Emergency Psychiatry
Depression
Anxiety
Psychosis
Substances
100
A patient comes in to the emergency department extremely agitated and combative. His friends say he took a drug. On physical exam, patient is noted to have nystagus. The substance he ingested is most likely?
What is PCP
100
Patient endorses a history of poor sleep, depressed mood, decreased interest, guilt, hopelessness, and intermittent suicidal ideation. How long do symptoms need to persist to be called Major Depressive Disorder?
What is 2 weeks?
100
Patient has been experiencing frequent thoughts of being unclean and has been performing multiple rituals daily of handwashing and takes showers 6-7 x per day. What diagnosis is likely?
What is Obsessive Compulsive Disorder? Characterized by ego dystonic intrusive thoughts
100
Patient states he believes others can hear his thoughts and are constantly intercepting his messages. What is the name of this phenomenon
What is thought broadcasting
100
A patient presents to the hospital with conjunctival injection, euphoric mood, dry mouth, and increased appetite? What substance is patient intoxicated with?
What is marijuana? Other names include weed, cannabis, ganga, hasish
200
A patient comes to the hospital with fever, rigidity, elevated CK level, and is confused and agitated. Patient has a history of schizophrenia and was recently discharged on haloperidol and risperidone. The appropriate diagnosis is....
What is NMS (neuroleptic malignant syndrome)?
200
A 15 year old patient meets criteria for MDD and you start patient on paroxetine. What black box warning do you need to make patient aware of?
What is suicidal ideation?
200
35 year old patient has been worrying constantly about finances, his marriage, his job to the point of feeling paralyzed and not wanting to participate in activities. He states he always anticipates the worst. What length of time needs to be meet for Generalized anxiety disorder?
What is Generalized Anxiety Disorder?
200
Patient sitting in the TV room becomes quickly upset and yells at the new anchor on the TV saying, why are they always talking about me on this program? stop giving me these instructions.
What is referential thinking/ ideas of reference?
200
Patient presents with goosebumps, lacrimation, rhinorrhea, and diarrhea and states "I am withdrawing." What substance was patient using?
What is opiates
300
Patient presents with dilated pupils, increased sweating, hyperreflexia, and diarrhea. On exam, patient exhibits clonus and has mildly elevated temperature. Patient current has this syndrome?
What is serotonin syndrome. Tx: d/c serotonergic medication, consider cyproheptadine
300
This is the first line medication for most depressive disorders?
What is an SSRI
300
A patient experiences frequent panic attacks and worries constantly about having another one, avoiding situations and places associated with the panic attacks. What diagnosis should be considered
What is Panic Disorder
300
An elderly woman believes that her husband is an imposter and that someone looking like her husband has taken over his body. She continually attacks him. The name of this type of delusion is....
What is Capgras delusion?
300
Patient states he has been feeling the colors of the sky after taking this substance.
What is LSD (lysergic acid) synesthesia
400
Patient is in acute alcohol withdrawal. What are the stages of alcohol withdrawal?
What is 1) increased physiologic arousal, tremor, diaphoresis, risk for seizures 2) alcoholic hallucinosis 3) DTs
400
A male patient complains about sexual side effects from his SSRI. Name another appropriate medication for this patient considering his desire to avoid these side effects
What is buproprion (wellbutrin) or mirtazapine?
400
25 year old female states that she was assaulted by a thief 3 months ago and she has been experiencing nightmares, flashbacks, and hypervigilance, worrying that it may happen again?
What is Post traumatic stress disorder?
400
A boyfriend believes that aliens have been tampering with the signals in the home and over time his girlfriend begins to buy into this belief as well. The French name for this delusion is ....
What is Folie e Deux
400
Name three medications useful in the treatment of opiate withdrawal?
What is clonidine, methadone, and suboxone?
500

45 year old patient presents to the Emergency Department in state of psychotic agitation. He receives haloperidol 10 mg IV from the ER physician and is later noted to have an abnormal concerning rhythm on telemetry. What rhythm was seen?

What is torsades de pointes

500

Name three of the most common side effects of SSRI medications.

What is Nausea/GI upset, headache, sleep disturbance

500
Patient is very fearful around new people, fears being judged and criticized by others, and avoids interactions with others due to this anxiety
What is social anxiety disorder?
500
This receptor is the main target for antipsychotic medications.
What is the D2 receptor? Multiple other receptors are affected including histamine, acetylcholine, serotonin (5-HT 2A?)
500
A patient feels paranoid that people are following him and the Mafia is going to kill him after smoking this substance? Physical symptoms experienced by patient are increased heart rate, dilated pupils, increased blood pressure
What is stimulants (meth, cocaine)
M
e
n
u