Kaplan Q bank Q

Prep for USMLE Forum

» Log in | Register

Forum

Step 1

Match

Prep4USMLE Forum » USMLE Step 2 CK Forum » Psychiatry & Ethics

Kaplan Q bank Q

Author

14 Posts

cirus
Forum Guru
avatar

Topics: 108
Posts: 740

07/09/07 - 04:08 AM

A 28 yr old woman comes to the clinic for the first time with symptoms of major depression lasting several weeks. She requests mdications because apart from feeling low & tired, she feels distracted, forgetful, & unable to focus on her work. She reports she was diagnosed as a child with ADHD & dyslexia, & she had been given methylphenidate. She takes no medication at this time. Which of the following would be the most appropriate ttt?

1. Alprazolam

2. Bupropion

3. Lithuim

4. Olanzapine

5. Paroxetine

cirus
Forum Guru
avatar

Topics: 108
Posts: 740

07/09/07 - 02:46 PM

anyone ??

dr in trouble
Forum Guru
avatar

Topics: 60
Posts: 590

07/10/07 - 05:35 PM

Paroxetine?

___________________
If u want to do something, do it today as there is no tomorrow.

cirus
Forum Guru
avatar

Topics: 108
Posts: 740

07/11/07 - 01:45 AM

Thats why I posted it, I answered Paroxetine, But he ans was Bupropion

Kaplans explanation is that its antidep & dopaminergic propert will essentially help this pts sympt, While paroxetine is usefull too but its antichlinergic properties might impair cognitive func

Well i swear ill go nuts, Isn't SSRIs the first line in any dep?????

ts97
Forum Senior

Topics: 13
Posts: 128

07/11/07 - 12:02 PM

We just need to figure out that this is related to her ADHD I think.

ts97
Forum Senior

Topics: 13
Posts: 128

07/11/07 - 12:47 PM

The right answer should be paroxetine. Paroxetine and methylphenidate ARE used together. This is the link:

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retr...

cirus
Forum Guru
avatar

Topics: 108
Posts: 740

07/11/07 - 01:05 PM

Bupropion is also effective for adult attention-deficit hyperactivity disorder[36] and for prevention of seasonal affective disorder[37] and was approved by the FDA for the latter indication( http://en.wikipedia.org/wiki/Bupropion )

So now I think when ADHD + Dep, it is the drug of choice

dr_arc
Forum Senior

Topics: 5
Posts: 156

07/16/07 - 09:46 AM

hey cirus this is really a good one. and all along i thought that bupropion was only used for helping pts quit smoking.

elitoki
Forum Guru
avatar

Topics: 54
Posts: 508

07/16/07 - 03:11 PM

Talking about bupropion...
- what is the side effect of bupropion + nicotine patch?
- what is the side effect of bupropion + MAO inhibitor?

dr_arc
Forum Senior

Topics: 5
Posts: 156

07/17/07 - 07:12 AM

#10

bupropion + nicotine patch = regular BP monitoring. risk of HT

bupropion and MAOI -- hmmmmmm, could be serotonin syndrome? raised eyebrow

elitoki
Forum Guru
avatar

Topics: 54
Posts: 508

07/19/07 - 01:23 PM

#11

bupropion increase risk of suicidal idea in pt who are using MAOi or other kind of antidepressant. Only fluoxetine caused a significant decrease in suicidal ideation/behavior.

dr_arc
Forum Senior

Topics: 5
Posts: 156

07/21/07 - 07:46 AM

#12

thanks elitoki i didnt know that

cirus
Forum Guru
avatar

Topics: 108
Posts: 740

07/22/07 - 04:32 AM

#13

dr_arc wrote:
hey cirus this is really a good one. and all along i thought that bupropion was only used for helping pts quit smoking.

Buproprion is a ver good antidepressant & is used in elderly or pts who suffer from sexual dusfc dt SSRI, the main side effect is that it decreases the seizure threshold so CI in epilept pt or if there is a hist of seizure

gr8doc
Forum Senior

Topics: 8
Posts: 210

08/08/07 - 12:42 PM

#14

Good one everyone. Just to add about Bupropion, its effect is Anorexia & hence causes weight loss ( the only anti depressant causing weight loss rather than gain) so pretty much useful for patients concerned about their weight with other antidepressants.
However, it is contra indicated in patients with Bulimia & Anorexia.

You don't have permission to post.