Answer to Question 1
ANS: D
Modafinil is used to increase wakefulness in patients with excessive sleepiness, including those with shift-work sleep disorder (SWSD). It acts without disrupting nighttime sleep. It is embryotoxic in laboratory animals and therefore is contraindicated during pregnancy. It can increase the heart rate and blood pressure. In rare cases it has been linked to serious skin reactions, including Stevens-Johnson syndrome, erythema multiforme, and toxic epidermal necrolysis.
Answer to Question 2
ANS: C
This patient is showing characteristics of panic disorder. All three major classes of antidepressants are effective, but selective serotonin reuptake inhibitors are first-line drugs. Benzodiazepines are second-line drugs and are rarely used because of their abuse potential. MAOIs are effective but are difficult to use because of side effects and drug and food interactions. Tricyclic antidepressants are second-line drugs, and their use is recommended only after a trial of at least one SSRI has failed.
A road sign telling drivers that there may be devils nearby
A Subject Prepared for a Night’s Sleep in a Sleep Laboratory
Night Attack on the Sanjo Palace (detail), from the Scrolls of Events of the Heiji Period.
Medical assistant working in a front office area of a medical office.
Avoid working with your elbows lifted.
Illustration of mitochondrial swapping, working with oocytes from rhesus monkeys