PA PSYCHIATRY EXAM 5 2026 PRACTICE TEST
WITH ANSWERS AND THERAPEUTIC
INTERVENTION SCENARIOS
◉ Bipolar II.
Answer: Dx:
MDD + Hypomania (DIG ST) < 1wk
Function in not fully compromised
Tx: *Risperdal*
◉ Bipolar I Disorder.
Answer: Dx:
MDD > 2wks + Mania (DIG FAST) > 1wk
Inhibits function of daily living
Tx:
Acute Manic Episode: Antipsychotic + Mood Stabilizer
Chronic Cycle Episodes: Mood Stabilizer
◉ Mood Stabilizers to Tx Bipolar Disorder (4).
,Answer: Lithium
Valproic Acid (Depakote)
Carbamazepine (Tegretol)
Lamotrigine (Lamictal)
◉ Side Effects of Lithium
*LMNOP*.
Answer: *L*ithium Side Effects
*M*ovements (tremors)
*N*ephrotoxicity
hyp*O*thyroid
*P*regnancy problems (Ebstein's Anomoly)
◉ Mood Stabilizer used to Tx Bipolar I Disorder w/ predominant
depressed state and may cause an *itchy rash or SJS*.
Answer: Lamotrigine (Lamictal)
◉ Tx of Bipolar I Disorder by ↑ GABA and ↓ Na+
C/I in pregnancy = *↓ Folate*
Hepatic Necrosis
C/I with ASA or Warfarin = ↓ protein binding availability.
Answer: Valproic Acid (Depakote)
,◉ Mood Stabilizer & Anticonvulsant especially helpful to Tx the
*cycling* of Bipolar Disorder but may cause........
Answer: Carbamazepine (Tegretol)
Agranulocytosis
◉ Anticonvulsant, not FDA approved for the use as a mood stabilizer,
causes *wt loss*, ↓ cognition, word searching, ↑ risk of kidney stones
and metabolic acidosis.
Answer: Topiramate (Topamax)
◉ Causes *rapid cycling* in Bipolar Disorder pts.
Answer: The use of *antidepressants* is C/I in Bipolar Disorder
- leads to mania
◉ Persistent depressive disorder (Dysthymic disorder).
Answer: Dx: (MDD Lite)
<5 SIGECAPS criteria for *>2 yrs*
Still able to function
Tx: *Psychotherapy* > SSRIs
, ◉ *Failed medication* criteria when using antidepressants to Tx
MDD?.
Answer: Noticeable change of Depressive Sx's in 2-6 weeks of Rx
initiation
◉ Cyclothymic disorder.
Answer: Dx: (Bipolar II Lite)
Hypomania + Dysthymia >2 yrs
Sx free for <2 mo
Still able to function
Tx: Psychotherapy/CBT/Family Therapy
◉ Premenstrual dysphoric disorder.
Answer: PMS on an anger pill - affecting function
◉ Major depressive disorder with peripartum onset.
Answer: Dx:
>2wks of SIGECAPS
Within 4 weeks of childbirth
WITH ANSWERS AND THERAPEUTIC
INTERVENTION SCENARIOS
◉ Bipolar II.
Answer: Dx:
MDD + Hypomania (DIG ST) < 1wk
Function in not fully compromised
Tx: *Risperdal*
◉ Bipolar I Disorder.
Answer: Dx:
MDD > 2wks + Mania (DIG FAST) > 1wk
Inhibits function of daily living
Tx:
Acute Manic Episode: Antipsychotic + Mood Stabilizer
Chronic Cycle Episodes: Mood Stabilizer
◉ Mood Stabilizers to Tx Bipolar Disorder (4).
,Answer: Lithium
Valproic Acid (Depakote)
Carbamazepine (Tegretol)
Lamotrigine (Lamictal)
◉ Side Effects of Lithium
*LMNOP*.
Answer: *L*ithium Side Effects
*M*ovements (tremors)
*N*ephrotoxicity
hyp*O*thyroid
*P*regnancy problems (Ebstein's Anomoly)
◉ Mood Stabilizer used to Tx Bipolar I Disorder w/ predominant
depressed state and may cause an *itchy rash or SJS*.
Answer: Lamotrigine (Lamictal)
◉ Tx of Bipolar I Disorder by ↑ GABA and ↓ Na+
C/I in pregnancy = *↓ Folate*
Hepatic Necrosis
C/I with ASA or Warfarin = ↓ protein binding availability.
Answer: Valproic Acid (Depakote)
,◉ Mood Stabilizer & Anticonvulsant especially helpful to Tx the
*cycling* of Bipolar Disorder but may cause........
Answer: Carbamazepine (Tegretol)
Agranulocytosis
◉ Anticonvulsant, not FDA approved for the use as a mood stabilizer,
causes *wt loss*, ↓ cognition, word searching, ↑ risk of kidney stones
and metabolic acidosis.
Answer: Topiramate (Topamax)
◉ Causes *rapid cycling* in Bipolar Disorder pts.
Answer: The use of *antidepressants* is C/I in Bipolar Disorder
- leads to mania
◉ Persistent depressive disorder (Dysthymic disorder).
Answer: Dx: (MDD Lite)
<5 SIGECAPS criteria for *>2 yrs*
Still able to function
Tx: *Psychotherapy* > SSRIs
, ◉ *Failed medication* criteria when using antidepressants to Tx
MDD?.
Answer: Noticeable change of Depressive Sx's in 2-6 weeks of Rx
initiation
◉ Cyclothymic disorder.
Answer: Dx: (Bipolar II Lite)
Hypomania + Dysthymia >2 yrs
Sx free for <2 mo
Still able to function
Tx: Psychotherapy/CBT/Family Therapy
◉ Premenstrual dysphoric disorder.
Answer: PMS on an anger pill - affecting function
◉ Major depressive disorder with peripartum onset.
Answer: Dx:
>2wks of SIGECAPS
Within 4 weeks of childbirth
