Uworld

Question 1

anorexia nervosa tx

Answer 1

• CBT
• nutritional rehabilitation
• olanzapine

-hospitalization for dehydration, electrolyte disturbance, bradycardia, severe weight loss, cardiac dysarrhythmias

Question 2

bulimia nervosa tx

Answer 2

• CBT
• nutritional rehabilitation
• SSRI

Question 3

onset & tx for dystonia vs pseudoParkinsonism

Answer 3

• dystonia: 4 hours-4 days
• antihistamine or anticholinergic (benztropine, diphenhydramine)
• pseudoParkinsonism: 4 days-4 months
• anticholinergic

Question 4

social anxiety disorder tx:

• generalized
• performance

Answer 4

• SSRI or SNRI
• benzo or beta blocker
• both can be treated with CBT as 1st line

Question 5

heroin intoxication px

Answer 5

pinpoint pupils + drowsiness + CNS depression + constipation

Question 6

mature defense mechanisms (4)

Answer 6

• altruism
• humor
• sublimation
• suppression

Question 7

immature defense mechanisms (16)

• behaving badly to ease bad feelings
• acting as if a part of reality doesn’t exist
• transferring feelings to a more acceptable object
• disrupting memory, identity & consciousness to cope with an event
• altering perception of upsetting reality to be more acceptable
• substituting imaginary scenarios
• using intellect to avoid uncomfortable feelings
• separating a thought from its emotional components
• avoiding conflict by expressing hostility covertly
• attributing one’s feelings to others
• justifying behavior to avoid difficult truths
• responding in a manner opposite to one’s actual feelings
• reverting to earlier in developmental stage
• blocking upsetting feelings from entering in consciousness
• transforming emotional conflicts into physical sx
• seeing others as all good or all bad

Answer 7

• acting out
• denial
• displacement
• dissociation
• distortion
• fantasy
• intellectualization
• isolation of affect
• passive aggression
• projection
• rationalization
• reaction formation
• regression
• repression
• somatization
• splitting

Question 8

cocaine withdrawal sx

Answer 8

• irritable
• drowsy
• fatigue
• hungry

Question 9

heroin withdrawal sx

Answer 9

• muscle spasms
• joint pain
• n/v
• diarrhea
• abdominal cramps
• rhinorrhea
• lacrimation
• sweating
• HTN (autonomic instability), dilated pupils

Question 10

panic disorder tx

Answer 10

• acute: benzo

- long-term: SSRI/SNRI, cognitive behavioral therapy

Question 11

panic disorder comorbidities

Answer 11

• major depression
• bipolar disorder
• agoraphobia
• substance abuse
• suicidal ideations/ attempts

Question 12

mood stabilizers

Answer 12

• lithium
• lamotrigine
• valproate

Question 13

neuroimaging findings in psychiatric disorders:

• autism
• OCD
• panic disorder
• PTSD
• schizophrenia

Answer 13

• inc brain volume
• orbitofrontal cortex & striatum abnormalities
• dec volume of amygdala
• dec hippocampal volume
• enlarged cerebral ventricles

Question 14

alcohol withdrawal px

Answer 14

• diaphoresis
• tremor
• inc BP & pulse
• seizures (12-48 hours)
• delirium tremens (2-4 days)

Question 15

vaginismus

Answer 15

= genito-pelvic pain/ penetration disorder

difficulties with:

• vaginal penetration during intercourse
• vaginal or pelvic pain during intercourse
• tenseness of pelvic floor muscles during attempted penetration
• at least 6 months
• significant distress
• no other disorder or relationship issue

Question 16

ego-dystonic vs ego-syntonic

Answer 16

OCD vs OCPD

Question 17

SSRIs

SNRIs

Answer 17

citalopram
fluoxetine
paroxetine
sertraline

duloxetine
venlafaxine
desvenlafaxine

Question 18

TCAs

MAOIs

atypical antidepressants

Answer 18

amitriptyline
clomipramine
doxepin
nortriptyline

phenelzine
tranylcypromine

bupropion
mirtazapine
trazodone

Question 19

bipolar 1 vs 2

Answer 19

• manic episodes; depressed episodes not required

- hypomanic episodes + depressive episodes

Question 20

major depressive disorder diagnostic requirements

Answer 20

• 4 of SIGECAPS

- depressed mood OR anhedonia

Question 21

atypical depression px

Answer 21

• hypersomnia
• inc appetite
• rejection sensitivity
• leaden paralysis (heavy limbs)

Question 22

how long must you wait before you change the dose of an SSRI?

Answer 22

4-6 weeks are required before they provide symptomatic relief

Question 23

psychotic sx + __ = ?

• depression
• mania
• euthymia +/- mania +/- depression

Answer 23

• depression with psychotic features
• bipolar 1
• schizoaffective disorder

Question 24

bipolar disorder tx:

• 1 episode
• 2
• 3 or more

Answer 24

maintenance therapy:

• continue for 1-2 years
• long term - lifetime
• lifetime

-lithium or valproic acid + 2nd generation antipsychotic

Question 25

atypical antipsychotic with highest vs lowest potential for metabolic syndrome?

Answer 25

-olanzapine & clozapine vs -aripiprazole & ziprasidone

Question 26

ziprasidone has been associated with what SE?

Answer 26

QT prolongation (at higher doses)

Question 27

risperidone most common SEs?

Answer 27

- EPS - hyperprolactinemia - -> galactorrhea, menstrual disturbances, sexual dysfunction, gynecomastia

Question 28

when do you use motivational interviewing?

Answer 28

substance abuse -therapist is nonjudgmental, motivate patient to change, tolerate their resistance to change

Question 29

psychodynamic psychotherapy utilizes ________ to explore unresolved issues in higher functioning patients.

Answer 29

transference -patients unconsciously redirect their feelings to the therapist