Chapters 38, 40, 41 With complete solu$on Latest
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Which of the following SSRIs requires up to a 5-week washout period because of the
long half-life of its potent ac ve metabolite?
A. Escitalopram
B. Fluvoxamine
C. Fluoxe ne
D. Sertraline - Ans C
Which of the following symptoms is most likely to improve within approximately 1 week
of star ng treatment?
A. Depressed mood
B. Suicidal thoughts
C. Anhedonia
D. Sleep - Ans D
Of the following combina ons of medica ons, which one would you want to avoid?
A. Fluoxe ne-lithium
B. Fluoxe ne-phenelzine
C. Citalopram-valproic acid
D. Citalopram-aripiprazole - Ans B
A 26-year-old man with a history of depression has been taking sertraline 200 mg/day for 12
weeks with no response. The pa ent has no other complica ons. The physician asks for your
recommenda on. The most reasonable recommenda on would be to:
,A. Increase sertraline
B. Add fluoxe ne
C. Switch to amitriptyline
D. Change to venlafaxine
E. Decrease sertraline - Ans D
Which of the following is a dangerous combina on?
A. MAOI-lorazepam
B. MAOI-acetaminophen
C. MAOI-meperidine
D. MAOI-ziprasidone - Ans C
A 23-year-old married white woman comes to the outpa ent psychiatric clinic
complaining of decreased sleep, decreased appe te, decreased concentra on, depressed
mood, thoughts of death, and lack of interest in ac vi es for 6 weeks' dura on. She has
no history of psychiatric illness and takes no medica ons except for Ortho-Tri Cyclen Lo
daily. Based upon the pa ents symptoms, choose the best medica on to treat this pa ent.
A. Nefazodone 100 mg po twice daily
B. Paroxe ne 20 mg po daily
C. St. John's wort 300 mg po three mes daily
D. Amitriptyline 25 mg at bed me - Ans B
A 36-year-old man is admi;ed to the hospital for a severe methicillin-resistant Staphylococcus
aureus diabe c foot infec on and is started on linezolid 600 mg IV every 12 hours. His
medica on profile includes paroxe ne 40 mg every morning, trazodone 100 mg at bed me as
needed for sleep, and me@ormin 1000 mg po twice daily. AAer 3
, days on these medica ons, the pa ent becomes agitated, confused, and diaphore c and
develops myoclonic jerks. Which of the following is the most likely diagnosis?
A. Overdose of me@ormin
B. Bacterial meningi s
C. Neurolep c malignant syndrome
D. Serotonin syndrome - Ans D
A 46-year-old woman presents to the psychiatric outpa ent clinic for follow-up treatment of
major depression. She is currently on paroxe ne 10 mg at bed me, which she started taking 2
months ago when admi;ed to the psychiatric hospital for suicidal idea on. During the
interview, she says that she does not think the medica on is working because she is just as
depressed as she was before taking the medica on and has recently started drinking eight to 10
beers daily to alleviate the depression. Before this episode, she was
sober for 4 years. Which of the following treatment strategies would be the appropriate choice
for this pa ent?
A. Stop the paroxe ne and start nefazodone 100 mg po twice daily
B. Increase the dose of paroxe ne to 20 mg po at bed me
C. Stop the paroxe ne and start duloxe ne 20 mg/day
D. Con nue the paroxe ne at them same dose for a longer period of me to evaluate
whether she will res - Ans B
Which of the following is a flaw in the monoamine hypothesis of depression?
A. Concentra ons of neurotransmi;ers are reduced in the synap c cleA
B. A switch to a different class of an depressants does not improve response
C. An depressant response is associated with a therapeu c level of the medica on
D. An depressant effects on neurotransmi;ers do not temporally correspond to response. - Ans
D