Psychiatry in the ED Quiz
Preview:
A 21 y/o F presents with dizziness and chest pain. Exam, vitals, troponin, and EKG WNL. Urine hCG is positive. What do you do next?
A. This is a panic attack. Give lorazepam and discharge with OB f/u.
B. Monitor for symptom improvement and provide reassurance. Recommend OB f/u.
How do you differentiate the sedative-hypnotic toxidrome from the opioid toxidrome?
A. HR/BP/RR/Temperature
B. Diaphoresis vs. dry skin
C. Pupils
D. Bowel sounds
What is seen in the sympathomimetic toxidrome that differentiates it from the anticholinergic toxidrome?
A. Decreased respirations, diaphoresis
B. Decreased respirations, dry skin
C. Increased respirations, diaphoresis
D. Increased respirations, dry skin
A 23 y/o F patient presents to the ED with chest pain and SOA. What is your first step in caring for this patient?
A. Anything serious is unlikely at this age, send her home w/psych resources
B. Administer one dose of a benzodiazepine
C. Consult Cardiology immediately
D. Complete history and physical. Order labs, EKG, etc. based on symptoms.
What is seen on EKG with TCA overdose?
A. Bradycardia
B. ST elevation
C. Widening of the QRS
A patient is found to have sympathomimetic toxicity. What must be avoided?
A. Physostigmine
B. Benzodiazepines
C. Fluids
D. Beta blockers
A 53 y/o M comes in to the ED weekly with SOA. Work-up is always unremarkable. What do you do when he presents to the ED again with similar symptoms and you are assigned to care for him?
A. Consult psychiatry
B. Complete a H&P. Order labs, EKG, etc. as appropriate.
C. Reassure this is another panic attack. Discharge with psych f/u.
D. Give patient a benzodiazepine and discharge.
A farmer presents w/numerous symptoms after spraying his garden w/pesticides. Which is NOT a treatment for his symptoms?
A. Atropine
B. Pralidoxime
C. Benzodiazepines
D. Physostigmine
What toxidrome causes pinpoint pupils?
A. Anticholinergic
B. Sympathomimetic
C. Opioid
D. Sedative-hypnotic
With which sympathomimetic must you restrict fluids or use hypertonic saline?
A. Amphetamines
B. MDMA (ecstasy)
C. Cocaine
D. Ephedrine
You diagnose a panic attack in the ED. What do you do next?
A. Give a benzo if appropriate, provide resources, send home w/follow-up
B. Consult psychiatry
C. Send home with a prescription for benzos
D. Admit to the inpatient unit
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