Chapter·PsychiatrySchizophrenia

Treatment-resistant schizophreniaDownloads

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Sample Questions

1

A 37-year-old woman presents with a 3-day history of fever. Past medical history is significant for chronic schizophrenia, managed with an antipsychotic medication. The patient has a low-grade fever and is slightly tachycardic. Physical examination is significant for the presence of tonsillar exudates. A CBC shows a markedly decreased WBC count. The patient’s antipsychotic medication is immediately discontinued. Which of the following is the antipsychotic medication that could have caused this problem?

AHaloperidol

BRisperidone

COlanzapine

DQuetiapine

EClozapine

2

A 22-year-old male with a history of difficult-to-treat bipolar disorder with psychotic features is undergoing a medication adjustment under the guidance of his psychiatrist. The patient was previously treated with lithium and is transitioning to clozapine. Which of the following tests will the patient need routinely?

AThyroid-stimulating hormone, prior to introducing the medication

BBasic metabolic panel, weekly

CHemoglobin A1c, weekly

DDexamethasone suppression test, monthly

EComplete blood count, weekly

3

A 45-year-old obese man is evaluated in a locked psychiatric facility. He was admitted to the unit after he was caught running through traffic naked while tearing out his hair. His urine toxicology screening was negative for illicit substances and after careful evaluation and additional history, provided by his parents, he was diagnosed with schizophrenia and was treated with aripiprazole. His symptoms did not improve after several dosage adjustments and he was placed on haloperidol, but this left him too lethargic and slow and he was placed on loxapine. After several dosage adjustments today, he is still quite confused. He describes giant spiders and robots that torture him in his room. He describes an incessant voice screaming at him to run away. He also strongly dislikes his current medication and would like to try something else. Which of the following is indicated in this patient?

AHaloperidol

BOlanzapine

CChlorpromazine

DFluphenazine

EClozapine

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