Misc Psych
More MISC
PHARM
Brain
Name the Artist
100
A parent brings their school age son in due to behavioral changes - They are not paying attention in school, are increasingly hyperactive, and acting out. They also have recently started wetting the bed and having night terrors. You should:
A) Screen for abuse
B) Screen for depression
C) Screen for sleep apnea
D) None of the above
E) All of the above
What is E, all of the above?
100
First line agents most often used for mania.
What are atypical antipsychotics?
Up to Date recommends lithium + an atypical for severe mania or VPA + an antypical. Lithium is very effective for mania and recommended but less oftne used due to safety profile. For severe, psychotic mania, an atypical + mood stabilizer + benzo are used.
100
The major risk re fetal exposure to lithium:
What is Ebstein's anomaly?
100
What is wrong here?
What is a bullet went through his brain?
100
Who is Annie Leibovitz?
200
Children with ASD have these co-morbidities at a rate of >70%.
A) MDD and GAD
B) ADHD and ODD
C) Schizophrenia and BPAD
D) OCD and GAD
What is B, ADHD and ODD?
200
A patient is experiencing hypr-vigilance and anxiety, occasionally reliving experiences he had in combat in Afghanistan. You recommend this treatment:
A) Paroxetine + CBT
B) Paroxetine + diazepam
C) Paroxetine + quetiapine
D) Hugs + Chicken soup
What is A, paroxetine +CBT?
200
A young woman comes to your office to discuss recurrent shoplifting. She cries, saying she is ashamed that she repeatedly gets the urge to take little things from the store like Chap-stick or gum and that she feels relief when she does it but is later full off regret and shame. You can offer meeication:
A) Fluoxetine
B) Depakote
C) Risperidone
D) Naltrexone
E) A or D
F) A or B
What is E -- fluoxetine or naltrexone?
SSRIs in general have shown efficacy and there is also evidence for naltrexone.
200
Label A,B, and C.
What are Broca's area, Wernicke's area, and the primary auditory cortex?
200
Who is Dorothea Lange?
300
How long symptoms must be present to diagnose cyclothymia in children.
What is 1 year?
A notable portion, varying from 15 to 50% in studies, will develop BPAD 1 or 2.
300
Best med combination for bipolar depression:
A) Lithium + olanzapine
B) Olanzapine + Depakote
C) Quetiapine +lamotrigine
D) Snickers bars and Tylenol
What is C --- ?
300
A 70y/o man has been responding well to sertraline, with increased energy and focus. His wife calls your office to complain that he has been confused and lower in energy. He has no medical complaints at all. You consider this SE of SSRIs that is 3x more common in the elderly.
What is SIADH?
300
What is Marchiafava–Bignami disease?
This is a "progressive neurological disease of alcohol use disorder, characterized by corpus callosum demyelination and necrosis and subsequent atrophy. The disease was first described in 1903 by the Italian pathologists Amico Bignami and Ettore Marchiafava in an Italian Chianti drinker."
The course of the disease may be acute, subacute, or chronic and is marked by dementia, spasticity, dysarthria, and inability to walk. Patients may lapse into coma and die, survive for many years in a demented condition, or occasionally recover. An interhemispheric disconnection syndrome has been reported in survivors
300
Who is Steve McCurry?
400
Ages for early onset and childhood onset schizophrenia.
What are prior to ages 18 and 13?
Poorer prognosis if it is earlier. Generally there is cognitive decline as part of a prodrome.
400
A patient reports improved cognition and energy while taking fluoxetine. This is responsible:
A) Serotonin re-uptake inhibition
B) NE re-uptake inhibition
C) 5HT2C antagonism
D) Vanillaminic receptor inverse agonism.
What is C, 5HT2C antagonism?
Increases DA and NE in the PFC.
400
A 45 yo man comes in for a follow up 3 weeks after starting an antidepressant. He says he feels "wired" and is having a hard time getting good sleep. The initial 1 week of jitters has faded but he feels energized. There is no restlessness/akathisia.
Most likely culprit:
A) Mirtazapine
B) Fluoxetine
C) Paroxetine
D) Amitriptyline
What is fluoxetine?
It and sertraline are potentially activating SSRIs. the other meds are sedating.
Bupropion is also another likely answer.
400
Variations of this disorder are on display here:
What is FTD?
Structural MRI in frontotemporal dementia (FTD) syndromes. Markers enclose areas of focal/lobar atrophy. In behavioral variant FTD (bvFTD), right frontal atrophy is characteristic (A), with relative sparing of posterior structures (B). In semantic variant primary progressive aphasia (svPPA) there is left anterior temporal atrophy (C, D), whereas people with nonfluent agrammatic variant primary progressive aphasia have degeneration in the inferior frontal gyrus and adjacent structures (E, F).
400
Who is Robert Capa?
500
A 65 yo man undergoes bilateral ECT with high energy and large pulse width. He is moved to maintenance ECT after 6 treatments with good effect but complains of larger periods of amnesia. Options to help with this:
A) Switch to right unilateral ECT
B) Decrease the pulse width to UBP
C) Increase the time between treatments
D) All of the above.
E) You don't need to do anything bc it will pass.
F) You don't care because your're a psycho.
What is D, all of the above?
Retrograde amnesia can occur and persist for weeks to months. This is less common, by far, and more persistent.
There is often a window of anterograde amnesia around the time window of the treatment that generally fades quickly if it does persist.
500
A patient drinks 2 pots of coffee a day, smokes 2 packs of cigarettes a day, and takes ibuprofen for pain on occasion. He was manic and started on olanzapine 7.5mg PO qHS, stabilizing well. After the hospital, he returned to his facility and has been adherent to meds but presents with increased energy and activities. His speech is pressured. This is the m/l culprit for the breakthrough symptoms.
What is that he didn't smoke in the hospital but went back to 2 packs a day at his facility, lowering the olanzapine level?
500
After years of anecdotal reports about this class of medications causing depression, a meta-analysis of more than 50,000 individuals from 258 studies concluded in 2021 that depression was no more common than with placebo.
What are beta blockers?
500
Identify the problem with this brain.
What is alcohol related cerebellar atrophy?
500
Who is Henri Cartier-Bresson?