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AMC MCQ > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Young female BMI 16bcoming to you with 1ry amenorrhea first inv…

A

US

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2
Q

Female BMI 16 with bony pain first inv

A

DEXA scan ..osteoporosis

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3
Q

Priority in anorexia nervosa

A

electrolytes (hypo K)

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4
Q

Most common:

Effect of anorexia nervosa on pregnancy

A

…Low birth weight

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5
Q

Effect of malaria on pregnancy

A

.low birth weight

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6
Q

Effect of cocaine on pregnancy

A

low birth weight

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7
Q

Effect of smoking on pregnancy

A

low birth weight

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8
Q

Main difference bet bulimia and anorexia nervosa

A

…normal weigh

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9
Q

Long term prognosis of bulimia nervosa

A

depression

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10
Q

Long term prognosis of OCD

A

..PSYCHOSIS

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11
Q

Long term prognosis of borderline personality disorder…

A

PSYCHOSIS

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12
Q

Long term prognosis of generalized anxiety

A

depression

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13
Q

Long term prognosis of panic attack……

A

depression

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14
Q

Psychiatric disorder causing highest rate of death

A

anorexia nervosa

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15
Q

Female always feel that she is overweight although normal BMI

A

.body dysmorphic disorder

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16
Q

Causes of body dysmorphic disorder?

A

2-anorexia nervosa
3-amputated limb
4-acromegaly
5- neglect syndrome

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17
Q

Distrustful suspicious person

A

paranoid

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18
Q

Female with history of crimes, drug abuse, sexual troubles, left her family and lives alone

A

borderline

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19
Q

Male with history of crimes, drug abuse, sexual troubles, left his family and lives alone more than 18 yrs

A

antisocial

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20
Q

Most risk with borderline

A

…suicide

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21
Q

Psychotherapy for borderline

A

dialectal

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22
Q

Psychotherapy for trichillomania

A

…..aversion

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23
Q

Male lives alone does not care about people

A

…schizoid

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24
Q

Male lives alone feels being rejected

A

..avoidant

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25
Q

Male lives alone with ideas of reference

A

…schizotypal

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26
Q

Male with high self esteem does not show empathy

A

.narcissitic

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27
Q

Female being abused by her boy friend but still feels as if she can never live without him…

A

dependent

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28
Q

Female gives great care to the order of furniture in her home and has a strict schedule of her life routine.

A

Obsessive compulsive

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29
Q

Female during interview wear sexy clothes and tries to seduce the employer to get the job

A

…histrionic

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30
Q

Child 5 yrs his mother complains of his overactivity and that he does not listen to what she says

A

.ADHD

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31
Q

First step to confirm ADHD

A

call the teacher and ask for his grades

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32
Q

Drug of choice for ADHD

A

.methyphenidate

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33
Q

Most imp test for ADHD………

A

..hearing test

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34
Q

Boy 4 yrs old with low IQ limited social activity, limited language development , fascinating with certain toys…..

A

AUTISM

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35
Q

Boy 4 ys old with normal IQ , limited social activity, normal language development , fascinating with certaing toys

A

.asperger

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36
Q

8 yrs child doing recurrent grimacing and recurrent strange sounds….

A

.Tourret’s

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37
Q

Most common association with Tourret’s……

A

OCD

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38
Q

Drug of choice for tourret’s

A

…antipsychotic

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39
Q

Child 14 yrs with history of drinking alcohol and recurrent fighting with his peers in school

A

Conduct

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40
Q

Is masturbation normal act?

A

..yesssssss

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41
Q

Is being Gay or lesbian normal act ?….

A

yesssssss

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42
Q

TTT of choice for :

Anorgasm

A

.self stimulation

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43
Q

Premature ejaculation, what to do?

A

….squeeze technique

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44
Q

Vaginismus

A

…vaginal dilators

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45
Q

Male feels orgasm by wearing his girlfriend underwear

A

.transvestism

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46
Q

Male feels orgasm by rubbing his body against clothed females in crowded places

A

……frotteurism

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47
Q

Male feels orgasm by having sex with kids….

A

pedophilia

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48
Q

Male feels that he is a woman in male’s body and asking for plastic surgeries to change his sex

A

transsexualism

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49
Q

Young females with recurrent attacks of hyperventilation, palpitations and feeling as if she will die…

A

panic

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50
Q

Long term prognosis of panic

A

depression

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51
Q

Most common association with panic

A

…agoraphobia

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52
Q

TTT of acute attack of panic……

A

benzodiazepine

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53
Q

Lab of panic

A

alkalosis, hypocapnia and increased O2

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54
Q

Woman with marked fear each time she has to give public speaking

A

social phobia

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55
Q

Best ttt for specific phobia

A

gradual exposure

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56
Q

Imp test for dementia

A

MMSE test|( less than 24)
There is no definitive investigation for Alzheimer
Alzheimer is not preventable nor curable

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57
Q

First to be affected in Alzheimer

A

memory

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58
Q

Least likely to be affected with Alzheimer is?

A

face recognition

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59
Q

Psychiatric illness increases in incidence

A

dementia

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60
Q

Memory affection with normal aging sometimes very similar to Alzheimer except that there is no impairment of normal function

A

he lives independently

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61
Q

CT of Alzheimer

A

brain atrophy with ventricular enlargement

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62
Q

Drug of choice for alzheimer

A

donepezil, tacrine

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63
Q

Best drug for alzheimer with heart disease

A

memantine

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64
Q

Dementia + visual hallucinations + parkinsonism

A

.lewy body

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65
Q

Dementia+personality changes+abnormal movements

A

Huntington

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66
Q

Dementia+urine incontinence+abnormal gait

A

normal pressure hydrocephalus

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67
Q

Dementia+young aged male with uncontrolled HTN

A

Vascular

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68
Q

Short history of dementia+sleeping troubles

A

depression

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69
Q

Old age in the hospital sleeping during the day, agitated

A

delirium

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70
Q

Most imp inv for delirium

A

urine analysis

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71
Q

Most imp drug to control agitation in delerium

A

.antipsychotic

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72
Q

Agitation in admitted person

A

think of alcohol withdrawal

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73
Q

TTT of alcohol withdrawal

A

diazepam

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74
Q

Female being raped now complains of flashbacks and troubles in sleeping

A

PTSD

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75
Q

Most effective ttt in PTSD

A

group counseling

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76
Q

Drug of choice for PTSD

A

SSRI

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77
Q

Drug of choice for OCD

A

SSRI

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78
Q

Drug of choice for depression

A

SSRI

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79
Q

Drug of choice for GAD

A

SSRI

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80
Q

Long term ttt for panic

A

.SSRI

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81
Q

Female patients with a long history of hospital admissions with many procedures and surgeries done

A

factitious

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82
Q

Kid admitted hospital becomes sick only when his mom visits him

A

munchausen syndrome by proxy

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83
Q

Male patient comes to the clinic with severe renal colic asking for strong analgesics, his investigations normal

A

malingering

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84
Q

First step in this patient of malingering

A

urine sampling in front of you

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85
Q

Male patient alcoholic now complains of nystagmus, gait instability and drowsy

A

wernicke’s encephalopathy

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86
Q

Main cause of wernicke’s encephalopathy

A

thiamine deficiency

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87
Q

TTT of wernicke’s encephalopathy

A

THIAMINE then GLUCOSE

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88
Q

Police brings to you male confused doesn’t know his name , you found airline ticket in his pocket….

A

dissociative fugue

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89
Q

Causes of IMPULSE CONTROL DISORDER?

A

1-KLEPTOMANIA
2-PYROMANIA
3-TRICHOTILLOMANIA
4-PATHOLOGICAL GAMBLING

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90
Q

Female patient with recurrent acts of stealing of stuff she does not really needs

A

KLEPTOMANIA

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91
Q

Main ttt of kleptomania

A

aversion

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92
Q

Male patient with recurrent episodes of doing firing in home and school

A

pyromania

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93
Q

Why pyromaniacs do firing……

A

satisfaction

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94
Q

Female patient with no hair on half of her scalp

A

TRICHOTILLOMANIA

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95
Q

Main ttt of grief

A

support

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96
Q

TTT of grief and depression

A

SSRI

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97
Q

Most imp to depression with grief

A

suicidal ideation

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98
Q

Grief + visual hallucination

A

abnormal grief

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99
Q

Imp question to patient with postpartum

A

if she has any feeling of hurting herself or her baby

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100
Q

Main risk factor for postpartum psychosis

A

….primipara

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101
Q

Important steps for mild postpartum blue

A

family involvement and continue breastfeeding

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102
Q

Treatment of cases of postpartum psychosis

A

…involuntary admission and .ECT

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103
Q

Inability to answer a question without giving excessive, unnecessary detail.. but eventually will answer the question

A

.Circumstantiality

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104
Q

if does not answer the question

A

tangentiality

105
Q

feeling that you saw this situation before

A

.deja vu

106
Q

Female patient told you that a very famous celebrity loves her

A

…delusion of erotomania

107
Q

Male patient came to told shouting that he is God and should be followed

A

..delusion of grandiosity

108
Q

Old age patient anxious telling you his neighbors trying to kill him by putting poisons in his food

A

.delusion of persecution

109
Q

Patient feels that the people are talking about him

A

.delusions of reference

110
Q

2 sisters sharing the same psychotic symptoms

A

folie a deux

111
Q

Female patient with recurrent thoughts of cleaning her hands

A

OCD

112
Q

Long term prognosis of OCD

A

……psychosis

113
Q

Female patient worries about her financial condition and also about her husband’s work ……

A

GAD

114
Q

Main ttt of GAD

A

.SSRI

115
Q

Long term prognosis of GAD……

A

depression

116
Q

Female patient with recurrent thoughts of washing her hands

A

OCD

117
Q

Young boy taking more than 10 showers per day…

A

OCD

118
Q

Drug of choice for OCD in kids……

A

SSRI

119
Q

Young male with recurrent attacks of sleeping per day that are accompanied with hallucinations

A

…narcolepsy

120
Q

Main ttt of narcolepsy

A

…psychostimulant

121
Q

Middle age male obese with recurrent attacks of sleeping and his wife complains of his snoring

A

…Obstructive sleep apnea

122
Q

Inv of choic for OSA….

A

polysomonography

123
Q

First advice for this patient OSA

A

loss weight

124
Q

TTT of choice of OSA

A

…CPAP

125
Q

What does insomnia means

A

…bad quality of sleep

126
Q

Main ttt of insomnia

A

……non pharmacological

127
Q

Drug of choice for insomnia

A

.short acting benzodiazepine

128
Q

Duration to diagnose depression

A

2 weeks

129
Q

Duration to diagnose schizophrenia……

A

6 months

130
Q

Duration to diagnose schizophreniform

A

.1-6 months

131
Q

Duration to diagnose brief psychotic disorder.

A

less than I month

132
Q

Duration to diagnose PTSD

A

.more than 1 month

133
Q

Drug of choice for depression

A

SSRI

134
Q

No effect after usage of SSRI for 1 week….

A

just continue

135
Q

Effect of SSRI appears after……

A

2-6 weeks

136
Q

When to shift to another drug…..

A

no effect after 2 months

137
Q

How long to use SSRI

A

at least 6 months

138
Q

How long to use SSRI in suicidal patient….

A

2 YEARS

139
Q

ld age + severe depression

A

ECT

140
Q

Depression+smoker

A

…..bupropion

141
Q

Depression+insomnia……..

A

mirtazapine

142
Q

Depression + decreased appetite……….

A

mirtazapine

143
Q

Most common season for depression

A

Winter

144
Q

Most common season for suicide……………

A

Spring

145
Q

Most common season for SIDS

A

Winter

146
Q

Depression memory impairement

A

……pseudodementia

147
Q

Depression and suicide

when is the Highest risk of suicide

A

first two weeks after leaving hospital

148
Q

Most important question to depressed patient……..

A

suicidal thoughts

149
Q

Highest probability of suicide

A

..history of previous suicidal attempt

150
Q

Once you discover suicidal thoughts

A

…involuntary admission

151
Q

Most risky patients

A

have a plan of suicide

152
Q

SSRI + Ecstasy…….lead to?

A

serotonin syndrome

153
Q

First step in serotonin syndrome

A

..stop both drugs

154
Q

Food should be avoided in patient taking MAOI….

A

cheese and wine

155
Q

What should be screened in patient taking MAOI

A

.blood pressure

156
Q

Patient on SSRI comes back to you complaining that there is no improvement………

A

….just.continue the medications

157
Q

how to stop SSRI ?

A

.TAPPERING SHOULD BE DONE FOR 2_4 WEEKs

158
Q

Effect of overdose of TCA

A

…arrhythmia

159
Q

Most imp Inv in TCA overdose?

A

ECG

160
Q

How to assess severitty of TCA overdose

A

…….duration of QRS complex

161
Q

Antidote for TCA overdose……

A

NaHco3

162
Q

Tests should be done in patient on lithium

A

.TSH and RFTs (thyroid and Kidneys)

163
Q

Main SE of lithium toxicity…..

A

ataxia, dysarthria delirium

164
Q

TTT of lithium toxicity

A

…dialysis

165
Q

Main SE of carbamazepine

A

……leucopenia

166
Q

Main SE of lamotrigine

A

…rash

167
Q

Patient coming to ER with neck contracted to one side

A

…dystonia

168
Q

TTT of acute dystonia

A

…diphenhydramine and benztropine

169
Q

Main 2 categories of drugs causing extrapyramidal symptoms

A

…antipsychotic and anti emetics drugs

170
Q

Patient on antipsychotic with continuous urge to move around the room……

A

akathisia

171
Q

Patient on antipsychotic with twitching of his face, tongue and hand

A

.tardive dyskinesia

172
Q

Patient on antipsychotic coming to ER with high fever, high blood pressure…….

A

neuroleptic malignant syndrome

173
Q

Risk with neuroleptic malignant syndrome

A

…rhabdomyolosis….acute renal failure

174
Q

TTT of choice for neuroleptic malignant syndrome…

A

dantrolene or bromocriptine

175
Q

Monitor of clozapine for? with?

A

CBC( AGRANULOCYTOSIS)

176
Q

Monitor of olanzapine

A

…FBS and lipid profile

177
Q

First line therapy for schizophrenia

A

olanzapine

178
Q

schizophrenia + insomnia

A

olanzapine

179
Q

drug with the least side effects

A

quitiapine

180
Q

schizophrenia+ oversleeping…

A

respiridone

181
Q

Most important step in psychotherapy

A

establish good relationship with the patient

182
Q

Main SE of ECT

A

Transient memory disturbance

183
Q

Schizophrenic patient taking marijuana first step

A

.stop marijuana

184
Q

Duration of usage of SSRI in suicidal patients……

A

2 yrs

185
Q

Type of SSRI in kids

A

.fluvoxamine

186
Q

Most imp to monitor in venalfaxine

A

…blood pressure

187
Q

Patient with pin point pupil and RR 6/min

A

.morphine toxicity

188
Q

TTT of morphine toxicity,…… (opiod)

A

naloxone

189
Q

Patient with pinpoint pupil, diarrhea and marked crepitation heared on the lung……

A

organophosphorus poisoning

190
Q

TTT organophosphorus….

A

atropine and oxime

191
Q

Patient with piloerection, yawning, rhinorrhea and myalgia…

A

.morphine withdrawal

192
Q

TTT of morphine withdrawal…..

A

methadone

193
Q

Main SE of benzodiazepine withdrawal….

A

agitation

194
Q

Type of benzodiazepine causing withdrawal symptoms…

A

short acting

195
Q

TTT of benzodiazepine overdose

A

Flumazenil

196
Q

Effect of cocaine on brain

A

stroke

197
Q

Effect of cocaine on nose

A

septal perforation

198
Q

Effect of cocaine on heart

A

MI

199
Q

Effect of cocaine on skin

A

bugs under skin

200
Q

Effect of cocaine on placenta

A

.abruptio placenta

201
Q

Effect of cocaine on fetus

A

low birth weight.

202
Q

Effect of cocaine on fetus

A

teratogenic

203
Q

Most common teratogenic substance

A

alcohol followed by cocaine

204
Q

Main SE of cocaine withdrawal

A

skin bugs

205
Q

Main SE of PCP toxicity

A

vertical/horizontal nystagmus

206
Q

Main SE of LSD toxicity…

A

hallucination

207
Q

Main SE of cannabis toxicity

A

increased appetite, dry mouth, conjunctival injection

208
Q

Active form of cannabis

A

etra hydro cannabinoid

209
Q

Main TTT to help patient stop smoking

A

nicotine patch

210
Q

alcohol questionnaire

A

CAGE

  1. Have you ever felt the need to Cut down on your drinking?
  2. Have you ever felt Annoyed by criticism of your drinking?
  3. Have you ever felt Guilty about drinking?
  4. Have you ever had to take a morning Eye opener?
211
Q

Most imp question to detect alcohol addiction

A

….morning eye opener

212
Q

Most important risk factor for:

Anorexia nervosa.

A

family history of athleticism

213
Q

Bulimia nervosa

A

history of child abuse

214
Q

Binge eating

A

family history of obesity

215
Q

Weight loss in young female without others symptoms except psychic problems

A

drug or alcohol abuse

216
Q

Drug of choice for catatonic schizophrenia

A

..benzodiazepine

217
Q

Most common drug used in parties

A

Ecstasy (MDMA)

218
Q

Most important sign of amphetamine withdrawal

A

paranoia

219
Q

Most important sign of amphetamine toxicity

A

…psychosis followed by hallucinations

220
Q

Drug of choice for agitation of drugs

A

antipsychotic

221
Q

Patient on SSRI comes back to you complaining that there is no improvement

A

just continue the medications

222
Q

Patient on SSRI still have symptoms first step

A

increase dose

223
Q

Patient on SSRI developed side effects

A

..shift to another SSRI

224
Q

Most common side effect of SSRI

A

.abdominal pain and agitation

225
Q

Patient on SSRI after taking tramadol developed serotonin syndromes first step

A

….stop both of them

Donepezil and SSRIs

226
Q

Synergistic effect

First step

A

.stop both of them

227
Q

Police brings to you homeless psychotic patient :

First step

A

.collateral history from the police

228
Q

If agitated

A

…antipsychotic then admission

229
Q

If not agitated……

A

admission

230
Q

Where to admit

A

.psychiatric unit

231
Q

DD of sudden withdrawal manifestation in teenagers??

A

1-drug abuse……..need to be excluded first
2-depression…..associated with decreased appetite, enegery, sleep and suicisal thoughts
3-prodrome of schizophrenia……associated with delusions and hallucinations

232
Q

Delusion with pregnancy…………

A

clozapine

233
Q

Drug causing teratogenicity in first trimester

A

..anticonvulsant

234
Q

Drug causing teratogenicity in last trimester

A

..antipsychotic

235
Q

First step if mom complains of behaviouir of her son …..

A

interview with the son

236
Q

Currently ttt of choice in agitated person if:

Psychotic patient

A

..antipsychotic medications

237
Q

Delirious patient

A

..antipsychotic medications

238
Q

Postoperative……………..

A

antipsychotic medications

239
Q

Amphetamine toxicity…………………

A

antipsychotics

240
Q

Alcoholic………

A

diazepam

241
Q

Alcoholic and liver impairment…….

A

.lorazepam

242
Q

Selective Mutism

A

where children will speak freely in somesettings (usually at home) but not in others

243
Q

Patient with dementia needs urgent surgery first step

A

.ask for advanced directive

244
Q

Serious complication of amphetamine poisioning?

A

MI

245
Q

Least common side effect of lithium?

A

Renal impairment

246
Q

Motor restlessness of feet and legs is termed?

A

Akathisia

247
Q

Muscle spasm of neck, face tongue and trunk is termed?

A

Dystonia

248
Q

Tx of Hoarding disorder?

A

CBT

249
Q

what is LESS common presentation in bipolar vs unipolar depression?

A

Decreased appetite

250
Q

In eating disorder, expect family history of what?

A

Obesity

251
Q

What is not a key diagnostic feature of eating disorder?

A

Hirsutism

252
Q

Believes that someone replaces your loved one is called?

A

Capgrass syndrome (dilusional misidentifivation syndrome)

253
Q

MCC of death in TCA overdose?

A

Arrhythmias

254
Q

Pt develops lethergy while on long term Lithium therapy, Check what?

A

Thyroid function

255
Q

flight of ideas is a feature of?

not?

A

Bipolar

not schizophrenia

256
Q

What is clock drawing test used for?

A

Access severity of dementia

257
Q

which antipsychotics protect against depression in a pt with Bipolar disorder?

A

Olanzapine and quetiepine

258
Q

only effective ssri for kids?

A

fluoexetine

AMC MCQ (14 decks)

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