AMC MCQ Canada Bank Exam Review Update 2023

AMC MCQ Canada Bank Exam Review Update 2023 Characteristic signs of hypertrophic pyloric stenosis - ANS-1)Projectile non-bilious vomiting 2) Hyperchloremic alkalosis 3) Good appetite SSRIs mechanism - ANS-5-HT (serotonin) reuptake inhibitors mechanism SSRIs clinical use - ANS-1st line for depression, generalized anxiety disorder, panic disorder, OCD, bulimia, social phobia, PTSD SSRI side effects - ANS-Sexual dysfunction, SIADH side effects SNRIs drug names - ANS-Venlafaxine, duloxetine class SNRI mechanism - ANS-Inhibit 5-HT and norepi reuptake mechanism SNRI clinical use - ANS-1st line for Generalized Anxiety, Panic Disorder, PTSD. 2nd line for depression. SNRI side-effects - ANS-Increased BP, Stimulant Effects as side effects TCA drug names - ANS--tripyline suffix, -pramine suffix, Doxepin, Amoxapine TCA mechanism - ANS-Inhibit 5-HT and norepi reuptake, also block α1 receptors and acetylcholine receptors. TCA clinical use - ANS-Depression refractory to 1st line treatment, OCD, peripheral neuropathy, chronic pain, migraine prophylaxis treatment TCA side effects - ANS-Sedation, Postural hypotension (due to α1 block); Tachycardia, Urinary retention, Dry mouth (due to muscarinic block), 3 Cs - Convulsions, Coma, Cardiotox (arrhythmias due to ↑QT interval - give NaHCO3 to prevent) as a side effect MAOi drug names - ANS-Tranylcypromine, Phenelzine, Isocarboxasid, Selegiline class MAO mechanism - ANS-Inhibits MAO, which ↑ norepi, dopamine, 5HT MAO clinical use - ANS-Refractory atypical depression treatment MAO side-effect - ANS-Hypertensive crisis with ingestion of tyramine in wine + cheese, CNS overstimulation as a side effect Atypical that acts more like typical antipsychotics at > 6 mg - ANS-Risperdone (EPS, TD) feature What does blocking serotonin 5HT2 receptors do? - ANS-Sedation, Nausea, Anticholinergic are side effects Atypical with a 1% incidence of agranulocytosis, Atypical with a 2-5% chance of seizure - ANS-Clozapine side effect Psych pt with fever and fast heart rate is sweaty and rigid. He has an obvious tremor. What labs do you draw? - ANS-Check CPK (Creatine phosphokinase test) and WBC. If pt has leukocytosis (increased WBC) and elevated CPK, it is neuroleptic malignant syndrome Treatment for neuroleptic malignant syndrome - ANS-Discontinue current medications, Supportive care (cooling, hydration) Sodium dantroline, bromocriptine, amantadine Uses of carbamazepine - ANS-Mixed episodes and rapid-cycling bipolar disorder treatment Onset of action of lithium and carbamazepine - ANS-5 to 7 days lenght What is the therapeutic range for lithium? - ANS-0.7 to 1.2 concentration in serum Toxic lithium levels - ANS->1.5 concentration in serum Lethal lithium levels - ANS->2 concentration in serum TCA for noctournal enuresis - ANS-Imipramine clinical use 2 TCAs for pain and insomnia - ANS-Amitriptyline and nortriptyline clinical use How many grams of TCAs are fatal? - ANS-2-3 g concentration in serum Treatment for TCA overdose - ANS-IV sodium bicarbonate clinical use Can a patient who got neuroleptic malignant syndrome (NMS) on haldol take haldol again later? - ANS-Yes. It is not an allergic reaction. Who gets TD (tardive dyskinesia) the most? - ANS-People who have used neuroleptics more than 6 months, Older women How often does TD spontaneous remit? - ANS-50% of the time. But if untreated it can be permanent... CONTINUES...