PSYCHIATRY GENERALITIES

64. Incorrect:
A. Psychiatrist must always maintain professional relationship
B. Giving in at times to pts demand is therapeutic
C. Pyshchiatrist refrain doing PE on opposite sex
D. Psychiatrist always aims to identify psychopathology

65. Which of the following is TRUE?

A. Open-ended questions are more precise and more genuine than close ended
B. Open-ended questions are more genuine and less reliable than close ended - TP
C. Open-ended questions are more genuine and more reliable than close ended
D. Open-ended questions are less genuine and more reliable than close ended

78. Incorrect in dealing with suspicious patients

A. Should explain in detail to the patient every decision and planned procedure
B. Should try to respond non-defensively to patient's suspiciousness
C. Should maintain a respectful but somewhat informal approach to the patient
D. May not show expression of warmth

79. JPC acknowledges that her depression is due to her low self-esteem and she also admits that her mother died of suicide. Her sis nurse ensures
that she is taking the prescribed meds everyday. 1 week prior to recent follow-up her sis gave her 7 pills so she could take it. Her sis revealed that
MJ missed 4 pills. She has:
a.Emotional insight
b.Intellectual insight
c.Awareness of being sick and blaming it to others
d.Awareness of being sick and blaming it to external factors

80. PS 35 yrs old male came in with his family. the parents provided you with a very reliable history. During mse, he refused to answer your
questions. what will you do?
a. ask one family member to answer for him
b. warn him that he will not be allowed to go home unless he answers your questions
c. write your observations of the pt
d. write hallucinations and delusions the parents told you.

RATIONALE:
Kaplan 10th ed page 227
the chief complaint, in the patients own words, states why he/she has come or been brought in for help. it SHOULD BE RECORDED EVEN IF THE
PATIENT IS UNABLE TO SPEAK, and the patients explanation, regardless of how irrelevant or bizarre it is, should be recorded verbatim. If the patient
is COMATOSE OR MUTE, THAT SHOULD BE NOTED IN THE CHIEF COMPLAINT AS SUCH

84. d/o of thought content:

a delusions hallucinations illusions
b. delusions tangentiality word salad
c. delusions cosmic identity circumferentiality
d. delusions cosmic identity ideas of reference

KAPLAN: Disturbances in content of thought include delusions, preoccupations (which may involve the patient's illness), obsessions, compulsions,
phobias, plans, intentions, recurrent ideas about suicide or homicide, hypochondriacal symptoms, and specific antisocial urges.

- Hallucination is a disorder in PERCEPTION

- Tangentiality, word salad, circumferentiality are disorders in THOUGHT PROCESSING

For two numbers

A. Transference
B. Countertransference
C. Transference and countertransference
D. Decompensation

75. Most common in patients in psychiatry than any other specialty

76. A deterioration of psychic functioning caused by a breakdown of defense mechanism - DECOMPENSATION

1. True except
a. Perseveration: repetition of words, phrases
b. Loose of association: flow of thought in completely unrelated
c. Flight of ideas: shifting of ideas that tend to be connected
d. Circumstantiality: speaker does get to a point to a desired goal*

2. In examination of a potentially violent psychiatric patient the doctor should:

a. Ask patient immediately to surrender his/her weapon to the doctor to ensure both their safety
b. Ask the patient to surrender whatever weapon he/she has to the guard*
c. The doctor may prolong examination for several days and he may gave the treatment based on history given by the family
d. Order physical restrain even if the patient is calm and cooperative

3. In PE or a laboratory test in a psych px which is incorrect:

a. One can differ complete PE or lab of combative or an acutely agitated delusional px
b. After PE an anxious px may be relieved to learn that inspite of troublesome symptoms there is no evidence of serious illness he fears
c. Sending a patient who has deeply rooted fear of a malignancy for another or repeated test is intended to reassure the px and is
rewarding*
d. A PE can stir up sexual feelings

4. The resident physician dictated a 6-digit numbers and ask px to repeat them forward and backward. Test of?
 a. Immediate memory
b. Immediate retention*
c. Recent past memory
d. Recent memory

5. MBA acknowledges that her depression is due to her low self-esteem and her negative thinking. Her sis nurse ensures that she is taking
the prescribed meds everyday. 1 week prior to recent follow-up her sis gave her 7 pills so she could take it. Her sis revealed that MBA
missed 3 pills. She has:
a. Emotional insight
b. Intellectual insight*
c. Awareness of being sick and blaming it to others
d. Awareness of being sick and blaming it to external factors

6. TRUE
a. Open-ended question are more precise and more genuine than close-ended
b. Open-ended question are more genuine and more reliable than close-ended
c. Open-ended question are more genuine and less reliable than close-ended*
d. Open-ended question are less genuine and more reliable than close-ended

1. Incorrect of examining a psychiatric patient

a. the physician should avoid writing during the interview to listen attentively
b.
c. asking the patient if he/she plans to commit suicide increases the risk
d.

2. true of PE/labs of psychiatric patients except:

a.
b. anxious patients are relieved when their results come out and they find out nothing is wrong with them
c.
d. PE arouses sexual thoughts

20. A physician attempts to get in detail about what was said by the patient .
Ans: clarification

21. After 45 mins, patient asked to recall resident physician's name.

a. immediate memory
b. immediate retention
c. immediate recall
d. recent memory

13. Incorrect of dopamine

A. Precursor is tryptophan
B. rate limiting is tyrosine hydroxylase
C. Primary metabolite is homovalinic acid
D. Stimulants increase dopamine thus causing psychotic symptoms

18. When there is a change of behavior (cooperative to uncooperative) seen in a patient, which is the best approach for the psychiatrist?
A. Let the patient go through with his change in behavior
B. Explore the change in behavior
C. Explain to the patient the concept of transference and counter transference
D. Both A and C

19. False sensoy perception occurring while the person is falling asleep. Which is Correct?
A. Hypnopompic hallucination, pathological
b. Hypnopompic hallucination, non-pathological
c. Hypnagogic hallucination, pathological
d. Hypnagogic hallucination, non-pathological

1. In the physical exam or laboratory test of a psychiatric patient, which is INCORRECT?

C. SETTING A PATIENT WHO HAS DEEPLY ROOTED FEAR OF MALIGNANCY FOR STILL ANOTHER TEST THAT IS INTENDED TO BE REASSURING IS
USUALLY REWARDING

2. False sensory perception occurring when a person is falling asleep. Which is correct?
D. HYPNAGOGIC HALLUCINATION NON-PATHOLOGIC

4. JPC acknowledges that her depression is due to her low self-esteem. She also admits that her mother died of suicide. Her sister who is a nurse
makes sure that she is taking medications prescribed by her psychiatrist everyday. One week prior to recent follow up, her sister gave her 7 pills so
she could take it. Her sister revealed that MJ missed 4 pills. She has:
D. INTELLECTUAL INSIGHT

5. In dealing with suspicious patients, physicians should do the ff EXCEPT:

B. HE OR SHE SHOULD MAINTAIN A RESPECTFUL BUT SOMEWHAT
INFORMAL APPROACH TO THE PATIENT

6. Exaggerated concern about health with no real medical PATHOLOGIC basis but based on unrealistic interpretation of physical science sensation
as abnormal
C. HYPOCHONDRIAC

7. Exaggerated feeling of well-being that is due to opiates

EUPHORIA

8. A private written language

CRYPTOGRAPHIA
9. Unconscious revealing of gaps and memories by imagining experiences that have no basis in facts
A. CONFABULATION

10. Morbid fear of leaving the family setting of the home

D. AGORAPHOBIA

11. What is demonstrated by this patient? Refer to dialogue:

Dr.: Have you had trouble studying lately?
Px: I usually study in the mezzanine but now I am studying in the dormitory
TANGENTIALITY

12. What computed, function is being tested when the doctor asks a patient who is a high school graduate: starting at 100, count backward by 7:
CONCENTRATION

13. Asking a patient what he should do when he sees smoke in a crowded movie theater is a test of?
JUDGMENT

14. Adjectives like anxious, depressed, irritable, euphoria, perplexed are used to describe:
A. MOOD

15. When a physician asks for the meaning of a simple proverb, he is testing for:
ABSTRACT REASONING

17. Dopamine is one of the most studied neurotransmitters. Which of the following is INCORRECT:
A. IT'S PRECURSOR IS TRYPTOPHAN

1. Thinks Michael Jordan retiring would be the end of the world = nihilistic delusion

1. Female patient with schizo admits that she has the disease and she inherited it from her mother. She has a negative view of herself and
of the future and she cannot change her views about it.
a. Awareness and blaming on others
b. Awareness and blaming on external factors
c. Intellectual insight (answer i think)
d. Emotional insight

2. Not true: asking suicidal thoughts will increase suicide risk

1. Do you know if you are ill?? Insight

2. Not true: if psychiatrist knows patient is lying, asking him to come back another time...

3. Hallucination occurring while falling asleep not pathological = hypnagogic hallucination

1. Doctor attempts to get detail about what’s said – clarification

1. Suspicious except – maintain respect but informal approach

2. When person awakens – hypnopompic

3. 45 mins, recall name –recent memory

4. Repression d/t low esteem , suicide mom – emotional insight

5. Patient says he has Trouble with sleep n doc says well dat happens from tym to tym – minimization

1. 35 y.o with fam, reliable history, MSE refuse to answer , what do u do – write it down

2. Which is true bout open ended – more genuine and less reliable

1. Delusion of thought content – delusion , idea of reference, cosmic identity

2. Delusion grandeur – substance induced , substance abuse, schizophrenia

3. Reported by except – psychomotor retardation and agitation

1. Nonverbal sign of movement , facies – affect

2. Incoherent mix of word – word salad

3. Panic attack escape difficult – agoraphobia

4. Psychosocial maladaptive behavioural social without positive feedback – behavioural

DEFENSE MECHANISMS
66) Anna was molested, bestfriend asks her to narrate the incident, in the middle of the conversation she said she forgot what happened, then
changed topic:
A) Suppression
B) Repression
C) Suppression and Rationalization
D) Repression and Rationalization
REPRESSION: Expelling or withholding from consciousness an idea or feeling.
a. Primary repression refers to the curbing of ideas and feelings before they have attained consciousness:
b. secondary repression excludes from awareness what was once experienced at a conscious level.

The repressed is not really forgotten in that symbolic behavior may be present. This defense differs from suppression by effecting conscious
inhibition of impulses to the point of losing and not just postponing cherished goals. Conscious perception of instincts and feelings is blocked in
repression.

SUPPRESSION: Consciously or semiconsciously postponing attention to a conscious impulse or conflict. Issues may be deliberately cut off, but they
are not avoided. Discomfort is acknowledged but minimized.

RATIONALIZATION: Offering rational explanations in an attempt to justify attitudes, beliefs, or behavior that may otherwise be unacceptable. Such
underlying motives are usually instinctually determined.

68. A.B, 20 years old, only child. Always asks for new gadgets. She had tantrums last week when parents did not buy her an IPad mini. She avoided
talking to her parents since that day. What are her defense mechanism?
A. Acting out
B. Displacement
C. Acting out and passive- aggressive
D. Displacement and passive aggressive

*Answer: C
(source: Dr. IgotDefense Mechanism notes, Kaplan)
Rationale: Temper tantrum is an example of acting out
Passive-aggressive wherein individual deals with emotional conflict or internal or external stressors by indirectly and unassertively expressing
aggression toward others.

3. Jm , a medical student... Phone on silent during class hours, only text his call center agent girlfriend during breaks
A. Sublimation
B. sexualization
C. Repression
D. Suppression

16. JRO sleeps on masturbating and reading porno magazines. One month ago he stopped doing those things because they were contrary to his
beliefs. When asked by a friend how he was able to stop, his answer was: I forgot the pleasure, I focused on my beliefs instead. What is his defense
mechanism?
ASCETICISM

4. Correct of defense mechanism except:

a.
b. narcissistic: displacement, denial, projection
c.
d.

7. True EXCEPT
a. Introjection and repression are defense mech used by depressed individuals
b. Introjection, repression, and confabulation are defense mech used by depressed ind*
c. Sublimation and humor are mature defenses
d. Acting out and passive-aggressive are immature def

8. JR eldest of three is not as good as his bro in math. He aware of this and is proud of his bros. he compensates in sports and has won in
competitions. He is sensitive to his bros needs. At times he fulfills their needs first rather than his. Defense mechs?
a. Sublimation
b. Compensation, sublimation, and altruism
c. Compensation and altruism
d. Sublimation and altruism*

MOOD DISORDERS
for the next number:
a. dopamine
b. serotonin
c. norepinephrine
d. b & c

72. decrease in depression – SEROTONIN and NOREPI

- Of the biogenic amines, norepinephrine and serotonin are the two neurotransmitters most implicated in the pathophysiology of mood disorders
(also in Doc Ygot’s notes, both are decreased in depression)

85. JR, 15 years old male, with irritabilty, insomnia, decreased appetite for 4 weeks. In svhool, she has lost interest hanging put with friendsw, late
in class, has slow movement, decreased concentration for 3 weeks now. On MSE, JR revealed that he feels guilty not being able to say goodbye to
his grand mom who died 6 weeks ago. What is the diagnosis?
A. MDD
B. Grief
C. MDD, Grief
D. Anxiety Disorder

Table 15.1-5 KAPLAN

Five(or more) during the same 2 week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed
mood (2) loss of interest or pleasure
1. Depressed mood most of the day
2. Markedly diminished interest or pleasure in all, or almost all activities most of the day
3. Significant weight loss not dieting or weight gain
4. Insomnia or hypersomnia
 5. Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Feelings of worthlessness or excessive inappropriate guilt
8. Diminished ability to think or concentrate or indecisiveness
9. Recurrent thoughts of death

I answered GRIEF for this... The grandma just died 6 weeks ago... Im not sure wit the answer but here’s KAPLANs description of GRIEF:

Bereavement
Because bereavement often evokes depressive symptoms, it may be necessary to demarcate normal grief reactions from major depressive disorder
(Table 2.6-2). According to DSM-IV-TR, if the symptoms of a major depressive episode begin within 2 months of the loss of a loved one and do not
persist beyond those 2 months, they are generally considered to result from bereavement, unless they are associated with marked functional
impairment or include morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

Table 2.6-2 Differentiating the Depressive Symptoms Associated with Bereavement from Major Depression
Bereavement Major Depressive Disorder
Symptoms may meet syndromal criteria for major depressive episode, but survivor rarely has Any symptoms as defined by DSM-IV-TR
morbid feelings of guilt and worthlessness, suicidal ideation, or psychomotor retardation.
Considers self bereaved May consider self weak, defective, bad
Dysphoria often triggered by thoughts or reminders of the deceased. Dysphoria often autonomous and independent of
thoughts or reminders of the deceased
Onset is within the first 2 mos of bereavement. Onset at any time
Duration of depressive symptoms is less than 2 mos. Depression often becomes chronic, intermittent,
or episodic.
Functional impairment is transient and mild Clinically significant distress or impairment
No family or personal history of major depression. Family and/or personal history of major
depression.

86. in pts with mdd which is incorrrect

a. t3 t4 tsh should be performed to r/o illness
b. nonsupression of dexamethasone means that pt has mdd
c. supression of dexamethasone means that the patient is positive for mdd
d. pharmacotherapy combined with psychotherapy has better outcome than pharmacothapy alone

KAPLAN: The dexamethasone suppression test (DST) is used to help confirm a diagnostic impression of major depressive disorder. The patient is
given 1 mg of dexamethasone (a long-acting synthetic glucocorticoid) by mouth at 11 PM, and the plasma cortisol level is measured at 8 AM, 4 PM,
and 11 PM. Plasma cortisol concentrations above 5 mg/dL (known as nonsuppression) are considered abnormal (i.e., a positive result). Suppression
of cortisol indicates that the hypothalamic-adrenal-pituitary axis is functioning properly. Since the 1930s, dysfunction of this axis has been known to
be associated with stress. The problems associated with the DST include varying reports of sensitivity and specificity. False-positive and false-
negative results are common and many medical conditions and pharmacological agents can interfere with results. Some evidence indicates that
patients with a positive DST result (especially, 10 mg/dL) will have a good response to somatic treatment, such as electroconvulsive therapy (ECT) or
cyclic antidepressant therapy

87. in pts with mood d/o there is marked impairement in the ff except
a. mdd
b. mania
c. hypomania
d. cyclothymia

88. for people with mdd, which is incorrect?

a. it is unrecognized more often in older people bec. they present with more somatic complaints
b. some clinician regard depression as normal part of aging process
c. 2/3 of depressed pts attempted suicide
d. anxiety is also a common symptom of depression

I answered A... they all sound correct but it is UNDERrecognized in oldies not really Undiagnosed... you decide..
KAPLAN: About two thirds of all depressed patients contemplate suicide, and 10 to 15 percent commit suicide. Anxiety, a common symptom of
depression, affects as many as 90 percent of all depressed patie. Depression is more common in older persons than it is in the general population.
Various studies have reported prevalence rates ranging from 25 to almost 50 percent, although the percentage of these cases that are caused by
major depressive disorder is uncertain. Several studies indicate that depression in older persons may be correlated with low socioeconomic status,
the loss of a spouse, a concurrent physical illness, and social isolation. Other studies have indicated that depression in older persons is
underdiagnosed and undertreated, perhaps particularly by general practitioners. The underrecognition of depression in older persons may occur
because the disorder appears more often with somatic complaints in older, than in younger, age groups. Further, ageism may influence and cause
clinicians to accept depressive symptoms as normal in older patients

16. What laboratory tests will you get when you give antipsychotic drugs to a 50-year old female with major depression with psychotic features?
A. CBC, prolactin levels
B. CBC, liver function tests
C. CBC, liver function tests, prolactin levels, thyroid levels
D. Thyroid levels, prolactin levels

17. the following is true regarding the therapy of mood disorders except:
a. depression may be seen in hypothyroidism
b. lithium causes hypothyroidism
c. DST is confirmatory for MDD
d.

32. JP, a 30-year old male, has negative self-perception. He also views the world as hostile and demanding, and thinks that he will fail in the future.
...
A. Cognitive Triad of Depression
B. Learned Helplessness
C. Melanie Klein's theory
D. Karl Abraham's theory
27. JM 18 year old male has Bipolar 1, he is maintained with lithium what is the blood level that is expected of this case?
C. 0.6-1.2 MEQ/L

28. For mothers diagnosed with MDD post partum onset

b. within 2 months (argued to be 4 weeks)

29. In patients with MDD which statement is INCORRECT?

C. SUPPRESSION OF DEXAMETHASONE MEANS THAT PATIENT IS POSITIVE FOR MDD

30. In mood disorders there should me marked impairment in the following EXCEPT:
C. HYPOMANIA

1. BCD views herself as worthless, sees her world as demanding and believes she will fail and suffer in the future. What did she manifest?
a. Cognitive triad of depression*
b. Learned helplessness
c. Melanie Klein’s theory
d. Karl Abraham theory

2. Which is incorrect?
a. Dexamethasone suppression test is used as a confirmatory test
b. T3, T4, TSH should be performed to rule out medical illness
c. Suppression of dexamethasone means positive for MDD*
d. Combined pharmacotherapy and psychotherapy has better outcome than pharmatpy alone

3. In mood dso there should be a marked impairment in the ff EXCEPT.

a. MDD b. mania c. hypomania* d. cyclothymia

4. In treating mood dso wc is INCORRECT

a. Adequate px education re antidepressant use is very imp
b. Achieving remission is one of the major goals
o
c. Px safety is the 1 goal
d. Antidepressant may have addictive or dependence potential if taken for long time*

5. CORRECT re course and prognosis of mod dso.

a. If a patient experiences more mood episodes, time interval bet episodes decreases and severity inc

6. DSM IV Criteria B of mania states that at least of sx should be present, if mood is irritable
a. 3/7 b. 4/7* c. 3/9 d. 4/9

7. Adolescent px with dysthymia, he/she should have depressed mood for at least .
a. 24 mo? b. 18 mo c. 12 mo* d. 6 mo

1. Subjective symptoms of depression:

a. Depressed mood, fatigue, diminished interest/pleasure, impaired concentration (psychomotor agitation/retardation is
objectively seen i guess)

2. Best given a mood stabilizer: cyclothymia, bipolar I and II

3. Best treatment for cyclothymia:

a. Antidepressant
b. Mood stabilizer (answer)
c. Antipsychotic first gen
d. Antipsychotic 2nd gen

3. Not true:
a. Untreated depressive episode lasts for 3 months (answer)
b. Untreated manic episode lasts for 3 months
c. First symptom of bipolar I is usually depression
d. MDD has better prognosis than bipolar

4. Dysthymia in adults = 24 months/96 weeks

5. True except:
a. DST is confirmatory for depression (answer)
b. You can discontinue antidepressant if without symptoms for 3 months or 12 weeks
c. Nonmood disorder dictates choice of treatment in comorbid states
d. Combination pharmacotherapy and psychotherapy is better than each alone

1. Khreplin- manic depressive psychosis

5. Mom dead 6 weeks ago, depressed for 4 weeks now – MDD

6. Cyclothymia – mood stabilizer

7. Dysthymia adolescent , depressed modd – atleast 12 mos

8. Mood disorder impaired except – hypomania

9. View world as hostile, fail, suffer - cognitive triad of depression

10. 2 bio amine in pathology of mood – NE and 5HT

11. Bipolar 2 – never manifest hallucination

 12. Bipolar 2 suicide – hospitalize

13. Easiest to recover– acute mania/ hypomania

PERSONALITY DISORDER
67. Patient displays excessive suspiciousness and distress to others
A. Dissocial personality disorder
B. anancastic
C. Paranoid
D. Negativistic

69. pts w/ borderline personality d/o exhibit the ff. EXCEPT:

a. they always appear to be in a state of crisis
b. they do not exhibit micropsychotic episodes
c. they have a frantic search for companionship
d. they have a low incidence of major depressive d/o

* an increase prevalence of mdd, alcohol use disorder and substance use is found in 1st degree relatives of persons with borderline personality
disorder
- patients with borderline personality disorder almost appear to be in crisis
- patient can have short-lived psychotic episodes (so-called micropsychotic episodes) rather than full blown psychotic break and the psychotic
symptoms of these patients are almost always circumscribed fleeting or doubtful
- persons with borderline personality disorder cannot tolerate being alone and they prefer a frantic search for companionship, no matter how
unsatisfactory, to their own company
Kaplan, page 799-800

70. All are incorrect in patient with personality disorder except?

A. ALL patients with OCD personality disorder have comorbid obessesive compulsive disorder
B. Remorse is common in patients with antisocial personality disorder
C. Onset may be current
D. They seldom deny their problems deny their problems and seek professional help

A - Approximately ½ of all psychiatric patients have personality disorder, which is frequently comorbid with Axis 1
- In OCD’s (otherwise called as Anancastic personality disorder), when recurrent obscessions or compulsions are present, obsessive-compulsive
disorder should be noted
B- In antisocial personality disorder, a notable finding is a LACK OF REMORSE for their actions; that is, they appear to LACK A CONSCIENCE
C – Personality disorders is a common and chronic disorders
- The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early childhood.
D- Persons with personality disorders are far MORE LIKELY TO REFUSE PSYCHIATRIC HELP and to DENY THEIR PROBLEMS than persons with anxiety
disorders, depressive disorders or obsessive-compulsive disorders

77. These are types of patients who act as though they are superior to everyone at times, including the doctor.
a.histrionic
b. narcissistic
c. obsessive
d. manipulative

5. Incorrect among personality d/o

a. odd and aloof: schizoid, paranoid
b.
c.
d. odd and aloof: dissociative, shizotypal

8. EBF diagnosed with Bipolar 1 dso. She had recurrent suicidal behavior, sexually impulsive, always on spending sprees, unstable sel-image,
chronic feelings of emptiness, always cant control anger, had unstable relationships with 4 bf. She may have
- Borderline personality dso

9. TRUE of personality dso

a. Personality dso are ego dystonic
b. Px with antisocial personalitydso always regret the bad things they did to others*
c. Patients with antisocial personality dso first develop conduct dso
d. Schizoid, schizotypal belong to cluster B

1. Not a characteristic of dependent personality disorder:

a. Need inordinate amount of attention and never seem reassured
b. Make repeated urgent calls between scheduled appointments
c. Psychiatrist firm when establishing limits
d. Does not make much demands (answer)

1. Patient acting superior- narcissist

SUBSTANCE ABUSE
71. what a the effects of alcohol?
a. decrease in REM
b. Decrease in stage 4
c. Decrease in REM, decrease in stage 4
d. decrease in REM, increase in stage 4

8. What is elevated in alcohol abuse?

A. Elevated gamma glutamyl transpeptidase
B. Elevated MCV
C. Elevated gamma glutamyl transpeptidase and MCV
D. Elevated gamma glutamyl transpeptidase and decreased MCV

9. true of alcohol withdrawal except:

a. most common sign is jitters/shakes
b. delirium tremens develops within 1 week of treatment
c. status epilepticus may occur in 30% of patients
d. carbamazepine may be used as treatment

11. alcohol metabolism

a. alcohol dehydrogenase
b. aldehyde dehydrogenase
c. both
d. neither

12. Catalyzes conversion of acetaldehyde to acetic acid

a. Alcohol dehydrogenase
b. Aldehyde dehydrogenase
c. Both
d. Neither

28. Ana reported increased intake of alcohol from 2 to 5 bottles per day. After 2 years, she tried to quit but failed and experienced withdrawal
symptoms. She complained her mother has no time for her. What is the diagnosis?
A. Substance dependence with physiologic dependence
B. substance dependence without physiologic dependence
C. Substance dependence, tolerance stage
D. Substance dependence, withdrawal stage

1. Alex has inc her beer intake 5 bot/day (prev 2 bot/day).for 2 yrs she tried to quit 3 times but failed and exhibited withdrawal sx as well.
Lab test showed elevated liver enz. Daughter complains that mom has no time for her. Ddx?
a. Substance dependence with physiological dependemce*

10. Alcohol has the ff effects EXCEPT: Inc REM, dec deep sleep, sleep fragmentation*

1. Legal intoxication for alcohol = 0.1-0.15%

2. Adolescent using shabu used with increasing doses, had withdrawal symptoms, drop out of college = substance dependence

SCHIZOPHRENIA
81. Schizophrenic patients with good prognosis:
A. young onset, with precipitating factors, positive symptoms
B. young onset, without precipitating factors, positive symptoms
C. late onset, with precipitating factors, positive symptoms <-- answer
D. late onset, with precipitating factors, negative symptoms

*Rationale: page 476 table 13-6 "Features weighting toward good to poor prognosis in schizophrenia"

82. True of Schizophrenia:

A. Increase serotonin, increase dopamine, increase GABA
B. Increase serotonin, increase dopamine, decrease GABA
C. Increase serotonin, decrease dopamine
D. Increase serotonin, increase dopamine

83. Criteria A of Schizophrenia: 2 or more of the characteristic symptoms should be present for how long?
A. 4 weeks
B. 5 weeks
C. 3 months
D. 6 months

for the next number:

a. dopamine
b. serotonin
c. norepinephrine
d. b & c

73. increase in psychosis – DOPAMINE

- KAPLAN: The simplest formulation of the dopamine hypothesis of schizophrenia posits that schizophrenia results from too much dopaminergic
activity

23. False of Schizophrenic pt.

A. Most are dependent to nicotine
B. 50% have undiagnosed problems.
C. occupy 50% of general hospital beds
D. Fertility rate close to general population

24. Type of schizo marked by regression to primitive, uninhibited and disorganized behavior:
A. Paranoid
B. Catatonic
C. Hebephrenic (Disorganized)
D. Latent
18. Among schizophrenic patients, which of the ff statements is FALSE:
B. THEY OCCUPY 50% OF BEDS IN THE GENERAL HOSPITAL

19. Type of schizophrenia characterized by marked regression to primitive, disinhibited and unorganized behavior:

C. HEBEPHRENIC TYPE

20. Schizophrenic patients with good prognosis:

C. LATE ONSET WITH PRECIPITATING FACTORS WITH POSITIVE SYMPTOMS

21. The ff findings are TRUE in schizophrenic patients:

B. INCREASE SEROTONIN, INCREASE DOPAMINE, DECREASE GABA

22. MR has schizophrenia. He has visual hallucination, persecutory delusions and avolition. He said he is depressed because his illness has no cure.
What will be the BEST to give?
D. SEROTONIN-DOPAMINE ANTAGONIST PLUS ANTI-DEPRESSANT

23. MR has improved with pharmacotherapy. Once he is in the stabilization phase, what will you do to him?
PSYCHOTHERAPY, PHARMACOTHERAPY AND ART THERAPY

25. BC is schizophrenic. He suffers from visual hallucinations, persecutory delusions, and avolition. He admits to to being depressed and plans to
commit suicide. What is the BEST treatment?
A. Dopamine antagonist
B. Serotonin Dopamine antagonist
C. Dopamine antagonist + Antidepressant
D. Serotonin Dopamine antagonist + Antidepressant (Answer)*

26. patient is done with pharmacotherapy; once he is in the stabilization phase, what will you do to him?
a. psychotherapy, pharmacotherapy
b. psychotherapy, art therapy
c. psychotherapy, art therapy, pharmacotherapy
d. pharmacotherapy, art therapy

2. False of Schizophrenic px?

a. Most are dependent to nicotine
b. 50% have underdiagnosed medical prob*
c. Occupy 50% of general hospital beds ?
d. Fertility rate is close to that of gen pop

3. Schizo px with poor prognosis

a. Young onset, w/ ppt sx, (+) sx
b. Young onset, w/o ppt sx, (-) sx*
c. Late onset, w/ ppt sx, (+) sx
d. Late onset, w/ ppt sx, (-) sx

4. Type of schizo marked by regression to primitive, uninhibited and disorganized behavior

a. Residual b. latent c. Catatonic d. hebephrenic type*

5. TM has schizophrenia, he has visual hallucinations, persecutory delusion and avolition. He said he is depressed and plans to commit
suicide because his illness has no cure. What will you give?
a. Dopamine antagonist
b. Serotonin dopamine antagonist
c. Dopamine antagonist +antidepressant
d. Serotonin dopamine antagonist + antidepressant*

6. Criteria A of schizophrenia: of the characteristic sx should be present for weeks

a. 1 or more, 4 weeks
b. 2 or more, 4 weeks*
c. 1 or more, 6 months
d. 2 or more, 6 months

7. TRUE clinical finding in schizo px

a. Inc Serotonin, inc dopamine
b. Inc serotonin, dec dopamine
c. Inc serotonin, inc dopamine, inc GABA
d. Inc serotonin, inc dopamine, dec GABA*

8. BM 29 yo has delusion that his wife has implanted a microchip in his leg for 12 months now. His wife did it becase someone from outer
space have instructed her. He admitted intake of marijuana but refuses to reveal info re his use. Working Ddx?
a. Delusional Dso
b. Schizophrenia
c. Delusional dso substance induced psychotic dso
d. Schizophrenia substance induced psychotic dso*

3. Not true of schizophrenia:

a. common from dysfunctional families (answer)
b. Double bind
c. Schisms between parents and children
d. Social theories about industrialization and urbanization

4. Type of schizo where preoccupation with one or more delusions or frequent auditory hallucinations = paranoid

5. Best prognosis for shizo: family history of depression, late onset, delusions and hallucinations (positive symptoms)
4. T of female schizo patient except – Females less functional compared to males
 5. Schizo false – 50% of bed in hospital

6. Marked regulated to primitive unorganized behaviour – hebephrenic

7. Schizo dats good prognosis– late onset precipitating factor , positive signs and symptoms

8. True of schizo – increased dopa , 5HT and dec GABA

9. s/s of criteria A did she manifest – 6

14. Schizo – dopa

DSM IV TR
2. MJ 19 y.o female, fulfilled the criteria for MDD 1 prior to consult. 1 week prior to consult she called her sister to express her anger after a certain
voice commanded her. She had also believed that her sister has a plot of poisoning her. She was subsequently treated by a psychiatrist. On 2nd
follow-up, her sister revealed that all MJ's symptoms were no longer present except that she keeps on being absent from school most of the time.
Her GAF SCORE at present should be:
A. 40

FOR THE NEXT 3 NOS: ERM 65 y.o female, manifested the ff. for 4 weeks: depressed mood, insomnia, weight loss, loss of interest in watching tv and
going out with friends, looks sick, indecisiveness and wishing being dead.. Diagnosis is MDD 1st episode

24. How many symptoms in criteria A of DSM-IV-TR did she manifest?

A. 6

25. After 6 weeks, she had delusions of infidelity. She also complained of headache. BP was elevated several times. She consulted a physician and
was managed as a case of Hypertension Stage 2. What would be given to ERM?
D. SSRI AND ANTIPSYCHOTIC

26. How long will ERM take the anti-depressant?

C. MINIMUM OF 6 MONTHS

22. GAF score: patient no longer manifests delusions but always absent in class
a. 40
b. 30
c. 20
d. 10

29. BDE 65/F Manifested the following for 4 weeks: depressed mood, insomnia, weight loss, loss of interest to watch TV and go out with friends,
guilty of being sick, indecissiveness, and wishes to die, diagnosed with MDD 1st episode. How many sx for Criteria A DSM MDD?
A. 8
B. 7
C. 6
D. 5

31. duration of treatment for patient ERM/BDE (from #29)

a. minimum of 2 years
b. minimum of 1 year
c. minimum of 6 months
d. minimum of 3 months

9. AM came in for his first follow-up check-up after his admission to a psych facility for two weeks. He was absent from class 5 times and his
hearing voices has decreased in frequency. GAF score?
b. 40 b. 30* c. 20 d. 10
st
18-20. BCD 65 yo F, diagnosed with MDD 1 ep. She came in alone for consult. She reported the ff sx occurring for 4 weeks, depressed
mood, insomnia, wt loss, motor retardation, loss of interest with watching tv and going out with friends, guilty of being sick, and wishes
to die.

10. How many sx of criteria A for DSM MDD is manifested?

a. 8
b. 7
c. 6
d. 5*

1. Axis II = personality disorders, defense mech, and mental retardation

10. MJ recalls express anger, plot of poisoning her – 30 GAF

15. DSMIV of mania atleast – 4 over 7 s/s

DRUG THERAPY
for the next number:
a. dopamine
b. serotonin
c. norepinephrine
d. b & c

74. its system is the major site of action for LSD – SEROTONIN

- KAPLAN: The pharmacodynamic effect of LSD remains controversial, although it is generally agreed that the drug acts on the serotonergic system,
either as an antagonist or as an agonist
89. The usual therapeutic response of most antidepressants and anyipsychosis is:
A. Immediate
B. Delayed in weeks
C. Equivalent to their effects on neurotransmitters
D. Within 24 hours

**antidepressants: therapeutic lag of 3-4wks

antipsychotics for mania: clinical response w/in 7 days
antipsychotics for schizophrenia: response by week 4

90. 26 yr old woman w/ schizoid affective d/o has difficulty in sleeping. she would be MOST benefited by which of the ff drugs?
a. chlorpromazine
b. ariprazole
c. haloperidol
d. risperidone

RATIONALE:
Sedative effects:
chlorpromazine +++
ariprazole 0/+
haloperidol +
risperidone ++

91. Which of the ff neuroleptics has been shown to be a partial agonist of DA?
A. Aripriprazole
B. Clozapine
C. Thioridazone
D. Halperidol

92. All of the ffare atypical antipsychotics, EXCEPT with high potential for EPS?
A. Aripriprazole
B. Haloperidol
C. Clozapine
D. Quetiapine

93. regarding antipsychotic drugs, which one of the ff statements is incorrect?

a. neuroleptic drugs are used primarily to treat schizophrenia but they are also effective in other psychoses, such as mania w/ psychotic symptoms
b. all currently available antipsychotic drugs that alleviate symptoms of schizophrenia decrease dopaminergic and/or serotonergic
neurotransmission
c. the newer atypical antipsychotics have fewer extrapyramidal effects and have a morr superior established efficacy than the typical agents –
SAME EFFICACY?
d. neuroleptic drugs are not curatice and do not eliminate the fundamental & chronic thought d/o, but often decrease the intensity of
hallucinations ans delusions and allow the schizophrenic patient to fxn in a supportive environment.

94. Do not give this antidepressant, due to its anticholinergic activity, if the patient has glaucoma
A. Amytriptyline( answer )
B. Bupropion
C. Fluvoxamine
D. Mirtazapine

*Rationale: GG pg 400 table 15-1 : only amitriptyline ( TCA ) has significant anti cholinergic activity

95. A 55 year old teacher began having mood changes. He was losing in work and lacked desire to play his daily tennis match. He had feelingsmof
guilt and worthlessness with generalized muscle aches. Labs were unremarkable. After 6 weeks of Fluoxetine, the patient's symptoms resolved
with sexual dysfunction. Which antidepresssant is devoid of sexual side effects?
A. TCA
B. Other SSRI
C. SNRIs
D. Atypical antidepressant

Rationale: page 410 GG

-SSRI- dec. libido, erectile dysfunction, anorgasmia, ejaculatory delay
-SNRI-similar S/E profile to SSRI; N/V, insomnia, headache and sexual dysfunction
(no mention of any sexual dysfunction in TCA)
(Serotonin Receptor antagonist--Priapism in Trazodone)

96. A MAO inhibitor previously approved for Parkinson and is currently the 1st antidepressant approved for transdermal delivery thus by passing
the first pass inactivation:
selegiline

97. An adverse effect of mao inhibitors if taken with tryamine rich foods:
A. Orthostatic hypotension
B.Hypertensive Crisis< ANSWER
C. Acute Blindness
D. Acute Renal Failure

*Rationale: GG. 12th edition p-411 Hypertensive Crisis resulting from food or drug interactions is one of the life threatening toxicities associated
with the use of the maois. Foods containing tyramine are a contributing factor. The ingestion of certain aged cheeses, red wines, sauerkraut, fava
beans leads to accumulation of tyrmine in adrenergic nerve endings and induces epi&norepi release, stimulating postsynaptic receptors in the
periphery & increasing blood pressure to dangerous levels. ORTHOSTATIC HYPOTENSION is caused by antagonism of a1 adrenergic receptors such as
TCAs

98. Antidepressants with the highest GIT side effects.

A. SSRIs - ANSWER
B. Atypical antidepressants
C. TCAs
D. MAOI

*Rationale: p. 411 GG 12th ed

Stimulation of 5-HT3 receptors in the CNS and periphery contributes to GI effects of SSRIs. (Also refer to table 15-1, SSRIs have 3+ for GI effects,other
drugs are less than that)

99. apt who has been on therapy for myocardial ischemia is recently diagnosed w/ severe depression. which of these classes of antidepressants is
contraindicated for the type of pt?
a. MaO inhibitors
b. atypical antidepressants
c. tertiary trycyclic amines
d. SSRIs

*TCA - quinidine-like effects on cardiac conduction that can be life-threatening

100. Most common adverse cardiac effect of antipsychotics

a. arrhythmias
b. hypertension
c. orthostatic hypotension
d. transient ischemic attack

Ventricular arrhythmias and sudden cardiac death are a concern with the use of antipsychotic agents. Cardiac arrhythmia is the most common
etiology for SCD. (GG p. 441)

31. selective serotonin reuptake inhibitors such as paroxetine cause significant interaction with which of the following drugs?
A. PHENELZINE

32. which of the following adverse effects is most commonly associated with tricyclic antidepressants?
D. ANTICHOLINERGIC EFFECTS

33. 25 year old female call center agent is treated for depression for the past 2 weeks. One night she’s been snacking on a blue cheese sandwich
involving redwine. She sooned complained of headache, nausea and palpitation. BP is noted to be 180/105. Which of the following antidepressant
drugs could have caused these manifestation?
D. TRANYLCYPROMINE

34. 37 year old male taxi driver is taking an anti-depressant for about a month with improvement in mood. On follow up he complains of dry
mouth, metallic taste, palpitation, weakness, fatigue and feeling pain on standing. Which anti-depressant is he taking?
C. IMIPRAMINE

35. Following the accidental death of her 6 year old daughter, 30 year old Jenica is given tricyclic anti-depressants to control her depression which
of the following adverse effect would not be of concern?
A. TARDIVE DYSKINESIA

36. A 55 year old businessman is treated doxepin after his networking business collapsed. 3 months have passed and there is no improvement for
his depressive mood so he is switch to another anti-depressant this time phenelzine. A week after stopping doxepin, 3 days later he develops high
grade fever, muscle rigidity and myoclonus which of the following can explain these findings:
D. INCREASED SEROTONIN LEVELS IN THE SYNAPSES

37. Anti-depressant agents have found broad utility in other disorders not necessarily related to mood disorders. The following anti-depressants
are correctly match with their therapeutic use EXCEPT:
C. MAOI – OBSESSIVE COMPULSIVE DISORDER

38. Which of the following anti-depressants selectively inhibits serotonin uptake with minimal effect on norepinephrine uptake?
A. DOXEPIN

39. 78 year old retired male janitor with on and off history of anxiety is treated with benzodiazepine because of increasing fearfulness of death.
Which of the following is favored because of its brief duration of action and direct obligation and elimination?
C. OXAZEPAM

40. Active metabolites contribute to overall duration of the action of a drug. Which of the following anti-depressant is an active metabolite whose
elimination half-life is approximately 10 days?
B. NORFLUOXETINE

41. Which of the following is a therapeutic use of chlorpromazine in addition to its use in the treatment of schizophrenia?
B. REDUCE NAUSEA AND VOMITING

42. A 15 year old out of school youth presents with incoherence and claims that he is the son of the moon king. Following treatment he suddenly
has tonic clonic generalized seizures. Which of the following neuroleptic agents was administered?
A. CLOZAPINE

43. A patient with manic disorder is given lithium caps. Which of the following statements DOES NOT relate with this agent?
D. IT CANNOT BE USED FOR LONG TERM TREATMENTS TO PREVENT RECURRENCES OF MANIA BECAUSE OF TOXICITY ASSOCIATED WITH LONG
TERM USE

44. Mara clara is treated with thioridazine because of recent history of going nude in a public claiming that she is the reincarnation of the goddess
venus. Since being treated with this drug she has several bouts of fainting spells and orthostatic hypotension noted on pe. Which of the following
best describes the mechanism of this drug effect:
C. ALPHA ADRENERGIC RECEPTOR ANTAGONISTIC ACTIVITY

45. Effects of thioridazine include the following EXCEPT:

A. HYPOPROLACTINEMIA
46. A 35 year old post partum female patient is treated with haloperidol for schizophrenia. She is brought to the emergency because of facial
grimacing and opisthotonos. What has occurred?
C. ACUTE DYSTONIA

47. Which of the following statements is true regarding haloperidol?

C. IT IS A SELECTIVE D2 RECEPTOR ANTAGONIST

48. Which of the following statements is NOT a pharmacokinetic feature of most anti-psychotics?
C. RAPID REMOVAL OF THE DRUG CONTRIBUTES TO THE EXACERBATION OF PSYCHOSIS AFTER STOPPING DRUG TREATMENT

49. Interaction between lithium and indomethacin is best described by which of the following:
A. INDOMETHACIN FACILITATES RENAL TUBULAR REABSORPTION OF LITHIUM INCREASING ITS PLASMA CONCENTRATION

50. The choice of an anti-psychotic drug is made on the following basis EXCEPT:
D. ANTICIPATED THERAPEUTIC EFFECT

33. therapeutic use of antidepressants:

a.
b.
c.
d. lifelong treatment is not advisable to prevent toxicity

35. does not cause weight gain = citalopram

36. Dr. Bora with breast CA, taking tamoxifen; don’t give:
a. MAOI
b. TCA
c. SSRI
d. SDA

37. patient with major depression dso and given with maoi. should be warned about:
a. can cause hallucination
b. maoi per se can cause hypertensive crisis
c. avoid beer
d. avoid fastfood cheeseburger

38. 54 yo given fluoxetine, decided to stop d/t sexual dysfunction, also with tobacco cessation; appropriate alternative:
a. citalopram
b. venlafaxine
c. bupropion
d.

39. A recently bereaved 60 yo female, treated with Benzodiazepine after death of husband; did not like daytime sedation at low dosage; no
significant medical disease; lives independently, infirm for age & poor eyesight. Depressive symptoms not abating. What would you most likely
give?
a. atomexitine
b. doxepine
c. mirtazapine
d. amitryptiline

41. The only anti-psychotic that can cause retinopathy and browning of vision.
A. Chlorpromazine
B. thioridazine
C. Haloperidol
D. Fluorperazine

42. Important unwanted side effect that is due to relative Ach deficiency secondary to super sensitive dopamine receptors
a. Akathisia
b. Pseudodepression
c. Tardive dyskinesia
d. NMS

43. About neuroleptic agent: (i think except ni) a. Causes low risk of EPSb. Atypical anti-depressantc. Causes relative D2 receptor antagonismd.
Contains tricyclic ringspls help me remember d question for those who are assigned to #43... tnx..

48. Which statement regarding lithium in the treatment of bipolar affective disorder is accurate?
A. Excessive intake of NaCl, enhances toxicity of lithium
B. Since lithium does not cross the placental barrier, it is safe for pregnant mothers
C. The elimination rate of lithium is equivalent to that of creatinine
D. The clinical effect of lithium has a late onset and is not clinically apparent before 1-2 weeks of daily treatment

50. Greatest concern in the long-term use of antipsychotics

a. cerebrovascular events
b. hyperprolactinemia
c. adverse metabolic effects
d. seizure risk

1. After 6 wks she had delusions of infidelity. Complained of headache BP elevated several times. Managed as HPN stage II. What will you
give?
a. SSRI
b. SSRI and antipsychotic*
c. TCA
d. TCA and antipsychotic

2. True regarding antidepressant

 a. Any antidep capable of potentiating neurotransmitter axn of NOR, 5HT, and DOPA
b. Usually produce therapeutic lag for several weeks*
c. All can provoke HPN cisis if taken w/ tyramine-rich food
d. Can lower convulsive threshold thus indicated for px with epilepsy

3. ECT may be tx of choice for agitated depressed px with high suicidal risk because
a. Its more rapid effect with that of oral antidep

4. Accurate pharmacokinetic parameter of antidep

a. Most are fairly well absorbed after oral administration
b. Metabolism mediated by hepatic CYP
c. Relatively lipohilic drugs strongly binds to plasma prot and constituents of tiss
d. High doses of potent anticholinergic antidep results in an erratic drug absorption and inc GI motility*

5. Anticholinergic side effects are highest with

a. MAO I b. atypical antidep c. SSRI d. imipramine-like antidep*

6. No side effects of weigt gain

Citalopram

7. Neuroleptic agent
Relatively prominent D2 receptor antagonism

8. Px has postpartum depression, given an antidep. After 2 doses MD learned she has unrecognized Bipolar dso. What to remember on use
of antidep on such case
a. Mood switches occur in vulnerable px especially with unrecognized Bipolar dso
b. That these adverse effect is dose related
c. This switch phenomenon occurs more often with TCA than SSRI buprion, perhaps MAO i
d. All of the above*

9. MAO B inhibitor, an antidepressant, approved for early parkinson’s dse

Selegiline

10. TRUE of antipsychotics

a. Because of their prominent sedative effects they are highly recommended for insomnia and anxiety
b. Effective antiseizure agents
c. Low therapeutic index
d. Though some degree of insomnia and physical dependence on abrupt discontinuation of chronic tx with antipsychotic, still
classified as non-addicting*

11. Have highest potential for extrapyramidal effects EXCEPT

a. Fluphenazine b.haloperidol c. aripiprazole* d. pimozide

12. Phenylbutylpiperidine analog, very short-acting, highly sedating neuroleptic, anesthetic agent
Droperidol

13. Antipsychotic with shortest elimination t1/2 of 6 hr

Quetiapine

14. Chlorpromazine tx for almost 1 yr. what neurologic manifestation will most likely occur with this duration?
Rabbit syndrome

15. To minimize neurologic syndromes that complicate the use of antipsychotics. Which principle is CORRECT?
a. Routine use of antiparkinson to prevent early extrpyramidal rxn is a must
b. Use of newer atypical agent is the best way to minimize adverse neuro fx
c. Best preventive practice is to use minimum dose that is effective*
d. Short-term therapy w/ older antipsychotic does not evoke extrapyramidal sx

16. TRUE pharmacological property of Lithium

a. Therapeutic concentration of Li have almost no discernable psychotropic effects on normal individuals*
b. Not a sedative, but a euphoriant
c. Unlike Na and K it has a relatively large gradient of distribution across biological membranes
d. Cannot maintain membrane potential because it cant replace Na in supporting action potential and is not a substrate of Na
pump

17. TRUE of Acute mania therapy

Li has a slow onset of action thus not employed as sole tx for controlling maniacal behavior

18. In tx of acute mania carbamazepine, Na valproate, and topiramate act mainly as

A. Sedative b. anxiolytic c. Anticonvulsant* d. antipsychotic

1. Most severe cardiac toxic effect of TCA: ( i don’t know the answer)
a. Orthostatic hypotension
b. Torsades de pointes (answer i think)
c. Cardiomyopathy
d. Myocarditis

2. Most common CNS side effect of lithium in therapeutic doses: (i don’t know the answer)
a. Fine hand tremors (answer i think)
b. Slurring of speech
c. Ataxia
d. Mental fatigue

3. Most severe effect of chronic ingestion of MAOI: (i don’t know the answer)
a. Serotonin syndrome
 b. Hypertensive crisis (answer i think)
c. Liver toxicity
d. Renal toxicity

4. Anti alpha 1 adrenergic activity of antidepressants = hypotension

5. Why bupropion is separated as antidepressant:

a. Acts as anticonvulsant in increased dosages (answer)
b. Different effects on EEG which is opposite that of other antidepressants
c. Has multiple mechanisms of action
d. Can increase release of dopamine and norepinephrine

6. Patch which prevents first pass metabolism: selegiline

7. Bioavailability of 20% of this antidepressant: nefazodone

8. Human platelet MAO B inhibition: at least 85%

9. 1 week already taking antidepressants: continue taking because of lag phase

10. Not found in typical antipsychotic:

a. High sedation
b. Postural hypotension
c. Partial agonism of D2 (answer)

16. Most antidepressant – delayed clinical onset of mood disorder

17. Antidepressant and antipsychotic –amoxapine

18. True antipsychotic – bind to H1 except haldol

19. Neuroleptic – EPS

20. Ttt potency with antipsychotic correlate with – D2

21. Antipsychotic easily fatigue – clozapine

22. TCA and heterocyclic – downregulation of adenoreceptor

23. Thru prevention except – MAOI

24. Fluoxetine allowed introduction of 1 per week by virtue of its – production of active metabolite with long half life 7-9days

25. Alogia and delusion of persecution, auditory hallucination hopeless cases, hanging – give 5HT-dopa antagonist and antidepressant

26. JR stabilization phase – psychotherapy , pharmacotherapy, art therapy

27. delusion of infidelity with problems wid heart rate – SSRI and antipsychotic

28. ERM antidepressant given – at least 6 months

OTHERS
11. Characteristic of batterer:
a. Unemployed
b. Paranoid psychotic
c. Alcoholic
d. Battered child themselves (answer)

12. Most difficult to intervene in domestic violence: honeymoon phase

13. Battered wife:

a. Inadequate finances
b. Fears retaliation
c. Believes husband is willing to change
d. All of the above (answer)

14. ER physician for domestic violence except:

a. Evaluate
b. Treat
c. Refer
d. Marital counselling (answer)

1. Anti-violence against women and children act of 2004 –RA 9262

2. Stage in the cycle of violence that is most difficult in terms of intervention –honeymoon phase

3. Spouse abuse is usually perpetrated by –men

4. Role of ER physician a. evaluate victim b. treat c. refer d. all of the above