MSN 671 NEI GLOBAL VIDEO COMPETENCY
REVIEW 2026 MOCK TEST COMPLETE KEY
INSIGHTS
◉ Key metabolic labs before starting antipsychotics.
Answer: CBC, CMP, A1C, lipids, weight/BMI, vitals, ECG.
◉ SGAs with most metabolic risk.
Answer: Olanzapine, clozapine.
◉ Antipsychotics causing most prolactin elevation.
Answer: Risperidone and paliperidone.
◉ TCAs lethal in overdose.
Answer: Cardiac sodium channel blockade → fatal arrhythmias.
◉ SSRI mechanism of action.
Answer: Block SERT, ↑ serotonin in cleft.
◉ Why SSRIs take weeks to work.
, Answer: Delayed 5-HT1A autoreceptor desensitization → increased
serotonin release.
◉ SSRI with longest half-life.
Answer: Fluoxetine (Prozac) (4-16 days metabolite).
◉ SSRI with worst withdrawal.
Answer: Paroxetine (Paxil).
◉ Low-dose vs high-dose trazodone effects.
Answer: Low: H1 + α1 block → sedation; High: SERT inhibition →
antidepressant.
◉ Age group with highest suicidality risk from antidepressants.
Answer: Children 6-12.
◉ Washout needed when switching SSRI → MAOI.
Answer: 2 weeks (except fluoxetine: 5 weeks).
◉ MAOI diet restrictions.
Answer: No tyramine (aged/fermented foods).
REVIEW 2026 MOCK TEST COMPLETE KEY
INSIGHTS
◉ Key metabolic labs before starting antipsychotics.
Answer: CBC, CMP, A1C, lipids, weight/BMI, vitals, ECG.
◉ SGAs with most metabolic risk.
Answer: Olanzapine, clozapine.
◉ Antipsychotics causing most prolactin elevation.
Answer: Risperidone and paliperidone.
◉ TCAs lethal in overdose.
Answer: Cardiac sodium channel blockade → fatal arrhythmias.
◉ SSRI mechanism of action.
Answer: Block SERT, ↑ serotonin in cleft.
◉ Why SSRIs take weeks to work.
, Answer: Delayed 5-HT1A autoreceptor desensitization → increased
serotonin release.
◉ SSRI with longest half-life.
Answer: Fluoxetine (Prozac) (4-16 days metabolite).
◉ SSRI with worst withdrawal.
Answer: Paroxetine (Paxil).
◉ Low-dose vs high-dose trazodone effects.
Answer: Low: H1 + α1 block → sedation; High: SERT inhibition →
antidepressant.
◉ Age group with highest suicidality risk from antidepressants.
Answer: Children 6-12.
◉ Washout needed when switching SSRI → MAOI.
Answer: 2 weeks (except fluoxetine: 5 weeks).
◉ MAOI diet restrictions.
Answer: No tyramine (aged/fermented foods).
