Simulations
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1
What treatments should be considered for a pt w/ GAD?
buspirone
lorazepam
paroxetine
hydroxyzine
venlafaxine ER
lorazepam
paroxetine
hydroxyzine
venlafaxine ER
2
What does the monoamine-deficiency therory detail?
Insufficient serotonin, norepinephrine, and/or dopamine causes depression
3
How does escitalopram work?
Increases serotonin in the synapse by blocking the presynaptic reuptake of the neurotransmitter into the presynaptic neuron
4
When a pt calls to report GI symptoms after starting a SSRI 4 days ago, what advice should be provided?
Continue the medication as this should subside
5
What should the clinician do when the pt is not fully responding to the initial dose of a SSRI?
Increase it and evaluate in 1 month
6
What is one way to offset the side effect of feeling tired with initiation or dose adjustments of a SSRI?
Switch the dosing to HS
7
A pt with depression and/or anxiety should remain on treatment for what length of time to prevent relapse of symptoms?
12 mo
8
What treatment options should be considered for a pt w/ a specific phobia?
Exposure therapy
CBT
Benzodiazepines to rapidly control symptoms
CBT
Benzodiazepines to rapidly control symptoms
9
What treatment options should be considered for a pt w/ social phobia?
venlafaxine ER
paroxetine
sertraline
paroxetine
sertraline
10
What treatment options should be considered for a pt w/ panic disorder?
sertraline
clonazepam
alprazolam
venlafaxine ER
fluoxetine
clonazepam
alprazolam
venlafaxine ER
fluoxetine
11
What treatment options should be considered for a pt w/ agoraphobia?
CBT
SSRI
SNRI
Exposure Therapy
SSRI
SNRI
Exposure Therapy
12
What treatment options should be considered for a pt w/ trichotillomania?
SSRIs
13
What treatment options should be considered for a pt w/ OCD?
CBT
clomipramine
SSRIs
(SGA are not first line)
clomipramine
SSRIs
(SGA are not first line)
14
When treating OCD, what should the clinician do before adding a SGA?
Maximize SSRI first
15
What treatment options should be considered for a pt w/ PDD?
paroxeitne
fluoxetine
sertraline
fluoxetine
sertraline
16
What treatment options should be considered for a pt w/ MDD?
fluoxetine
escitalopram
sertraline
escitalopram
sertraline
17
What treatment options should be considered for a pt w/ dysthymia?
sertraline
fluoxetine
citalopram
fluoxetine
citalopram
18
A pt w/ schizoaffective disorder depressive type will present w/ what symptoms?
Symptoms associated w/ a major depressive episode that is present a majority of the time
Postitive symptoms for >2 weeks in the absence of the major depressive or manic episode
An uninterrupted period of a major mood episode (depressive or manic) & aligns w/ criteria for schizophrenia
Postitive symptoms for >2 weeks in the absence of the major depressive or manic episode
An uninterrupted period of a major mood episode (depressive or manic) & aligns w/ criteria for schizophrenia
19
What are the first-line treatment options for schizoaffective disorder?
SGAs
20
A pt w/ hypomania will present w/ what symptoms?
At least 4 days of symptoms that appear "abnormal" and "persistent" which have a elevated, expansive, or irritable mood with increased activity or energy
3+ of the following with the mood/activity changes: inflated self-esteemrandiosity; decreased need for sleep; more talkative/pressure to keep talking; flight of ideas/thoughts racing; distractability; increased goal-directed activity/psychomotor agitation; >risk taking behaviors
3+ of the following with the mood/activity changes: inflated self-esteemrandiosity; decreased need for sleep; more talkative/pressure to keep talking; flight of ideas/thoughts racing; distractability; increased goal-directed activity/psychomotor agitation; >risk taking behaviors
21
What are the first-line treatments for BPII?
SGA/Mood Stabilizers
22
A pt has had at least 3 manic episodes in the past and presents to the office with a major depresssive episode. What is your dx?
BPI, depressed
23
A pt w/ BPI current episode depressed will present w/ what symptoms?
-H/O at least one episode of mania (1+ week of symptoms)
-For 2+ weeks: 5+ symptoms of major depressive episode (depressed mood or loss of interest/pleasure must be present): change in wt >5% from baseline, insomnia/hypersomnia, psychomotor agitationetardation, fatigue/<energy, feelings of worthlessnessuilt, poor concentration/indecisiveness, recurrent thoughts of death or suicidal ideation
-For 2+ weeks: 5+ symptoms of major depressive episode (depressed mood or loss of interest/pleasure must be present): change in wt >5% from baseline, insomnia/hypersomnia, psychomotor agitationetardation, fatigue/<energy, feelings of worthlessnessuilt, poor concentration/indecisiveness, recurrent thoughts of death or suicidal ideation
24
What are the first-line treatments for BPI w/ a depressive episode?
SGAs: lurasidone, quetiapine, olanzapine/fluoxetine
25
A pt w/ cyclothymia presents with what sympotms?
2 yrs of hypomanic episodes (never w/o symptoms for >2 mo)
No mania, major depressive episode, or true hypomanic episodes noted in history (none meet full criteria)
**think chronic fluctuating mood involving both hypomanic symptoms or depressive symptoms that are not "as severe" as bipolar
No mania, major depressive episode, or true hypomanic episodes noted in history (none meet full criteria)
**think chronic fluctuating mood involving both hypomanic symptoms or depressive symptoms that are not "as severe" as bipolar
26
What is the first-line treatments for a pt w/ cyclothymia?
SGAs: lurasidone, quetiapine, olanzapine/fluoxetine
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