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Kaplan Qbank USMLE



Author9 Posts
  #1

An 81 year old man with Parkinson's disease and dementia for the past 15 years is admitted to the psychiatric unit following attacks of agitation at home..He has been getting paranoid lately and accusing others of persecuting him and trying to kill him. He has not slept well for the past 2 weeks and has stayed at night talking ot himself.
Which of the following drugs is the most appropriate treatment?

a donepezil
b lorazepam
c Quetiapine
d Risperidone
e Sertraline

This is actually a question in the diagnostic test of Kaplan...i am not sure what to choose for an answer....u can't tell whether they actually mean emergent treatment or treatment (long-term)

  #2

maybe lorazepam to calm him down

  #3

yes i guess so maybe.......but it is so tempting to give him an antipsychotic...hehe

I guess even if the question isn't clear if there is h/o any recent agitation ....might as well just calm him down even if their question isn't so evident
ok Which antipsychotic wld u give him?

  #4

sertraline :?

  #5

You love that confused look....hehehe

No losergirl...i meant antipsychotic....this patient has psychotic symptoms....
come on give it a try

  #6

risperidone then

  #7

Look at the stem of the question....it stresses on this patient not sleeping.......WLd u still give him resperidone......

and another thing ur getting too fast.....hahaha
i can't catch up with u..just kiddin

  #8

u should post the answer n the reason cuz its obvious i am just getting so if i guess this time n get it right, it wont b fair on my part so its better to learn whats the reason of the correct tx

  #9

Well Basically...I am not sure about the test but this question doesn't indicate whether they want an answer as to a patient who is agitated or his long term treatment

for the long term treatment ...this is classical....and i am repeating again very very classical

Any psychotic patient with insomnia.....the answer wld be quetiapine or olanzapine cause their side effect is sedation.......
Previously when the old classical agents where popular Thioridazine with prominent sedative properties was given.........
But Resperidone has very minimal sedative property and shld be given to patients in which sedation is not favored

Hope that expalins it all







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