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 cocaine-induced MI cocaine due to sympathetic overactivity causes hypertension. cocaine also activates platelets leading to thrombus formation and MI. therefore, aspirin is prescribed in cocaine induced MI. schedule patient for PCI. Benzodiazepine is first line treatment. if patient's pain is not relieving ,then you can give CCB but do not give beta blocker. we can give phentolamine for persistent hypertension.

 psychiatry  1. definition of major depression : if 5 out of 9 symptoms persist for more than 2 weeks symptoms can be remembered with mnemonics: low mood SIGECAPS S-sleep I-loss of interest G-guilty/ worthlessness E-lack of energy C- concentration/ attention A-Appetite loss P-psychomotor changes S-suicidality Low mood In adjustment disorder, the precipitant can be anything except bereavement. what is the difference between normal grief vs major depression? In normal grief about the death of a loved one, the idea ruminates around that loved one only. she may think she would have died with her loved ones. She can feel auditory/visual hallucinations of her loved ones. But these do not significantly impair daily life functioning. these episodes occur intermittently but in major depression, these symptoms are persistent. In major depression, there is greater social and occupational dysfunction. 2. How to differentiate schizoaffective disorder from mood disorder with psychotic features and

 Treatment of ADHD first-line treatment is drugs in children aged 6 and above. In children below 6 years, the first line of treatment is behavioral therapy. Among drugs, first, try stimulants (amphetamine/ methylphenidate). Second-line options are atomoxetine and clonidine.  what is the mechanism of action of atomoxetine norepinephrine reuptake inhibitor How to titrate the dose of the stimulant? we should titrate it every week until max dose is reached or the patient experiences intolerable side effects. H ow long to wait to see whether the stimulant will be effective? its effect is seen within 1 week. if the patient does not feel improvement within 1 week, change to alternate medications. what are the features of stimulant toxicity? diaphoresis, mydriasis, tachycardia, hypertension, dilated pupil, anxiety, agitation, psychosis, decreased appetite cannabis intoxication also causes tachycardia, and hypertension; then how to differentiate it from stimulant toxicity? in cannabis intoxicat

 Difference between serotonin syndrome (SS) and neurolept malignant syndrome (NMS): in SS, a patient has neuromuscular hyperactivity (hyperreflexia, myoclonus, ocular clonus) instead of bradykinesia and rigidity in NMS. Fluoxetine has a half-life of 5 weeks, so, before switching to MAOi, wait for 5 weeks because it will cause serotonin syndrome.

  Beta blocker toxicity clinical features CVS: hypotension and bradycardia hypoglycemia, hyper kalemia bronchospasm CNS: mental status changes, Seizure, coma D/D for bradycardia: CCB poisoning, digoxin poisoning, poisoning with clonidine and cholinergic agents

 HPV vaccination in boys/ girls: Vaccination at 9-12 years of age (if missed then can take till 26 years of age) what are the conditions where it can be given after 26 years of age? answer: HCPs who are involved in surgery of HPV wounds; people who have not been previously exposed to HPV due to few sexual partners schedule of vaccination: under 15 years of age: 2 vaccinations at 6 months apart if the age is more than 15 years or immunocompromised patients, give 3 vaccination: 0, 1-2month and 6 month