QUESTION: 25

After starting Antidepressant drug, if patient is not improving then when you decide to stop drugs?

3-4 weeks
1 day
1 week
2 weeks

Answer(s): A

Explanation:

Some people notice an improvement within a few days of starting treatment. However, an antidepressant often takes 2-4 weeks to build up its effect and work fully. Some people stop treatment after a week or so thinking it is not helping. It is best to wait for 3-4 weeks before deciding if an antidepressant is helping or not.
If poor sleep is a symptom of the depression, it is often helped first, within a week or so. With some types of tricyclic antidepressant, the initial dose that is started is often small and is increased gradually to a full dose. (One problem that sometimes occurs is that some people remain on the initial dose which is often too low to work fully.) If you find that the treatment is helpful after 3-4 weeks, it is usual to continue. A normal course of antidepressants lasts at least six months after symptoms have eased. If you stop the medicine too soon, your symptoms may rapidly return. Some people with recurrent depression are advised to take longer courses of treatment (up to 2 years or longer)

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QUESTION: 26

A young woman fell and hit her knee. Exam: valgus test +ve. What ligament was most probably injured?

Lateral collateral
Ant cruciate
Post cruciate
Medial collateral
Meniscus

Answer(s): D

Explanation:

Medial collateral. The valgus stress test involves placing the leg into extension, with one hand place on the knee. With the other hand placed upon the foot applying an abducting force, an attempt is then made to at the knee into valgus. If the knee is seen to open up on the medial side, this is indicative of medial collateral damage.

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QUESTION: 27

A 32-year-old man with schizophrenia and a history of violence and distressing auditory hallucinations was a ward with aggressive behavior and has already smashed his room. He is refusing any oral meds.
What is the s appropriate injection?

Flupenthixol
Risperidone
Haloperidol
Fluphenazine

Answer(s): B

Explanation:

Protocol of treating agitated violent patient.
1. Try to talk to the patient but don't touch him.
2. If he agrees on oral meds, give oral atypical antipsychotics olanzapine, risp or quetiapine
3. If refusing oral, give IV atypical antipsychotics preferably its Olanzapine or Risperidone
4. If agitation not controlled give IM Lorazepam
5. If that doesn't work, give IV Haloperidol as last resort.
6. If acute sedation is required, for immediate effect give IV Diazepam.

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QUESTION: 28

A 14-year-old girl presents with primary amenorrhea and a short stature.
What is the most likely diagnosis?

Down's syndrome
Fragile X syndrome
Turner's syndrome
Klinefelter's syndrome
Normal finding

Answer(s): C

Explanation:

Down's syndrome and Fragile x syndrome don't have primary amenorrhea. Klinefelter's patients are tall males. So the likely diagnosis is Turner's syndrome.

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