PSYCHIATRY EOR LATEST EXAM WITH 270 QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) GRADED A+/ PSYCH EOR PAEA LATEST 2024 EXAM (NEW!!)
Which antipsychotics are associated with the greatest degree of anticholinergic side effects? - ANSWER-Anticholinergic effect are especially prominent w...
1. Which antipsychotics are associated with the greatest degree of
anticholinergic side effects? - ANSWER-Anticholinergic effect are
especially prominent with weaker-binding aka *low potency first
generation APs* as well as with *clozapine*
2. What effect do NSAIDs have on lithium levels? What are the exceptions -
ANSWER-NSAIDs decrease lithium excretion thus INCREASE levels.
Exception are slindac and aspirin
3. In terms of thought disorders, what is the difference between tangentiality
and loosening of associations? - ANSWER-Although both are
characterized by speech that is initially goal directed, in tangentiality the
speech gradually deviates and an association between thoughts can be
appreciated whereas with LOA or derailment, the topics shift more
rapidly and there is NO logical connection between topics.
4. What are the 5 As of negative sexes in schizophrenia? - ANSWER-
Anhedonia, affect (flat), alogia (poverty of speech), avolition (apathy),
and attention (poor)
5. Which APs are most highly associated with problems related to metabolic
syndrome? - ANSWER-Clozapine and olanzapine (zyprexa)
6. What is the diagnostic criteria for schizophrenia? - ANSWER-Patient
must have two or more of the listed symptoms for at least one month, one
of which has to be delusions, hallucinations, or disorganized speech.
,7. What is the nature of sedation as a side effect of APs? Which
antipsychotics are associated with greatest degree of sedation? -
ANSWER-- ALL antipsychotics are associated with some degree of
sedation that is generally dose related and many patients become tolerant
to sedative effects over time. *Low-potency 1st generation APs* and
*clozapine* are the MOST sedating.
8. What receptor blockage determines the degree of orthostatic hypertension
experienced with APs? What is a way to decrease the occurence of
orthostatic hypotension when dosing the medication? - ANSWER-
Orthostatic hypertension with APs assocaited with degree of alpha 1
antagonism. Particularly seen with the low potency 1st generation APs
and clozapine. Careful dose titration can help patients become tolerant to
the effect
9. What symptoms and signs characterize pseudoparkinsonism? What is the
treatment? - ANSWER-remulousness in the hands and arms, rigidity in
the arms and shoulder, bradykinesia, akinesia, hypersalivation, maksed
facies, and shuffling gait. Treated by reducing AP dosage or adding an
anticholinergic agent such as benztroping or diphenhydramine.
10.What is the treatment for akathisia secondary to antipsychotic treatment?
- ANSWER-Treatment can be with dosage reduction or the addition of a
low dose beta blocker ie 20-80mg per day
11.What is usually required for treatment of acute dystonic reactions
secondary to AP treatment? - ANSWER-Often required IV or IM
anticholinergic agent.
12.What is the receptor physiology behind why ketamine causes psychosis? -
ANSWER-because NMDA antagonist
,13.When do the movements of tardive dyskinesia generally become most
prominent? - ANSWER-TD movements most evident when patients are
aroused but ease during relaxation and disappear during sleep.
14.What is the risk of a patient having prolonged prolactinemia secondary to
their antipsychotic medication? - ANSWER-Chronic hyperprolactinemia
associated with osteoporosis and increases risk of hip fracture.
15.Which two antipsychotics do NOT cause hyperprolactinemia? -
ANSWER-aripiprazole (Abilify) and quetiapine (Seroquel)
16.When do the majority of people taking Clozapine develop
agranulocytosis? Which groups are at greater risk? - ANSWER-The
majority will develop agranulocytosis within the first 3 months of starting
treatment. Risk increases with older age, female sex, and Asian race.
17.Which antipsychotics are most strongly assocaited with prologation of
ventricular repolarization aka QT interval prolongation? - ANSWER-
Thioridazine and ziprasidone (Geodon) which is dose dependent,
however ALL APs carry risk.
18.Which 1st generation APs are considered high potency? Which are
considered low potency? - ANSWER-High potency = haloperidol and
fluphenazine
19.low potency = chlorpromazine, thioridazine
20.What is the correlation between level of sedation and degree of seizure
threshold with antipsychotics? - ANSWER-Found that generally, the
more sedating the antipsychotic, the more it lowers the seizure threshold.
Seizures most common with low-potency first generation APs and
clozapine.
, 21.Which two 2nd generation APs are considered "weight neutral"? -
ANSWER-aripiprazole (abilify), ziprasidone (geodon)
22.What should you do if a patient is developing signs of metabolic
syndrome while on a second generation AP? - ANSWER-Should consider
swtiching to a first generation or a more "weight neutral" AP such as
aripiprazole (abilify), or ziprasidone (geodon)
23.Which two antipsychotic medications are associated with retinal
deposits/pigmentation - ANSWER-Chlorpromazine and thioridazine
24.What differentiates schizoaffective disorder from mood disorder with
psychotic fxs? - ANSWER-In schizoaffective, delusions or hallucinations
are present for 2 weeks in ABSENCE of mood d/o symptoms
25.What is the recommended treatment for delusional disorder even though
there is limited evidence? - ANSWER-antipsychotics
26.What is the treatment for neuroleptic malignant syndrome? - ANSWER-
Dantrolene or bromocriptine
27.What is the effect of drantrolene? What serious medical emergency is it
used in? - ANSWER-direct muscle relaxant use in NMS
28.What class of medicaiton is bromocriptine? what medical emergency is it
used in? - ANSWER-direct dopamine receptor agonist effects used in
NMS because can overcome AP induced D2 receptor blockade.
29.Why is lorazepam used in combination with haloperidol for treatment of
acute psychosis in a patient? - ANSWER-Because lorazepam or any
benzo, with an AP reduces the amout of AP needed and protects against
dystonic reactions.
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