Alright, let’s sit down and wrap up this week’s medical trivia questions! I’m excited to walk you through each one, break down the correct answers, and explain why the other options don’t quite fit. Let’s dive in!
Question 1: A man on venlafaxine reports sweating, fast heartbeat, and tremors after starting a new herbal supplement. What condition should be suspected?
Options: A) Diabetes B) Serotonin syndrome C) Panic attack D) Stroke
Correct Answer: B) Serotonin syndrome
Explanation:
Venlafaxine is an SNRI (serotonin-norepinephrine reuptake inhibitor), a kind of medication which boosts serotonin levels in the brain to treat depression or anxiety. Now, imagine serotonin levels getting too high—that’s where serotonin syndrome comes in. It’s a potentially serious condition caused by excessive serotonin, often triggered when someone mixes an antidepressant like venlafaxine with another substance that also raises serotonin, like certain herbal supplements (St. John’s wort is a classic culprit). Symptoms include sweating, fast heartbeat, tremors, agitation, and, in severe cases, confusion or seizures. The timing here—starting a new herbal supplement—raises a red flag for serotonin syndrome.
Why the other options don’t fit:
A) Diabetes: Diabetes can cause sweating or a fast heartbeat if blood sugar drops (hypoglycemia), but tremors aren’t typical, and there’s no link to starting a new supplement. The symptoms here point more to a neurological or neurotransmitter issue than a metabolic one.
C) Panic attack: Panic attacks can mimic some symptoms, like a fast heartbeat and sweating, but tremors are less common, and panic attacks are usually triggered by stress or anxiety, not a new supplement. The connection to the herbal supplement strongly suggests a drug interaction.
D) Stroke: Strokes cause neurological symptoms like weakness, slurred speech, or confusion, but sweating, fast heartbeat, and tremors aren’t typical. Plus, strokes don’t usually correlate with starting a new supplement.
Question 2: A patient on amitriptyline (a tricyclic antidepressant) reports dry mouth, constipation, and blurred vision. What’s the likely cause?
Options: A) Allergic reaction B) Wrong dose C) Anticholinergic side effects D) Dehydration
Correct Answer: C) Anticholinergic side effects
Explanation: Amitriptyline is a tricyclic antidepressant, and one thing you need to know about this class of drugs is that they block acetylcholine, a neurotransmitter(aka Brain chemical) involved in many bodily functions. This blocking action leads to what we call anticholinergic side effects. Think of it like hitting the brakes on your parasympathetic nervous system( The body system that calms you down), which controls things like saliva production, digestion, and eye focus. Dry mouth happens because saliva glands slow down, constipation occurs because gut motility decreases, and blurred vision comes from trouble focusing the eyes. These are classic side effects of amitriptyline and other tricyclics.
Why the other options don’t fit:
A) Allergic reaction: Allergic reactions typically involve symptoms like rash, itching, swelling, or breathing trouble. Dry mouth, constipation, and blurred vision don’t fit that pattern—they’re more specific to how the drug affects the nervous system.
B) Wrong dose: While a high dose could worsen side effects, these symptoms are expected even at standard doses of amitriptyline because of its anticholinergic properties. There’s no evidence here suggesting an overdose.
D) Dehydration: Dehydration might cause dry mouth, but it doesn’t typically lead to constipation or blurred vision in this specific combination. These symptoms align better with the drug’s mechanism than a general condition like dehydration.
Question 3: A patient on antidepressants wants to stop them after 2 weeks because they don’t feel better. What is the right advice?
Options: A) Stop the medication, change to another one B) Increase the dosage of the medication C) Continue for at least four to six weeks then review D) Recommend herbal therapy
Correct Answer: C) Continue for at least four to six weeks then review
Explanation: Medications used to treat depression like SSRIs, SNRIs, or tricyclics don’t work overnight. They need time—usually 4 to 6 weeks—to build up in your system and start balancing the brain’s neurotransmitters, like serotonin or norepinephrine, which help improve mood. If a patient stops after just 2 weeks, they haven’t given the medication a fair chance to work. The best advice is to stick with it for at least a month, then check in with their doctor to see how things are going. Stopping too early could mean missing out on benefits that are just around the corner.
Why the other options don’t fit:
A) Stop the medication, change to another one: Switching medications after only 2 weeks is premature. Most antidepressants take time to show effects, and changing too soon could disrupt treatment without good reason.
B) Increase the dosage of the medication: Increasing the dose this early isn’t usually recommended unless there’s a specific reason, like severe side effects or no response after a longer trial. Plus, it risks more side effects without giving the current dose time to work.
D) Recommend herbal therapy: Herbal therapies, like St. John’s wort, can interact dangerously with antidepressants (remember serotonin syndrome from Question 1?). Plus, there’s no evidence here that herbal therapy is a better option than continuing a prescribed treatment.
Question 4: A patient with depression starts an antidepressant and feels more energetic after one week but still has low mood. What’s a concern during this early phase?
Options:
A) The drug isn’t working
B) Side effects are gone
C) Increased suicide risk due to more energy
D) He is cured
Correct Answer: C) Increased suicide risk due to more energy
Explanation:
This is a critical point about treating depression. Antidepressants can sometimes boost energy levels before they fully lift mood, especially in the first couple of weeks. For someone with depression, this can be risky. If they’re still feeling hopeless but now have the energy to act on those feelings, their risk of suicide might increase. This is why doctors closely monitor patients in the early weeks of treatment, especially younger adults or those with suicidal thoughts before starting the medication. It’s not that the drug is failing—it’s just that energy and mood don’t always improve at the same pace.
Why the other options don’t fit:
A) The drug isn’t working: It’s too early to say the drug isn’t working after just one week. Antidepressants typically take 4–6 weeks to show full effects, and increased energy is actually a sign the drug is starting to act.
B) Side effects are gone: The question doesn’t mention side effects, so this option doesn’t apply. Feeling energetic is more about the drug’s therapeutic effect than side effects disappearing.
D) He is cured: Low mood is still present, so the patient isn’t cured. Increased energy is a partial response, not a full recovery.
Question 5: James, 32, has been feeling sad and tired for weeks. He no longer enjoys football, sleeps poorly, and has lost weight without trying. What’s the most likely diagnosis?
Options:
A) Anxiety disorder
B) Depression
C) Schizophrenia
D) Burnout
Correct Answer: B) Depression
Explanation:
James’s symptoms paint a classic picture of depression. Feeling sad and tired for weeks, losing interest in things he used to love (like football), poor sleep, and unintentional weight loss are all hallmark signs of major depressive disorder. Depression affects mood, energy, sleep, appetite, and pleasure in activities, and these symptoms need to persist for at least two weeks to meet the diagnostic criteria. James’s case checks all those boxes, making depression the most likely diagnosis.
Why the other options don’t fit:
A) Anxiety disorder: Anxiety can cause tiredness or poor sleep, but it’s more about excessive worry, restlessness, or panic. James’s loss of interest in football and weight loss point more to depression than anxiety.
C) Schizophrenia: Schizophrenia involves symptoms like hallucinations, delusions, or disorganized thinking, none of which are mentioned here. James’s symptoms are mood-related, not psychotic.
D) Burnout: Burnout is stress-related and often tied to work, with symptoms like exhaustion and cynicism. While it can overlap with depression, James’s weight loss, low mood, and loss of interest in hobbies suggest a broader, more clinical condition like depression.
Summary
It was a good week. These questions really shows how nuanced mental health treatment can be—whether it’s recognizing side effects, understanding medication timelines, or spotting serious risks. If any of these topics hit home or sparked questions, talk to a healthcare provider for personalized advice. I’ll be back next week with more trivia to keep us learning together. Until then, take care and stay curious!