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PSYCHIATRY EOR

EXAM 1 TEST BANK WITH 250 REAL EXAM

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What's the common genetic heritability that is shared with this condition? - ANSWER-Generalized anxiety disorder [GAD]

1st line: SSRIs [sertraline, paroxetine]

2nd line: Benzos [Lorazepam]

Usually starts: early adulthood in women

Genetic heritability with: Major Depressive Disorder

Pt presents with:

• frequent episodes of palpitations
• diaphoresis, feeling of going to "pass out"
• fear of having another episode

What's the # of occurrence and the time frame to diagnose?What's an unusual risk factor for it? besides the obvious ones - ANSWER-Panic Disorder

• panic attacks in 3 weeks
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Risk factor: Neuroticism personality trait

~ This disorder does not have specific genes identified that are associated with it.~ decrease GABA and ACh has been found - ANSWER-Schizophrenia

* Remember its presentation: presence of hallucinations, delusions,

disorganization, and negative symptoms.

• Pathogenesis has multifactorial pathways= genetic + environmental +

physiological.

*Sx must be present for >6 months

Generalized anxiety disorder [GAD] may present with psychological sx, physical sx that at times can mimic a _____.Therefore what should we rule out [3] - ANSWER-GAD physical sx can mimic myocardial infarction.

Also rule out: substance abuse, thyroid fxn, and ETOH withdrawal

Always check: ECG, Troponin --> rule out an MI.

What's the tx for someone who has sudden unexpected periods of intense fear or discomfort? [3] - ANSWER-Panic Disorder

* SSRIs: Paroxetine, Sertraline, Fluoxetine

* Benzos: for acute attacks

• Relaxation, desensitization, examining behavior consequences) 2 / 4

1st line tx for social anxiety disorder

what are the other options...[2] - ANSWER-* 1st line: Cognitive Behavioral

Therapy

** IF it's affecting day to day living: SSRI/SNRI + CBT

if pt is experiencing physical sx: tremors, sweating, palpitation THEN you rx

PROPRANOLOL

#1 A/E: erectile dysfunction! - ANSWER-Selective Serotonin Reuptake Inhibitors

(SSRI)

What's unique about Clozapine? - ANSWER-FIVE BLACK BOX WARNING!

Cardiomyopathy/Myocarditis Orthostatic hypotension Mortality [increase] in elderly w/dementia- psychosis Agranulocytosis - monitor CBC It shows @ beginning of tx) Seizures

"COMAS"

*fyi- ALL pts who are Rx. Clozapine MUST be enrolled in: "Risk Evaluation and Mitigation Strategy program". Clozapine is titrated at a slower rate to mitigate the risk of s/e, including neutropenia.

Pt presents with these sx for more than 6 months: 3 / 4

• poor school performance
• sleep disturbances
• difficulty concentrating, and irritability

What's the 1st line and 2nd line?When does this condition typically begins?

first line for long term treatment of panic disorder? [4] - ANSWER-SSRI:

paroxetine, fluoxetine, sertraline, and venlafaxine

neurotransmitter for depression [4] - ANSWER-* Decreased Serotonin, NE, & dopamine

• INCREASE cortisol

neurotransmitter for Anxiety [3] - ANSWER-1. Decreased GABA, NE & serotonin

neurotransmitter for Bipolar [2] - ANSWER-(+) symptoms = Low dopamine Manic = NE

neurotransmitter for Panic disorder [3] - ANSWER-Decreased GABA & serotonin

INCREASE NE

neurotransmitter for PTSD [1]

what are the two dissociative sx of PTSD? - ANSWER-NT: Decreased serotonin

Dissociative sx:

~ Depersonalization: Feeling detached from one's mental processes or body, so that one feels like an outside observer of one's own experience.

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