Rx 2/19

Front 1

Which class of antidepressants can cause hypertensive crisis when you eat foods containing tyramine like red wine or cheese?

Back 1

MAOis

Front 2

Example of an MAOi?

Back 2

Phenelzine

Front 3

Example and class of a drug used to treat the EPS of antipsychotic medications?

Back 3

Benztropine is an anticholinergic

Front 4

First line pharmacologic therapy for PTSD?

Back 4

SSRIs

Front 5

What are the 4 short acting benzos that often cause dependence?

Back 5

Alprazolam, Triazolam, Oxazepam, and Midazolam

Front 6

Mechanism of action of amitriptyline? Drug class?

Back 6

Inhibit presynaptic neuronal uptake of NE and 5HT. Tricyclic antidepressant.

Front 7

What personality disorder is "splitting" used as a defense mechanism in?

Back 7

Borderline personality disorder

Front 8

MOA of cocaine?

Back 8

Inhibits presynaptic reuptake of NE, 5HT, and dopamine

Front 9

What drug is used to treat performance anxiety and specific phobias but is contraindicated in patients with asthma?

Back 9

Propranolol (beta2 blocker)

Front 10

What is an atypical antipsychotic that causes agranulocytosis and requires frequent monitoring of WBC count?

Back 10

Clozapine

Front 11

Difference between avoidant and schizoid personality?

Back 11

Avoidant patients desire companionship but fear rejection while schizoid patients prefer social withdrawal.

Front 12

What is an idea of reference?

Back 12

Misinterpretation that other people's statements or other neutral objects in environment are directed towards one's self when in fact they are not. Like having false convictions that one is the subject of attention by other people or the media.

Front 13

Which antidepressant class (and example?) is known for strong atropine like anticholinergic effects like urinary retention, tachycardia, dry mouth, constipation, and blurred vision especially in old people?

Back 13

TCAs like amitryptiline

Front 14

Typical antipsychotics treat which kinds of symptoms?

Back 14

Positive symptoms

Front 15

What disorder is marked by 1 month of nonbizarre delusions like that of infidelity with no impairment of the person's daily activities?

Back 15

Delusional disorder

Front 16

Difference between direct acting and indirect acting sympathomimetics?

Back 16

Direct acting ones enter he CNS less readily than indirect acting ones and thus have less undesired side effects.

Front 17

Effective pharmacological treatment of OCD includes what class of drugs? Example?

Back 17

SSRIs like sertraline and fluoxetine

Front 18

What happens in somatic symptom disorder?

Back 18

Patient presents with several physical complaints in multiple organ systems with a long history of several tests but no deliberate desire to produce false symptoms.

Front 19

What drug class is given for treatment of panic disorder?

Back 19

Benzodiazapine

Front 20

What drug do you give for overdose by short acting benzos and what is its mechanism of action?

Back 20

Flumazenil displaces the drug from its binding site as a competitive antagonist

Front 21

What side effect do you need to watch for with flumazenil?

Back 21

Rapid reversal of benzo overdose can result in rebound seizures.

Front 22

What is St. John's wort used for and what kind of contraindications are associated with it?

Back 22

SJW inhibits 5HT reuptake and is an OTC antidepressant type drug that can cause serotonin syndrome through interaction with SSRIs and MAOis and meperidine and cocaine.

Front 23

What happens in serotonin syndrome?

Back 23

Mental status change, fever, diarrhea, diaphoresis, tachycardia, hyperreflexia, tremor, and rigidity.

Front 24

Parkinsonian symptoms are associated with long term use of what kind of drugs?

Back 24

Antipsychotics

Front 25

When is involuntary hospitalization be appropriate?

Back 25

If patient has suicidal ideations and is deemed to be a risk to harm himself

Front 26

What drug causes seizures in bulimic or anorexic patients?

Back 26

Bupropion

Front 27

Orthostatic hypotension is seen with which antidepressant drug class and by which mechanism?

Back 27

TCAs block alpha 1 receptors causing increased vascular tone through Gq second messenger system leading to decreased phospholipase C and calcium release

Front 28

Which drug is first line in bipolar disorder and what birth defect does it cause?

Back 28

Lithium causes Ebstein anomaly in which the tricuspid valve is displaced inferiorly into the right ventricle leading to a split first and second heart sound due to a right bundle branch block with possible tricuspid regurgitation.

Front 29

MOA of the drug to reverse diazepam overdose?

Back 29

Flumazenil is a competitive antagonist of gamma aminobutyric acid (A) receptors

Front 30

What disorder is characterized by unexpected, discrete panic attacks?

Back 30

Panic disorder

Front 31

What is the MOA or class of imiprarmine? Side effects?

Back 31

TCA that causes orthostatic hypotension and anticholinergic effects

Front 32

Patient presents with diaphoresis, palpitations, HTN, and a BAC of 0.08%, so what antidepressant were they taking? What is going on?

Back 32

Phenelzine or another MAOi (this is a hypertensive crisis)

Front 33

First line treatment for unintentional weightloss, worthlessness feelings, troule sleeping, anhedonia, and crying a lot? Common adverse effect of this treatment?

Back 33

Treatment of MDD by SSRIs can cause sexual dysfunction

Front 34

Patient with somnolence, ataxia, lack of orientation to time and self, hepatosplenomegaly, nystagmus, and what kind of vitamin deficiency? What lab anomaly does this deficiency result in?

Back 34

Thiamine deficiency in an alcoholic will cause high serum lactate and low pH.

Front 35

What do you call yrhe onset of visual, auditory, and tactile hallucinations 12-24 hours after the most recent alcoholic drink?

Back 35

Alcoholic hallucinosis

Front 36

What is delirium tremens?

Back 36

Visual or tactile hallucinations with delirium, tachy, HTN, fever, and autonomic instability within 48-96 hours after the most recent drink and lasting up to 5 days?

Front 37

What drug used for bipolar disorder is notable for a narrow therapeutic window?

Back 37

Lithium

Front 38

HTN tachycardia and belligerence with a difficulty to arouse the next day is associated with abuse of which illicit drug?

Back 38

Cocaine

Front 39

Stooped posture and shuffling gait after new medication for schizophrenia and depression- medication is blocking dopamine receptors in which pathway? What are these symptoms called?

Back 39

Nigrostriatal pathway and extrapyramidal symptoms

Front 40

Neuroleptic malignant syndrome is treated with which 2 drugs?

Back 40

Dantrolene or bromocriptine

Front 41

Mechanism of action of amphetamines?

Back 41

Promote release of catecholamines from intracellular vesicles into the cytoplasm and then extravesicular release into the synaptic cleft

Front 42

Serotonin syndrome is reversed by which drug?

Back 42

Cyproheptadine

Front 43

What do patients with avoidant personality disorder do?

Back 43

They are sensitive to rejection and want relationships but are afraid of not being accepted

Front 44

What is flumazenil used for? MOA?

Back 44

Benzo overdose. Competitive inhibition of GABA receptors.

Front 45

Treatment of depression for a patient with arrhythmia, urinary retention (like in BPH), or glaucoma, which antidepressant class should you avoid and why? What class should be used?

Back 45

TCAs should be avoided because they have anticholinergic effects that can exacerbate these conditions. Instead, use SSRIs.

Front 46

Patient who has become more quiet and thinks the TV is talking to him but is otherwise fine has dysfunction in which brain pathways? What is this condition called if it persists for more than 6 months and causes social or occupational dysfunction?

Back 46

Mesolimbic (positive) and mesocortical (negative) increase of dopamine. Schizophrenia.

Front 47

What conditions are associated with autism spectrum disorder?

Back 47

Hamartomas in CNS, Angiofibromas, Mitravel valve regurg, Ash leaf spots, Rhabdomyoma in heart, Tuberous sclerosis, Mental retardation, renal Angiomyolipoma, Seizures, and Shagreen patches

Front 48

Patient with elevated and irritable mood for more than 1 week with marked social impairment and associated grandiosity, irresponsibility, flight of ideas, etc. is diagnostic of what phase of what disorder?

Back 48

Bipolar 1 manic phase

Front 49

Post partum depressive diagnoses are separated by what time period? Basically, when is it post partum blues and when is it postpartum depression?

Back 49

Baby blues is over after 10 days and depression starts at 2 weeks.

Front 50

First line pharm treatment for tourettes?

Back 50

Tetrabenazine (MAOi)

Front 51

Which drug reverses EPS like haloperidol dystonia?

Back 51

Benztropine

Front 52

Hypomanic symptoms with minor depression periods alternating for 2 years?

Back 52

Cyclothymia

Front 53

How to treat alchohol withdrawal when there is a risk for delirium tremens? Specific drugs in liver disease?

Back 53

IV benzos. Oxazepam, lorazepam, or temazepam.

Front 54

Describe the difference between operant conditioning and classical conditioning?

Back 54

Operant- modify behavior through positive and negative reinforcement with reward and punishment. Classical- natural response is elicited by a conditioned stimulus previously presented in cojunction with an unconditioned stimulus in which programming is by association, not reward.

Front 55

What age requirement is needed for diagnosis of antisocial personality disorder? What are comorbid conditions associated with this?

Back 55

Conduct disorder before age 15 years and comorbid substance or alcohol abuse.

Front 56

Difference between delirium and brief psychotic disorder?

Back 56

Brief psychotic disorder cannot be attributed to a medical conditions unlike delirium in which drug intoxication, metabolic disturbances, organ failure, trauma, or infection, etc are the cause.

Front 57

MOA of dantrolene?

Back 57

Uncouples muscle excitation contraction coupling by binding the ryanodine receptor and preventing intracellular calcium buildup

Front 58

How is TCA overdose fatal? Treatment?

Back 58

It causes arrhytmias. Reverse by administration of sodium bicarbonate IV.