PA Psychiatry EOR Test Questions and Answers Graded A+
*SIGECAPS* of Depression - ANSWER -
*S*leep disturbances
*I*nterests are ↓ SSRI known to cause QT interval prolongation -
*G*uilt ANSWER -Citalopram (Celexa)
*E*nergy is ↓
*C*oncentration is ↓
*A*ppetite is ↓ Screening tool or questionnaire used in clinic for:
*P*sychomotor Agitation Bipolar Disorder
*S*uicidal thoughts Major Depression Disorder - ANSWER -
BPD: The Mood Disorder Questionaire
Major depressive disorder - ANSWER - MDD: Beck Depression Inventory
Depressed Mood or Anhedonia
Dx: 5 or more of the SIGECAPS Sxs for *> 2
wks* effecting normal function Atypical Antidepressant which inhibits DA
reuptake, has less sexual and wt-related side
effects, but decreases *seizure* threshold -
Tx: ANSWER -Bupropion
*SSRI* or *SNRI* > TCA/MAOi > ECT *smoking cessation*
S/Es of SSRIs - ANSWER -*Sexual *SNRI Trade Names*
Dysfunction* Effexor
Wt gain Pristiq
Anxiety Cymbalta
Nausea Fetzima - ANSWER -*SNRI Drug Names*
Venlafaxine
Desvenlafaxine
*SHIVERS* of Serotonin Syndrome - Duloxetine
ANSWER -*S*hivering Levomilnacipran
*H*yperreflexia
*I*ncreased temp (fever)
*V*itals, unstable TCA antidepressants
*E*ncephalopathy *special characteristics* - ANSWER -
*R*estless Desipramine - selective NET inhibitor
*S*weating Imipramine - tx of enuresis
Amitriptyline- tx of neuromuscular pain
Tx: Cyproheptadine Nortriptyline
*QT Interval prolongation* = arrythmias
1st line Tx of depression in children -
ANSWER -Fluoxetine (Prozac)
- Longest Half-life of all SSRIs MAO Inhibitors used as antidepressants
*T*ake *P*ride in *S*hanghai - ANSWER -
- Caution ↑ SI in the 1st 2 weeks of use Tranylcypromine
,PA Psychiatry EOR Test Questions and Answers Graded A+
Phenelzine MDD > 2wks + Mania (DIG FAST) > 1wk
Selegiline Inhibits function of daily living
Tx:
Antidepressant which inhibits MAO b Acute Manic Episode: Antipsychotic + Mood
mechanisms and can ↑ dopamine concentrations Stabilizer
- ANSWER -Selegiline Chronic Cycle Episodes: Mood Stabilizer
- Can be added in Tx of Parkinson's
Mood Stabilizers to Tx Bipolar Disorder (4) -
Suicide Risk Assessment ANSWER -Lithium
*SAD PERSONS* Valproic Acid (Depakote)
0-4 Low Carbamazepine (Tegretol)
5-6 Moderate Lamotrigine (Lamictal)
7-10 High - ANSWER -*S*ex (males)
*A*ge (biphasic)
*D*epression Side Effects of Lithium
*P*revious attempts *LMNOP* - ANSWER -*L*ithium Side
*E*xcessive substance abuse Effects
*R*ational thinking, loss *M*ovements (tremors)
*S*ocial support lacking *N*ephrotoxicity
*O*rganized plan hyp*O*thyroid
*N*o spouse *P*regnancy problems (Ebstein's Anomoly)
*S*ick (chronic)
Mood Stabilizer used to Tx Bipolar I Disorder w/
*DIG FAST* of Bipolar - ANSWER - predominant depressed state and may cause an
*D*istractibility *itchy rash or SJS* - ANSWER -Lamotrigine
*I*rresponsibility (Lamictal)
*G*randiosity
*F*light of ideas Tx of Bipolar I Disorder by ↑ GABA and ↓ Na+
*A*gitation C/I in pregnancy = *↓ Folate*
*S*leep disturbances Hepatic Necrosis
*T*alkative C/I with ASA or Warfarin = ↓ protein binding
availability - ANSWER -Valproic Acid
(Depakote)
Bipolar II - ANSWER -Dx:
MDD + Hypomania (DIG ST) < 1wk
Function in not fully compromised Mood Stabilizer & Anticonvulsant especially
helpful to Tx the *cycling* of Bipolar Disorder but
Tx: *Risperdal* may cause....... - ANSWER -
Carbamazepine (Tegretol)
Bipolar I Disorder - ANSWER -Dx: Agranulocytosis
, PA Psychiatry EOR Test Questions and Answers Graded A+
>2wks of SIGECAPS
Within 4 weeks of childbirth
Anticonvulsant, not FDA approved for the use as
a mood stabilizer, causes *wt loss*, ↓ cognition, Tx: *Rest & Support*
word searching, ↑ risk of kidney stones and Paroxetine
metabolic acidosis - ANSWER -Topiramate Sertraline - if breast feeding
(Topamax)
Schizophrenia - ANSWER -Dx:
Causes *rapid cycling* in Bipolar Disorder pts - *Auditory hallucinations*
ANSWER -The use of *antidepressants* is Delusions (fixed, false beliefs)
C/I in Bipolar Disorder Sx's continue for *at lease 6mo*
- leads to mania
Tx: *Olanzapine*
- S/E: *↑ wt gain* unrelated to caloric intake
Persistent depressive disorder (Dysthymic
disorder) - ANSWER -Dx: (MDD Lite)
<5 SIGECAPS criteria for *>2 yrs* Prodromal Sx's of Schizophrenia -
Still able to function ANSWER -Social Isolation
New interest in religion/philosophy
Tx: *Psychotherapy* > SSRIs Restlessness
Difficulty concentrating
*Failed medication* criteria when using
antidepressants to Tx MDD? - ANSWER - Positive Sx's of Schizophrenia - ANSWER -
Noticeable change of Depressive Sx's in 2-6 Delusions
weeks of Rx initiation Hallucinations
Strange behaviors
Incoherent thought process
Cyclothymic disorder - ANSWER -Dx: Grossly disorganized
(Bipolar II Lite) Catatonic behavior
Hypomania + Dysthymia >2 yrs
Sx free for <2 mo
Still able to function Negative Sx's of Schizophrenia -
ANSWER -Flat affect
Tx: Psychotherapy/CBT/Family Therapy Decreased fluency
Decreased productivity of thought & speech
Social withdrawal
Premenstrual dysphoric disorder - Decrease in goal-directed behavior
ANSWER -PMS on an anger pill - affecting
function
Rx for acute, agitated psychosis in schizophrenic
pts
Major depressive disorder with peripartum onset
- ANSWER -Dx: S/E's seen w/ chronic use - ANSWER -
*SIGECAPS* of Depression - ANSWER -
*S*leep disturbances
*I*nterests are ↓ SSRI known to cause QT interval prolongation -
*G*uilt ANSWER -Citalopram (Celexa)
*E*nergy is ↓
*C*oncentration is ↓
*A*ppetite is ↓ Screening tool or questionnaire used in clinic for:
*P*sychomotor Agitation Bipolar Disorder
*S*uicidal thoughts Major Depression Disorder - ANSWER -
BPD: The Mood Disorder Questionaire
Major depressive disorder - ANSWER - MDD: Beck Depression Inventory
Depressed Mood or Anhedonia
Dx: 5 or more of the SIGECAPS Sxs for *> 2
wks* effecting normal function Atypical Antidepressant which inhibits DA
reuptake, has less sexual and wt-related side
effects, but decreases *seizure* threshold -
Tx: ANSWER -Bupropion
*SSRI* or *SNRI* > TCA/MAOi > ECT *smoking cessation*
S/Es of SSRIs - ANSWER -*Sexual *SNRI Trade Names*
Dysfunction* Effexor
Wt gain Pristiq
Anxiety Cymbalta
Nausea Fetzima - ANSWER -*SNRI Drug Names*
Venlafaxine
Desvenlafaxine
*SHIVERS* of Serotonin Syndrome - Duloxetine
ANSWER -*S*hivering Levomilnacipran
*H*yperreflexia
*I*ncreased temp (fever)
*V*itals, unstable TCA antidepressants
*E*ncephalopathy *special characteristics* - ANSWER -
*R*estless Desipramine - selective NET inhibitor
*S*weating Imipramine - tx of enuresis
Amitriptyline- tx of neuromuscular pain
Tx: Cyproheptadine Nortriptyline
*QT Interval prolongation* = arrythmias
1st line Tx of depression in children -
ANSWER -Fluoxetine (Prozac)
- Longest Half-life of all SSRIs MAO Inhibitors used as antidepressants
*T*ake *P*ride in *S*hanghai - ANSWER -
- Caution ↑ SI in the 1st 2 weeks of use Tranylcypromine
,PA Psychiatry EOR Test Questions and Answers Graded A+
Phenelzine MDD > 2wks + Mania (DIG FAST) > 1wk
Selegiline Inhibits function of daily living
Tx:
Antidepressant which inhibits MAO b Acute Manic Episode: Antipsychotic + Mood
mechanisms and can ↑ dopamine concentrations Stabilizer
- ANSWER -Selegiline Chronic Cycle Episodes: Mood Stabilizer
- Can be added in Tx of Parkinson's
Mood Stabilizers to Tx Bipolar Disorder (4) -
Suicide Risk Assessment ANSWER -Lithium
*SAD PERSONS* Valproic Acid (Depakote)
0-4 Low Carbamazepine (Tegretol)
5-6 Moderate Lamotrigine (Lamictal)
7-10 High - ANSWER -*S*ex (males)
*A*ge (biphasic)
*D*epression Side Effects of Lithium
*P*revious attempts *LMNOP* - ANSWER -*L*ithium Side
*E*xcessive substance abuse Effects
*R*ational thinking, loss *M*ovements (tremors)
*S*ocial support lacking *N*ephrotoxicity
*O*rganized plan hyp*O*thyroid
*N*o spouse *P*regnancy problems (Ebstein's Anomoly)
*S*ick (chronic)
Mood Stabilizer used to Tx Bipolar I Disorder w/
*DIG FAST* of Bipolar - ANSWER - predominant depressed state and may cause an
*D*istractibility *itchy rash or SJS* - ANSWER -Lamotrigine
*I*rresponsibility (Lamictal)
*G*randiosity
*F*light of ideas Tx of Bipolar I Disorder by ↑ GABA and ↓ Na+
*A*gitation C/I in pregnancy = *↓ Folate*
*S*leep disturbances Hepatic Necrosis
*T*alkative C/I with ASA or Warfarin = ↓ protein binding
availability - ANSWER -Valproic Acid
(Depakote)
Bipolar II - ANSWER -Dx:
MDD + Hypomania (DIG ST) < 1wk
Function in not fully compromised Mood Stabilizer & Anticonvulsant especially
helpful to Tx the *cycling* of Bipolar Disorder but
Tx: *Risperdal* may cause....... - ANSWER -
Carbamazepine (Tegretol)
Bipolar I Disorder - ANSWER -Dx: Agranulocytosis
, PA Psychiatry EOR Test Questions and Answers Graded A+
>2wks of SIGECAPS
Within 4 weeks of childbirth
Anticonvulsant, not FDA approved for the use as
a mood stabilizer, causes *wt loss*, ↓ cognition, Tx: *Rest & Support*
word searching, ↑ risk of kidney stones and Paroxetine
metabolic acidosis - ANSWER -Topiramate Sertraline - if breast feeding
(Topamax)
Schizophrenia - ANSWER -Dx:
Causes *rapid cycling* in Bipolar Disorder pts - *Auditory hallucinations*
ANSWER -The use of *antidepressants* is Delusions (fixed, false beliefs)
C/I in Bipolar Disorder Sx's continue for *at lease 6mo*
- leads to mania
Tx: *Olanzapine*
- S/E: *↑ wt gain* unrelated to caloric intake
Persistent depressive disorder (Dysthymic
disorder) - ANSWER -Dx: (MDD Lite)
<5 SIGECAPS criteria for *>2 yrs* Prodromal Sx's of Schizophrenia -
Still able to function ANSWER -Social Isolation
New interest in religion/philosophy
Tx: *Psychotherapy* > SSRIs Restlessness
Difficulty concentrating
*Failed medication* criteria when using
antidepressants to Tx MDD? - ANSWER - Positive Sx's of Schizophrenia - ANSWER -
Noticeable change of Depressive Sx's in 2-6 Delusions
weeks of Rx initiation Hallucinations
Strange behaviors
Incoherent thought process
Cyclothymic disorder - ANSWER -Dx: Grossly disorganized
(Bipolar II Lite) Catatonic behavior
Hypomania + Dysthymia >2 yrs
Sx free for <2 mo
Still able to function Negative Sx's of Schizophrenia -
ANSWER -Flat affect
Tx: Psychotherapy/CBT/Family Therapy Decreased fluency
Decreased productivity of thought & speech
Social withdrawal
Premenstrual dysphoric disorder - Decrease in goal-directed behavior
ANSWER -PMS on an anger pill - affecting
function
Rx for acute, agitated psychosis in schizophrenic
pts
Major depressive disorder with peripartum onset
- ANSWER -Dx: S/E's seen w/ chronic use - ANSWER -
