Psychiatry Flashcards
7 cards from real SPEX practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Psychiatry flashcards as text
A 40-year-old man with alcohol use disorder presents with confusion, ophthalmoplegia, and ataxia after 5 days of poor oral intake. What is the immediate treatment?
Answer: IV thiamine 500 mg followed by dextrose
Wernicke encephalopathy requires immediate high-dose IV thiamine before glucose to prevent precipitating or worsening the encephalopathy.
A patient with schizophrenia is non-adherent to oral antipsychotics. She has had three hospitalizations in the past year. What pharmacological strategy best addresses adherence?
Answer: Switch to a long-acting injectable antipsychotic
Long-acting injectable antipsychotics (LAIs) eliminate the need for daily oral adherence and are the preferred strategy for patients with repeated non-adherence-related relapses.
Which of the following is the primary mechanism by which benzodiazepines exert anxiolytic and sedative effects?
Answer: Positive allosteric modulation of GABA-A receptors, increasing chloride conductance frequency
Benzodiazepines are positive allosteric modulators at GABA-A receptors; they increase the frequency of chloride channel opening in the presence of GABA but do not activate the receptor directly.
A psychiatrist is treating a patient who discloses intent to kill a specific identifiable third party. The psychiatrist is located in a state that has a Tarasoff-based duty-to-protect statute. What is the MINIMUM required action?
Answer: Warn the potential victim and/or notify law enforcement
Most state duty-to-protect laws require clinicians to take reasonable steps to protect an identifiable third party, which typically includes warning the victim and/or notifying law enforcement.
A 68-year-old man with major depressive disorder fails to respond to two adequate SSRI trials. Which of the following is a reasonable augmentation strategy with strong evidence?
Answer: Adding lithium to the existing antidepressant
Lithium augmentation of antidepressants has strong evidence for treatment-resistant depression, converting partial responders or non-responders to full response.
A 25-year-old woman with borderline personality disorder presents after self-cutting during a conflict with her partner. She says she either 'loves or hates' people with nothing in between. This defense mechanism is called:
Answer: Splitting
Splitting is the primitive defense mechanism central to BPD, characterized by viewing people or situations as all-good or all-bad without integration of ambivalent feelings.
Which of the following is TRUE regarding informed consent for psychiatric treatment?
Answer: Informed consent requires disclosure of risks, benefits, and alternatives
Informed consent requires that clinicians disclose material information including risks, benefits, and alternatives so the patient can make a voluntary, competent decision.