PA PSYCHIATRY EOR EXAM SCRIPT 2025/2026 QUESTIONS
WITH ANSWERS MARKED A+
✔✔Mood Stabilizer used to Tx Bipolar I Disorder w/ predominant depressed state and
may cause an *itchy rash or SJS* - ✔✔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 - ✔✔Valproic Acid (Depakote)
✔✔Mood Stabilizer & Anticonvulsant especially helpful to Tx the *cycling* of Bipolar
Disorder but may cause....... - ✔✔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 -
✔✔Topiramate (Topamax)
✔✔Causes *rapid cycling* in Bipolar Disorder pts - ✔✔The use of *antidepressants* is
C/I in Bipolar Disorder
- leads to mania
✔✔Persistent depressive disorder (Dysthymic disorder) - ✔✔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? - ✔✔Noticeable
change of Depressive Sx's in 2-6 weeks of Rx initiation
✔✔Cyclothymic disorder - ✔✔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 - ✔✔PMS on an anger pill - affecting function
✔✔Major depressive disorder with peripartum onset - ✔✔Dx:
>2wks of SIGECAPS
,Within 4 weeks of childbirth
Tx: *Rest & Support*
Paroxetine
Sertraline - if breast feeding
✔✔Schizophrenia - ✔✔Dx:
*Auditory hallucinations*
Delusions (fixed, false beliefs)
Sx's continue for *at lease 6mo*
Tx: *Olanzapine*
- S/E: *↑ wt gain* unrelated to caloric intake
✔✔Prodromal Sx's of Schizophrenia - ✔✔Social Isolation
New interest in religion/philosophy
Restlessness
Difficulty concentrating
✔✔Positive Sx's of Schizophrenia - ✔✔Delusions
Hallucinations
Strange behaviors
Incoherent thought process
Grossly disorganized
Catatonic behavior
✔✔Negative Sx's of Schizophrenia - ✔✔Flat affect
Decreased fluency
Decreased productivity of thought & speech
Social withdrawal
Decrease in goal-directed behavior
✔✔Rx for acute, agitated psychosis in schizophrenic pts
S/E's seen w/ chronic use - ✔✔Typical 1st Generation Antipsychotics
-Haldol
-Chlorpromazine (corneal deposits)
-Thioridazine (retinal deposits)
S/E: ↑ risk of extrapyramidal symptoms or Neuroleptic Malignant Syndrome
✔✔Extrapyramidal Symptoms (EPS) seen w/ typical antipsychotics high affinity for *D2*
receptors - ✔✔Dystonia "muscle" - hours
Akathisia "rustle" - days
Akinesia "hustle" - weeks
, - Tardive Dyskinesia (haldol)
✔✔Neuroleptic Malignant Syndrome (NMS) seen w/ typical antipsychotic use
*FEVER* - ✔✔*F*ever
*E*levated enzymes (CPK)
*V*itals are unstable (BP)
*E*ncephalopathy
*R*idgity (psudoparkinsonism)
Tx: *Dantrolene* + ice baths
✔✔Atypical antipsychotic known to *↓ rate of suicide* in psychotic patients but can
cause *agranulocytosis* - ✔✔Clozapine (Clozaril) - 2nd Line Tx of schizophrenia due to
S/E's
Absolute C/I to use: Hx of agranulocytosis or myocarditis
✔✔Erroneous beliefs
Grandeur thinking
Disorganized speech
Loose associations
Tangential responses - ✔✔Delusions
Sx's of delusions w/o hallucinations = *Delusional Disorder*
✔✔Onset of schizophrenia based on gender - ✔✔Men: 10-25 y/o
Women: 25-35 y/o
The earlier the onset = the worse the disease
✔✔Same sx's as Schizophrenia, but lasting only 1-6 months - ✔✔Schizophreniform
✔✔Schizoaffective disorder - ✔✔Schizophrenia + Major Depressive episode
(Hallucinations & Delusions persist even when not depressed)
✔✔Brief psychotic disorder - ✔✔Sudden onset of psychotic symptoms
May include delusions, hallucinations, disorganized speech or behavior, or catatonic
behavior
Sx's last >1 day, but <1mo
✔✔Alcohol-related CAGE Questions - ✔✔1. Ever wanted to *C*ut down?
2. Ever get *A*nnoyed when ppl criticize your drinking?
3. Ever feel *G*uilty about drinking?
4. Ever need an *E*ye-opener?
WITH ANSWERS MARKED A+
✔✔Mood Stabilizer used to Tx Bipolar I Disorder w/ predominant depressed state and
may cause an *itchy rash or SJS* - ✔✔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 - ✔✔Valproic Acid (Depakote)
✔✔Mood Stabilizer & Anticonvulsant especially helpful to Tx the *cycling* of Bipolar
Disorder but may cause....... - ✔✔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 -
✔✔Topiramate (Topamax)
✔✔Causes *rapid cycling* in Bipolar Disorder pts - ✔✔The use of *antidepressants* is
C/I in Bipolar Disorder
- leads to mania
✔✔Persistent depressive disorder (Dysthymic disorder) - ✔✔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? - ✔✔Noticeable
change of Depressive Sx's in 2-6 weeks of Rx initiation
✔✔Cyclothymic disorder - ✔✔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 - ✔✔PMS on an anger pill - affecting function
✔✔Major depressive disorder with peripartum onset - ✔✔Dx:
>2wks of SIGECAPS
,Within 4 weeks of childbirth
Tx: *Rest & Support*
Paroxetine
Sertraline - if breast feeding
✔✔Schizophrenia - ✔✔Dx:
*Auditory hallucinations*
Delusions (fixed, false beliefs)
Sx's continue for *at lease 6mo*
Tx: *Olanzapine*
- S/E: *↑ wt gain* unrelated to caloric intake
✔✔Prodromal Sx's of Schizophrenia - ✔✔Social Isolation
New interest in religion/philosophy
Restlessness
Difficulty concentrating
✔✔Positive Sx's of Schizophrenia - ✔✔Delusions
Hallucinations
Strange behaviors
Incoherent thought process
Grossly disorganized
Catatonic behavior
✔✔Negative Sx's of Schizophrenia - ✔✔Flat affect
Decreased fluency
Decreased productivity of thought & speech
Social withdrawal
Decrease in goal-directed behavior
✔✔Rx for acute, agitated psychosis in schizophrenic pts
S/E's seen w/ chronic use - ✔✔Typical 1st Generation Antipsychotics
-Haldol
-Chlorpromazine (corneal deposits)
-Thioridazine (retinal deposits)
S/E: ↑ risk of extrapyramidal symptoms or Neuroleptic Malignant Syndrome
✔✔Extrapyramidal Symptoms (EPS) seen w/ typical antipsychotics high affinity for *D2*
receptors - ✔✔Dystonia "muscle" - hours
Akathisia "rustle" - days
Akinesia "hustle" - weeks
, - Tardive Dyskinesia (haldol)
✔✔Neuroleptic Malignant Syndrome (NMS) seen w/ typical antipsychotic use
*FEVER* - ✔✔*F*ever
*E*levated enzymes (CPK)
*V*itals are unstable (BP)
*E*ncephalopathy
*R*idgity (psudoparkinsonism)
Tx: *Dantrolene* + ice baths
✔✔Atypical antipsychotic known to *↓ rate of suicide* in psychotic patients but can
cause *agranulocytosis* - ✔✔Clozapine (Clozaril) - 2nd Line Tx of schizophrenia due to
S/E's
Absolute C/I to use: Hx of agranulocytosis or myocarditis
✔✔Erroneous beliefs
Grandeur thinking
Disorganized speech
Loose associations
Tangential responses - ✔✔Delusions
Sx's of delusions w/o hallucinations = *Delusional Disorder*
✔✔Onset of schizophrenia based on gender - ✔✔Men: 10-25 y/o
Women: 25-35 y/o
The earlier the onset = the worse the disease
✔✔Same sx's as Schizophrenia, but lasting only 1-6 months - ✔✔Schizophreniform
✔✔Schizoaffective disorder - ✔✔Schizophrenia + Major Depressive episode
(Hallucinations & Delusions persist even when not depressed)
✔✔Brief psychotic disorder - ✔✔Sudden onset of psychotic symptoms
May include delusions, hallucinations, disorganized speech or behavior, or catatonic
behavior
Sx's last >1 day, but <1mo
✔✔Alcohol-related CAGE Questions - ✔✔1. Ever wanted to *C*ut down?
2. Ever get *A*nnoyed when ppl criticize your drinking?
3. Ever feel *G*uilty about drinking?
4. Ever need an *E*ye-opener?
