Answer targeted questions : PSY-Q

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Aggression

Antianxiety

Antidepressants

Antipsychotics

Anxiety disorders

Augmentation agents

Bipolar and related disorders

BRAIN / NNCI

Cognitive enhancers

Depressive disorders

Disorders (includes substance/medication, medical condition - induced)

Disruptive, impulse control, conduct

Dissociative disorders

Environmental - Risk/Protective Factors

Feeding and eating disorders

Gender Dysphoria

Mood stabilizers

Neurocognitive disorders

Neurodevelopmental

Non-Suicidal - Self-injurious behavior

Obsessive-compulsive and related disorders

Other High Risk Behaviors

Other mental disorders

Paraphilic disorders

Personality disorders

Psychogenomics

Psychostimulants

Schizophrenia spectrum/ other psychotic disorders

sedative-hypnotics

Sexual dysfunctions

Sleep-wake disorders

Somatic symptom and related disorders (may include pain syndromes)

Substance-related and addictive disorders

Suicidality

Trauma and stressor-related disorders

Question : 1 / 258

A 39-year-old woman with a history of generalized anxiety disorder on escitalopram who works as a restaurant manager is diagnosed with acute myelogenous leukemia and undergoes an allogenic stem cell transplant from an unrelated donor. Which of the following statements most accurately reflects considerations for her psychiatric management in the post-transplant period?

Returning to work 2 months post-transplant is feasible in the absence of medical complications and may reduce risk of worsening depression and anxiety
Because escitalopram has the highest degree of serotonin reuptake inhibition among SSRI's, the patient should be monitored closely for bleeding post-transplant
Having a donor who is not a 10/10 match may increase anxious cognitions pre- and post-transplant in a patient with GAD
Medical PTSD is more common than delirium in the HSCT population
THe risk of delirium peaks at 1 month post stem cell infusion/transplantation

The correct answer is C. Donor mismatch may lead to anxious cognitions. A is incorrect because pts must remain in isolation for 100 days post transplant. B is incorrect because fluoxetine, paroxetine and sertraline have the highest risk of serotonin reuptake inhibition and are more frequently associated with bleeding problems. D and E are incorrect because delirium (35% prevalence) is more common than PTSD (20% prevalence) in HSCT patients and peaks at 2 weeks after infusion.

Publication reference : Amonoo HL, Massey CN, Freedman ME, et al. Psychological considerations in hematopoeitic stem cell transplantation. Psychosomatics 2019; 60: 331-342
Reference URL: https://www.ncbi.nlm.nih.gov/pubmed/31072626

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