COPEing in year 2020

Armin Moradi

2020-12-17

Table of Contents

Questions

Questions

1

Indigenous ethnicity associated with which of the following?
Increased accessing of primary care
Increased rate of homelessness
Increased life expectancy
Increased prevalence of schizophrenia

2

12yo with sudden, rapid, recurrent, non-rhythmic movements and periodic vocalizations
Tetrabenazine
Guanfacine
Risperidone
Aripiprazole

Guanfacine (alpha-2-agonist)

3

First line for OCD and PTSD
Clonidine
Clomipramine
EMDR therapy (Eye Movement Desensitization & Reprocessing)
Paroxetine

SSRI - Paroxetine First-line Escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline Second-line Citalopram, clomipramine, mirtazapine, venlafaxine XR

4

"Recovery" in measuring effectiveness of mental health services
personal process that allows a patient to gain control, meaning, and purpose
a patient and family learning to accept a severe mental illness
50% reduction of psychiatric symptoms on standardized measures
complete absence of symptoms of mental illness

Determining the effectiveness of mental health services from a consumer perspective Personal process

5

paper with "red" on green font. asked to read the word. cognitive domain?
complex attention
learning and memory
language
executive functioning

complex attention ability to maintain information in their mind for a short time and to manipulate that information As the demands on attention increase, performance slows down and information is less able to be held in mind Experienced as information overload

6

Frequent binge+purge. bloodwork?
hyperkalemia
hyponatremia
hypokalemia
hyperchloremia

natremia -> water issue (they still eat/drink) chloremia -> related to sodium hypo vs hyper purge -> vomiting acid -> low acid -> K and H antiporter H needs to go out of the cell, then K needs to go in low K in the blood -> hypokalemia

7

Lung transplant recipient. on tacrolimus. Has MDD. likely to present with tacrolimus toxicity?
Escitalopram
Venlafaxine
Fluvoxamine
Mirtazapine

Tacrolimus is metabolized through CYP3A4 So, we're looking for CYP3A4 inhibitors BC guidelines: fluoxetine, fluvoxamine >> sertraline, venlafaxine, mirtazapine, paroxetine

8

Most prominent negative symptom in schizophrenia
avolition
anosognosia
alogia
anhedonia

Avolition ? data

9

studying association between NTD vs escitalopram. randomly chooses NTD, another random healthy. retroactively asked about escitalopram use. what is measured?
relative risk
prevalence ratio
relative rate
odds ratio

relative risk: risk of one group over the other
prevalence ratio: more focused on intervention than epidemiologic data
relative rate: between 2 different groups, measuring the rate of occurrence

less likely to apply

odds ratio: ratio of chances, most likely to be useful in this type of study

10

Hx of Bipolar I on valproic acid 500 bid, carbamazepine 300 bid, zopiclone 5 qhs, clonazepam 0.5 prn. wants to start OCP, which should be discontinued?
carbamazepine
valproic acid
zopiclone
clonazepam

carbamazepine, topiramate, phenytoin) decrease effectiveness of OCP lamotrigine and OCP: increases metabolism of lamotrigine

11

Best method of reducing stigma?
targeted education to influential groups
work with people to stabilize income
help people identify their creative and spiritual needs
assist patients to achieve housing and food security

nil

12

Long stem, 65yo hx of PTSD and MDD, hx of attempted suicide, divorced, anniversary of PTSD event. most important risk factor for suicide attempt?
race
PTSD comorbidity
prior suicide attempt
marital status

most important: prior suicide attempt

13

Most common ect side effect
arrhythmia
episodic memory impairment
prolonged seizure
headache

most common: memory and cognitive issues. also one of the reasons we change ect positions

COPEing in year 2020Armin Moradi2020-12-17