Back to Basics Psychiatry MCQs

1. Back to BasicsPsychiatry MCQs Tin Ngo-Minh, MD R2 Psychiatry University of Ottawa

2. MCC Objectives • Stimulant – Depressants - Volatile Inhalants toxidromes • Need for emergency care b/c of withdrawal SSx or other complications • LFTs and tests if suspected of ETOH abuse • CAGE • Alcohol withdrawal management, indications and contraindications for disulfiram, and naltrexone, methadone; outline management of withdrawal from opioids and benzodiazepines • Outline management for stopping nicotine including advice to quit, nicotine replacement therapy, setting quitting dates, behavioral counseling, information about community resources • Discuss guidelines for safe prescription writing for benzodiazepines and opioids. • Outline management of cardiovascular complications of cocaine and alcohol. • Outline prevention, detection, and management of infectious complications of IV drugs use including Hepatitis B, C, and HIV.

3. Neuropsychological effects of hallucinogens may include all of the following EXCEPT: a) miosis b) tremor c) hyper-reflexia d) incoordination e) blurred vision

4. Cocaine withdrawal can include all of the following EXCEPT: a) Crash sleep b) anergia c) anhedonia d) euphoria e) continued craving

5. Alcohol withdrawal includes all of the following EXCEPT: a) autonomic hyperactivity b) tremor c) starts within 2-4 hours after prolonged drinking d) nausea e) irritability

6. A 30 year-old man presents in emergency with right lower quadrant abdominal pain. His wife reports that he had been drinking heavily in response to marital problems and had never had such pain before. Appendicitis was diagnosed and an appendectomy was successfully performed. Four days later the patient was anxious, restless, unable to sleep and claimed his wife was a stranger trying to harass him. The likeliest diagnosis is: a) paranoid reaction b) delirium tremens c) mania d) schizophreniform reaction e) post-operative delerium

7. Which of the following is best treated with high dose benzodiazepines: a) schizophrenia, catatonic type b) major depression c) generalized anxiety disorder d) delirium tremens e) psychogenic amnesia

8. A thorough assessment for the presence/absence of alcohol withdrawal should include questions about all of the following EXCEPT: a) nausea and vomiting b) mood c) difficulty walking (ataxic gait) d) visual disturbances e) tremulousness

14. Unrelated Qs

15. Patients with conversion disorders will show each of the following EXCEPT: a) “la belle indifference” b) severe depression c) loss of special sense function d) secondary gains e) paralysis of voluntary muscles

16. All of the following are common side effects of tricyclic antidepressants EXCEPT: a) dry mouth b) constipation c) parkinsonian tremor d) tachycardia

17. Which of the following investigations need not be performed before starting treatment with lithium carbonate? a) serum creatinine b) serum electrolytes c) thyroid function studies d) serum bilirubin e) all of the above

18. Toxicity due to lithium carbonate is associated with all of the following EXCEPT: a) nausea b) serum lithium level of 0.1 mEq/L c) tremulousness d) convulsions

19. Which of the following neurological symptoms can be produced by antipsychotic drugs? a) akathesia b) shuffling gait c) oculogyric crisis d) tremor at rest e) all of the above

20. 20yo male with schizophrenia presents with acute onset of neck pain. Recent change in meds from risperidone to haldol. Likely diagnosis and treatment?

23. Sources • Toronto Notes and MCC Practice Exams 2003 • MCC Self-Administered Evaluating Examination - Online