11

NMS

Question 12

Which drugs cause NMS?

Answer 12

typical antipsychotics like haloperidol

Dopamine blockade

Question 13

Atypical antipsychotic that most commonly causes tardive dyskinesia?

Answer 13

Resperidone

Question 14

Good initial medical treatment for a patient with performance anxiety disorder…

Answer 14

Propanolol or Benzo

Choose B blocker if Pt uses drugs

Question 15

Brain imaging findings consistent with the following disorders:

OCD

Panic disorder

PTSD

Schizophrenia

Autism

Answer 15

OCD: Orbitofrontal and striatum changes

Panic disorder: small amygdala

PTSD: Hippocampal changes

Schizophrenia: Lateral ventricular enlargement

Autism: overal brain enlargement

Question 16

Clozapine causes this important reaction…

Answer 16

Agranulocytosis

Question 17

Why imipramine (TCA) is good for bed wetting…

Answer 17

Highly anticholinergic

Question 18

TCA that is good for OCD

Answer 18

Clomipramine

Question 19

This drug can cause HTN crisis when combined with aged food due to ______ in the food.

Answer 19

MAOi’s

Tyramine

Question 20

Antidepressant that causes weight loss. Good for smokers.

Answer 20

Buproprion

Question 21

This drug causes sedation and weight gain

Answer 21

Mirtazepine (remeron)

Question 22

Side effects of lithium

Answer 22

Tremor

Polyuria (diabetes insipidus)

Cardiac arrythmia

hypothyroidism

weight gain

edema

leukocytosis

Question 23

First generation antipsychotics work by…

They treat the (positive or negative) sx of schizophrenia?

Answer 23

Blocking central dopamine receptors

Tx +symptoms of schizophrenia

Question 24

Most common side effect assocaited with Haldol use…

Answer 24

EPS

Question 25

These are examples of this drug class.... Risperidone Olanzepine (zyprexa) Clozapine Quetiapine (seroquel) Ziprazadone (geodon) Aripiprazole (abilify)

Answer 25

Atypical antipsychotics Serotonin-dopamine antagonist

Question 26

Class of meds used to treat akathisia (restlessness) from psychotropic meds

Answer 26

amantidine and levodopa

Question 27

Antidote to beonzodiazepine overdose

Answer 27

Flumazenil

Question 28

This is a common treatment for excesive daytime sleepyness...

Answer 28

Modafanil

Question 29

Clozapine and olanzapine (atypical antipsychotics) have been assiciated with this medical condition...

Answer 29

Metabolic syndrome

Question 30

Treatment of panic disorder

Answer 30

SSRI with Behavioral cognitive therapy Short course of benzo--then dicontinue

Question 31

Side effects of olanzapine

Answer 31

Sedation and weight gain

Question 32

Treatment for Bipolar I (manic episode with psychotic features)

Answer 32

Valproic acid or lithium and atypical antipsychotic

Question 33

Only drug FDA approved for tx of bipolar in children 12 and older?

Answer 33

Lithium

Question 34

Best drug for treatment of bipolar in children 12 and under

Answer 34

valproic acid

Question 35

Bipolar II disorder

Answer 35

Hypomania with episode of depression

Question 36

Olanzapine and clozapine are both associated with this side effect...

Answer 36

Weight gain and dyslipidemia

Question 37

When asked about tx for ADHD and methylphenidate or dextromethorphine is not a choice, what is the correct answer? Why?

Answer 37

Amantadine It has a milder side effect profile

Question 38

What is the best choice of treatment in a patient who is depressed and also has neuropathy

Answer 38

duloxetine (cymbalta)

Question 39

Best antidepressant for a pt with depression and does not want to have excessive weight gain or sexual dysfunction

Answer 39

Buproprion (wellbutrin)

Question 40

Atypical depressive symptoms

Answer 40

weight gain increased sleep increased appetite

Question 41

Medical treatment of serotonin syndrome

Answer 41

cyproheptadine

Question 42

This atypical antipsychotic has a side effect of QT prolongation

Answer 42

Ziprasidone (Geodon)

Question 43

Which of the antipsychotics is least likely to cause metabolic issues (good for DM and fat ppl)

Answer 43

Arapiprazole (abilify) Ziprasidone (Geodon)

Question 44

First line treatment for PTSD

Answer 44

Sertraline and paroxetine

Question 45

Absolute contraindication to buproprion use?

Answer 45

Seizure condition or predisoposing electrlyte abnormality