First Aid for the USMLE Step 2CK Rapid Review – Psychiatry

question

First-line pharmacotherapy for depression
answer

SSRIs
question

Antidepressants associated with hypertensive crisis
answer

MAOIs
question

Galactorrhea, impotence, menstrual dysfunction, and ↓ libido
answer

Dopamine antagonists
question

A 17-year-old girl has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found
answer

Conversion disorder
question

Name the defense mechanism: – A mother who is angry at her husband yells at her child. – A girl who is upset with her best friend acts overly kind. – A man calmly describes a grisly murder. – A hospitalized 10-year-old begins to wet his bed.
answer

– Displacement – Reaction formation – Isolation – Regression
question

Life-threatening muscle rigidity, high fever, autonomic instability, confusion, and elevated creatine phosphokinase
answer

Neuroleptic malignant syndrome
question

Amenorrhea, low body weight (< 85%), bradycardia, and abnormal body image in a young woman
answer

Anorexia
question

A 35-year-old man has recurrent episodes of palpitations, diaphoresis, and fear of impending doom
answer

Panic disorder
question

The most serious side effect of clozapine
answer

Agranulocytosis
question

A 21-year-old man has 3 months of social withdrawal, worsening grades, flattened affect, and concrete thinking
answer

Schizophreniform disorder (a diagnosis of schizophrenia requires ≥ 6 months of symptoms)
question

Key side effects of atypical antipsychotics
answer

Weight gain, type 2 DM, QT-segment prolongation
question

A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
answer

Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
question

Medication to avoid in patients with a history of alcohol withdrawal seizures
answer

Neuroleptics, which can lower the seizure threshold
question

A 13-year-old boy has a history of theft, vandalism, and violence toward family pets
answer

Conduct disorder. Associated with antisocial personality disorder in adults
question

A 5-month-old girl has ↓ head growth, truncal discoordination, and ↓ social interaction
answer

Rett disorder. Loss of milestones is commonly described
question

A patient hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?
answer

Acute mania. Start a mood stabilizer (eg, lithium)
question

After a minor “fender bender,” a man wears a neck brace and requests permanent disability
answer

Malingering
question

A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C-peptide
answer

Factitious disorder
question

A patient spends most of his time acquiring cocaine despite losing his job and being threatened with legal charges
answer

Substance use disorder
question

Medication to avoid in patients with PTSD
answer

Benzodiazepines (have high addiction potential). Patients commonly have a history of substance abuse
question

A violent patient has vertical and horizontal nystagmus
answer

Phencyclidine hydrochloride (PCP) intoxication
question

A woman who was abused as a child frequently feels outside of or detached from her body
answer

Depersonalization disorder
question

A schizophrenic patient takes haloperidol for 1 year and develops uncontrollable tongue movements. Diagnosis? Treatment?
answer

Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (eg, risperidone, clozapine)
question

A man with major depressive disorder is counseled to avoid tyramine-rich foods with his new medication. What class of medications is he taking?
answer

MAOIs

Get instant access to
all materials

Become a Member