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#+AUTHOR: Armin Moradi
#+TITLE: COPEing in year 2020
#+DATE: 2020-12-17
* 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
#+BEGIN_NOTES
Guanfacine (alpha-2-agonist)
#+END_NOTES
** 3
- First line for OCD and PTSD
- Clonidine
- Clomipramine
- EMDR therapy (Eye Movement Desensitization & Reprocessing)
- Paroxetine
#+BEGIN_NOTES
SSRI - Paroxetine
First-line Escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline
Second-line Citalopram, clomipramine, mirtazapine, venlafaxine XR
#+END_NOTES
** 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
#+BEGIN_NOTES
Determining the effectiveness of mental health services from a consumer perspective
Personal process
#+END_NOTES
** 5
- paper with "red" on green font. asked to read the word. cognitive domain?
- complex attention
- learning and memory
- language
- executive functioning
#+BEGIN_NOTES
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
#+END_NOTES
** 6
- Frequent binge+purge. bloodwork?
- hyperkalemia
- hyponatremia
- hypokalemia
- hyperchloremia
#+BEGIN_NOTES
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
#+END_NOTES
** 7
- Lung transplant recipient. on tacrolimus. Has MDD. likely to present with tacrolimus toxicity?
- Escitalopram
- Venlafaxine
- Fluvoxamine
- Mirtazapine
#+BEGIN_NOTES
Tacrolimus is metabolized through CYP3A4
So, we're looking for CYP3A4 inhibitors
BC guidelines: fluoxetine, fluvoxamine >> sertraline, venlafaxine, mirtazapine, paroxetine
#+END_NOTES
** 8
- Most prominent negative symptom in schizophrenia
- avolition
- anosognosia
- alogia
- anhedonia
#+BEGIN_NOTES
Avolition
? data
#+END_NOTES
** 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
#+BEGIN_NOTES
- 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
#+END_NOTES
** 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
#+BEGIN_NOTES
carbamazepine, topiramate, phenytoin) decrease effectiveness of OCP
lamotrigine and OCP: increases metabolism of lamotrigine
#+END_NOTES
** 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
#+BEGIN_NOTES
#+END_NOTES
** 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
#+BEGIN_NOTES
most important: prior suicide attempt
#+END_NOTES
** 13
- Most common ect side effect
- arrhythmia
- episodic memory impairment
- prolonged seizure
- headache
#+BEGIN_NOTES
most common: memory and cognitive issues.
also one of the reasons we change ect positions
#+END_NOTES