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Chapter 1 Anatomy
1. In L5 root involvement, which among the following is not affected?
A.Thigh adduction
B. Knee flexion
C. Knee extension
D. Toe extension
Ref: B.D Chaurasia 4th. Vol II. 59, 142 Tab 12.1, 148 Tab 12.2
Exp:
Muscles Nerve supply
Knee extension: Quadriceps femoris (main) Femoral N (L2,3,4)
Tensor fascia lata (accessory) Superior gluteal N (L4,5 S1)
Knee flexion: Semitendinosus
Semimembranosus Tibial part of Sciatic N (L5
S1,2)
Biceps femoris
}
Toe extension: Ext. digitorum longus Deep peroneal N (L4,5 S1)
Thigh Adduction: Adductor longus
Adductor brevis
)
Obturator N (L2,3,4Adductor magnus
Pectineus (accessory)
Gracilis ( ,, )
}
Cleft b/w 1st & 2nd toes is supplied by: Deep peroneal nerve (L5) (PGI 1998)
Trendelenberg test is positive in damage of: Superior gluteal nerve (paralysis
of gluteus medius & minimus)
Nerve damaged during venous cut down to access great saphenous vein:
Saphenous nerve (AI
2008)
Largest cutaneous branch of femoral N: Saphenous nerve
Short saphenous vein is accompanied by: Sural nerve (a pure sensory branch
of Tibial nerve)
1) A. Thigh Adduction
2 Rapid Review AIPGMEE 2011
2. Which of the following passes through foramen magnum? (AI 2010)
A. Internal Carotid Artery
B. Sympathetic chain
C. Hypoglossal Nerve
D. Vertebral Artery
Ref: B.D.Chaurasia, 4th, Vol 3. 18
Exp:
STRUCTURES PASSING THROUGH FORAMEN MAGNUM
Apical ligament of dens
Vertical band of cruciate ligament
Membrana tectoria
} Through Anterior part
Vertebral artery
Ant. Spinal artery
Post. Spinal artery
Spinal accessory nerve
Sympathetic plexus around
vertebral arteries
}
Through Subarachnoid space
2) D. Vertebral artery
ANATOMY 3
VERTEBRAL ARTERY
Divisions
V1 : From origin to transverse process of C6 vertebra
Passes through vertebral triangle
V2 : Runs through foramina transversaria of upper six cervical
vertebrae
V3 : Lies in the sub-occipital triangle
V4 : From post. atlanto occipital membrane to the lower border of
pons
Passes through foramen magnum
Pierces duramater, arachnoid & enters subarachnoid space*
(*AIIMS Nov 2005)
Branches
- Cervical branches
· Spinal branches
· Muscular branches
- Cranial branches
· PICA
· Medullary artery
· Ant. spinal artery
· Rarely Post. spinal artery (usually it is a branch of PICA)
20 Rapid Review AIPGMEE 2011
Chapter 2 Physiology
18. Basal metabolic rate is closely associated with:
(AI 2009, 2010)
A. Lean body mass
B. Body surface area
C. Body mass index
D. Body weight
Ref: Ganong. 22nd. 282
Exp:
BMR depends both on lean body mass and body surface area. But it is more
closely related to lean body mass.
Lean body mass gives an estimate of metabolically active components i.e.,
muscles & internal organs
Katch-McArdle formula (BMR based on lean body weight)
BMR (men and women) = 370 + (21.6 X lean mass in kg)
FACTORS AFFECTING BMR
· Genetics. Some people are born with faster metabolisms; some with
slower metabolism.
· Gender. Males > Females. Men have a greater muscle mass and a lower
body fat percentage.
· Age. BMR reduces with age.
· Weight. The heavier you are, the higher your BMR
· Body Surface Area. This is a reflection of your height and weight. The
greater your Body Surface Area factor, the higher your BMR.
Eg. Tall, thin people have higher BMRs.
Exp:
Papez circuit is a complex circuit involved in expression of emotions. It connects
the limbic system with Hypothalamus & Thalamus.
Mammillary body
(Hypothalamus)
Cingulate gyrus
(Limbic system)
Chapter 3 Biochemistry
27. Vitamin K is involved in the post-translational modification of:
(AIIMS Nov 08, May 01)
A. Glutamate
B. Aspartate
C. Lysine
D. Proline
Ref: Harrison 17th. 743
Exp:
Gamma carboxylation of glutamic acid residues is the post-translational
modification involved in Vit.K dependent clotting factors. Reduced Vit.K is the
co-factor involved in this reaction and is converted to Vit.K epoxide.
VIT. K DEPENDENT FACTORS
· Clotting factors II, VII, IX, X
· Protein C, Protein S
· Osteocalcin, Bone Matrix GIa protein
Vit. C is required for post-translational modification of proline & lysine.
(AIIMS Feb 97)
Vitamin excreted in urine is: Vit. C
VIT. C: FUNCTIONS
· Collagen formation
· Capillary integrity
· Absorptionof iron
· Part of ETC (Electron transport chain)
· Thyroxine metabolism
· Prevents atheromatous plaque formation
27) A. Glutamate
BIOCHEMISTRY 33
Vit.A intoxication casues injury to: Lysososmes (AIIMS May07)
Vit. E toxicity affects: Lymphocytes
Bitoin is required for the activity of: Carboxylases (AIIMS May
03)
Exp:
Neuropathy, Ataxia and Retinitis Pigmentosa (NARP) syndrome is a
mitochondrial function disorder arising from mutation of ATP-ase 6
(Complex-5)
MITOCHONDRIAL DISORDERS (maternal inheritance/heteroplasmy)
· MELAS (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis & Stroke)
· Kearns-Sayre syndrome
· NARP syndrome
· Myoclonic Epilepsy with Ragged Red Fibres (MERRF)
· C/c Progressive External Ophthalmoplegia (CPEO)
Retinitis pigmentosa (RP ) is associated with:
· Bassen-Kornzweig syndrome (Abetalipoproteinemia)
· Refsum’s disease
· Usher’s syndrome
· Kearns-Sayre syndrome
28) A. Mitochondrial function disorder
42 Rapid Review AIPGMEE 2011
Chapter 4 Pharmacology
37. Drug of choice for central Diabetes insipidus is:
A. Desmopressin
B. Leuprolide
C. Thiazide diuretics
D. Lithium
Ref: Harrison. 17th. 2220
Exp:
The signs and symptoms of uncomplicated pituitary DI can be eliminated
completely by treatment with desmopressin (DDAVP: 1-desamino-8-D-arginine
vasopressin).
Desmopressin
· Longer acting, V2 selective, synthetic analogue of AVP
-Acts selectively at V2 receptors to increase urine concentration and
decrease urine flow.
-More resistant to degradation than AVP and has 3-4 fold longer
duration of action.
· Uses:
1. DOC for nocturnal enuresis.
2. Also used in Von-Willebrand’s disease
· Routes of administration: I.V, SC injection, Nasal inhalation or Oral.
Drugs used in Nephrogenic DI
1. Thiazide diuretics
2. Indomethacin
3. Amiloride in conjunction with low Na diet
DIDMOAD syndrome (Wolfram’s syndrome): Diabetes insipidus, Diabetes
mellitus, Optic atrophy & Deafness (neural)
SIADH: Characterised by excessive release of ADH (vasopressin) which
enhances the reabsorption of water, resulting in concentrated urine &
hyponatremia.
37) A. Desmopressin
PHARMACOLOGY 43
Treatment of SIADH:
1. Conivaptan (DOC, V2 + V1 antagonist)
2. Demeclocycline
Drugs causing SIADH:
1.Vasopressin
2. Chlorpropamide
3. Vincristine
4. Carbamazepine
5. Nicotine
6. Phenothiazines
7. Cyclophosphamide
8. TCA
9. MOA inhibitors
10. SSRI
Vasopressin receptors Action
V1 a Vasoconstriction
V2 Water absorption in collecting duct via Aquaporin
2VasodilatationRelease of Von-Willebrand factor
& Factor VIII from endothelium
V1b (V3) Release of ACTH from pituitary
Lypressin & Terlipressin (V1+V2 analogues): Both are used for the control
of esophageal variceal bleeding.
38. All are true regarding Selective estrogen-receptor downregulator
(SERD), Fulvestrant except:
A. Used for breast cancer
B. Is a selective estrogen antagonist
C. Is slower acting, safer & less effective than SERM
D. Given as once a month i.m. dose
Ref: Goodman & Gilman 34.
Fulvestrant
Fulvestrant is the first FDA approved agent in the new class of estrogen-receptor
downregulators (SERD), which were hypothesized to have an improved safety
profile, faster onset and longer duration of action than the SERMs due to their
pure ER antagonist activity . It was approved in 2002 for
Chapter 5 Pathology
64) B. Alpha-2-macroglobulin
68 Rapid Review AIPGMEE 2011
METABOLIC SYNDROME (Syndrome X)
Diagnosis requires 3 or more of the following
· Central obesity: Waist circumference > 102 cm (M), > 88 cm (F)
· Hypertriglyceridemia: Triglycerides >150 mg/dL
· Low HDL: <40 mg/dL (M) & <50 mg/dL (F)
· Hypertension: B.P >130 mm systolic or >85 mm diastolic
· Fasting plasma glucose > 100mg/dL
65. Which is not an autoimmune disease?
A. SLE
B. Grave’s disease
C. Myasthenia gravis
D. Sickle cell disease
Exp:
As we know, Sickle cell disease is a hemoglobinopathy and not an
autoimmune disease.
Gamma Gandy bodies are seen in: Sickle cell anemia (AIIMS, Nov
93)
Commonest renal manifestation in Sickle cell trait: Isosthenuria
Sickling: Mutation in Sickle cell anemia leads to: GAG GUG (Adenine is
replaced by Uracil).
In effect, polar glutamic acid is replaced by non-polar valine. The amino acid
substitution creates a site on the surface of the Hemoglobin molecule, sometimes
referred to as “sticky patch”. Only deoxyhemoglobin S has a complementary
site to this sticky patch. Therefore deoxyhemoglobin molecules in the RBC
bind to each other and polymerize into long fibers that distort it’s shape.
Note: Sticky patch is present on both oxygenated & deoxygenated HbS. But, in
oxygenated HbS molecule, the complementary site is masked. This is the reason
behind deoxygenation favouring sickling. (AI, 2009)
Role of HbA in polymerisation: HbA does not contain any sticky patch. But it
does have a binding site for sticky patch. Thus it can bind to HbS but cannot
extend the polymer. That is how HbA interferes with polymerisation.
(AIIMS Nov, 2004)
Chapter 6 Microbiology
78) A. Cholera
82 Rapid Review AIPGMEE 2011
81. A farmer developed swellings in the inguinal region which later ulcerated
along with development of constitutional symptoms. What stain can be
used to detect the bipolar stained organisms? (AI 2006)
A. Albert’s stain
B. Wayson stain
C. Ziehl–Neelsen stain
D. Nigrosin stain
Ref: Harrison 17th. 983
Exp:
This is a case of Bubonic plague and the inguinal smear should be examined
immediately with Wayson or Giemsa stain.
Yersinia pestis
· Gram negative, non-motile, oxidase negative coccobacillus
· Bipolar staining (safety pin appearance)
· Stalactite growth in Ghee broth
· DOC: Streptomycin. The drug used for chemoprophylaxis is
TetracyclineAnother gram-negative bacillus showing bipolar staining, but motile
& oxidase positive is Burkholderia pseudomallei causing Meliodosis.
(AIIMS Nov 2003).
82. Which among the following is the most common fungal infection seen
in immunocompetent patients?
A. Aspergillus
B. Candida
C. Cryptococcus
D. Penicillium marneffei
Ref: 1. Greenwood 16th. 575
2. Textbook of Diagnostic Microbiolgy 3rd. 745
3. Robbins 7th. 397
Exp:
Candida is the most common fungal infection in immunocompetent individuals,
most commonly Candida albicans.
-Prevalence of Aspergillus is second only to Candida albicans.
81) B. Wayson stain 82) B. Candida
FORENSIC MEDICINE 101
Chapter 7 Forensic
Medicine
Exp:
This is a case of Battered Baby syndrome (non-accidental injury of
childhood).
Battered Baby syndrome is characterised by bruises, abrasions & lacerations
of different ages due to direct manual violence. Battered babies are frequently
found to have subdural hematoma & intraocular bleeding due to violent
shaking, so also called ‘infantile whiplash syndrome’. In such cases there is no
fracture of skull or no external injuries on the head or body other than bruises
produced in areas where the child is held by the hands.
Exp:
Soot deposits (blackening) & gun powder on dark coloured fabric & skin can
be better visualised by IR photography.
All tattoos & faint letter marks can be visualised by: IR photography
(AI 1991,2003|AIIMS 1992)
Tests for gun powder detection:
· IR photography
· Dermal nitrate/ Paraffin test (AIIMS Nov 2005)
· Neutron activation analysis
· Atomic absorption spectrophotometry
· Scanning electron microscopy with Xray analyser
Black gun powder (smoke producing) contains: Pot. Nitrate, Sulphur,
Charcoal (PGI Dec 2006|AIIMS 1997)
Smokeless gun powder contains: Nitrocellulose & nitroglycrine
The terms FG, FFG, FFFG are used to describe: Black gun powder (depending
on size of grains) (PGI Jun 2007, Dec 2008)
Dried semen stain on clothes is identified by: UV light (AIIMS Nov 2009)
106. Signature fracture refers to: (AIIMS May 2006)
A. Depressed skull fracture
B. Suture displacement fracture
C. Contrecoup injury
D. Fracture at foramen magnum
Ref: Reddy, 25th. 209
Exp:
Depressed fracture is also known as Signature fracture (fracture-ala signature),
as their pattern often resembles the weapon or agent which caused it.
Chapter 8 Community
Medicine
113. Which is not true regarding diet modification recommended in high
cardiovascular risk groups?
A. Cholesterol less than 100 mg/1000kcal/day
B. Avoid alcohol
C. Fat intake < 10% of total calories
D. Salt limitation to less than 5 gm
Ref: Park 20th. 320
Exp:
The WHO committee considers the following dietary changes necessary for
prevention of CHD
· Reduction of fat intake to 20-30% of total energy intake
· Saturated fat < 10% of total energy intake
· Cholesterol <100mg/1000kcal/day
· Increase in complex carbohydrate consumption
· Avoid alcohol
· Salt intake <5g/day
114. Orthotoluidine test is used for detecting: (AIIMS Nov 04,PGI June 06)
A. Chlorine
B. Nitrites
C. Nitrates
D. Ammonia
Ref: Park 20th. 626
Exp:
-Orthotoluidine test determines both free and combined chlorine in water
together.
Methods of chlorination:
1. Chlorine gas
2. Chloramine
3. Perchloron (High Test Hypochlorite)-contains 60-70% of available chlorine.
Chlorine kills pathogenic bacteria, but has no effect on spores and certain
viruses (Eg. polio, viral hepatits) except at high doses (Superchlorination).
Ozone and UV radiation are more effective than chlorine (have virucidal effect
also). But there will be no residual germicidal effect.
Bleaching powder (CaOCl2) contains 33% available chlorine. Used for
household purification.
Drinking water requires a residual chlorine level of 0.5 ppm for a contact
period of 1 hour. (AIIMS May04)
In post disaster period: 0.7 ppm for contact period of 1 hour.
Swimming pool disinfection : 1 ppm for 1 hour.
ENT 129
Chapter 9 ENT
137. A 5 year old boy while having dinner suddenly becomes aphonic and
is brought to the casualty with complaint of respiratory distress. What
should be the appropriate management? (AIIMS1999|AI2002)
A. Cricothyroidotomy
B. Emergency tracheostomy
C. Humidified oxygen
D. Heimlich manoeuvre
Ref: Dhingra 3rd. 389
Exp:
This is a case of laryngeal foreign body. Emergency management, especially
when the patient is not in a hospital setup is Heimlich’s manoeuvre. Stand
behind the patient and place your arms around his lower chest and give
strong abdominal thrusts. In pediatric patients pounding the back after
turning the patient head down may be tried. If all attempts fail,
cricothyrotomy (laryngotomy) should be performed. It should be converted
to tracheostomy later.
138. Time of occurrence of secondary haemorrhage after tonsillectomy:
(JIPMER 2003)
A. 24 hrs
B. 6 days
C. 12 days
D. 12 hrs
Ref: Dhingra 3rd. 492
Chapter 10 Ophthalmology
145. Which of the following is the most probable diagnosis in a young patient
with loss of central vision and a normal ERG with no family history?
A. Best’s disease
B. Stargardt’s disease
C. Retinitis pigmentosa
D. Central macular hole
Ref: Kanski Ophthalmology 5th. 498, 507
Exp: Patient with loss of central vision & normal ERG, narrows down our
diagnoses to Best’s disease & Stargardt’s disease. However, Best’s disease
can be excluded as it usually appears during childhood & family history
will be invariably present as the condition is autosomal dominant.
Stargradt’s disease usually manifests in young individuals (late second decade
& third decade) & it does not usually have a family history as the condition
is AR.
Stargardt’s Disease
Clinical features
· AR disorder
· Most common form of inherited juvenile macular dystrophy
· Characterised by B/L discrete yellowish flecks of lipofuschin deposition in
the macula
· Macular damages start to occur b/w 6 -20 yrs though visual impairment
becomes apparent in the 3rd decade
· Patients typically present after 20 yrs with gradual blurring of central vision
& black or hazy spots in the centre of their vision
· Vision suddenly deteriorates thereafter
Investigations
Fluorescein angiography: Investigation of choice (shows dark choroid)
Electroretinogram (ERG), (Electrooculogram) (EOG): Usually normal or may
be subnormal
Chapter 11 Medicine
155. A girl presented with recurrent occipital headache associated with
ataxia and vertigo. There is history of her mother having similar
complaints. Most probable diagnosis is: (AIIMS Nov 2009)
A. Vestibular neuronitis
B. Basilar migraine
C. TIA
D. –
Ref: Harrison’s 17th. 141
Exp: The above mentioned clinical scenario correlates with Basilar migraine.
Ataxia is due to involvement of cerebellar nuclei and vertigo due to
vestibular nuclei. Both are supplied by branches of basilar artery.
Basilar Migraine: It can be familial and classically the pain is occipital.
Clinical features
· Occipital headache
· Visual symptoms
· Dysarthria
· Ataxia
· Vertigo
· Tinnitus
Retinal migraine: Migraine with involvement of retinal circulation which causes
unilateral photopsia/transient monocular blindness.
Ophthalmoplegic migraine: Migraine with transient, partial 3rd nerve palsy.
(AIIMS May, 2003)
Hemiplegic migraine: AD trait characterized by episodes of hemiparesis along
with migraine.
MIGRAINE
With aura: Classical migraine (*AIIMS Jun, 2000|AI 2001)
· Recurrent U/L headache with nausea/vomiting & preceded by an aura
which is usually a disturbance of nervous function
Eg. Photopsia, Scintillating scotoma, Paresthesia–lips, face &
hands*, Transient weakness, Aphasia, Dysarthria etc.
Without aura: Common migraine
· 5 times more common than classical migraine
· No aura preceeding headache
· Nausea/ vomiting +
· Hemicranial throbbing headache usually affecting frontotemporal part
· Sensitivity to light & noise is characterisitic
Chapter 12 Surgery
195. A surgeon removed the part of liver to the left of the falciform ligament.
Which segments have been removed? (AI 2008)
A. 1 & 4a
B. 2 & 3
C. 1 & 4b
D. 5 & 6
Ref: Bailey 24th. 1063: Fig 63.2, 18: Fig 2.24
Exp:
Resection of segments II and III is a commonly performed sublobar
resection and is often referred to as a left lateral segmentectomy and
left lateral sectionectomy or left lobectomy. Left lobe is that part of
liver to the left of the falciform ligament.
Couinad & Bismuth (French) classification
(Functional segmental liver anatomy)
-Liver is divided into 8 functional segments based on distribution of He-
patic vein (mainly) & Portal vein.
(AI 2004)
-Couinaud's segments are numbered in anti-clockwise direction when liver
is visualized from posterior surface.
· Segment I is called Caudate lobe
· Segment IV is called Quadrate lobe
(*line passing through gall bladder fossa, middle hepatic vein & IVC)
The lobe enlarged in Budd-Chiari syndrome: Caudate lobe
Chapter 14 Orthopaedics
247. A 65 yrs old lady presented with a swollen and painful knee. On
examination, she was found to have grade III osteoarthritic changes. What
is the best course of action?
A. Conservative management
B. Arthroscopic washing
C. Partial knee replacement
D. Total knee replacement
Ref: 1. Campbell 11th. 916
2. Apley‘s 9th. 573
Exp:
The radiological grading system for OA is Kellgren-Lawrence scale given below.
However, the treatment of OA is not dependent on radiological grading. It is
only based on symptoms & disability of the patient. Moreover, the radiological
grading may not correlate with symptomatology.
Kellgren-Lawrence Grading Scale
Grade 1: doubtful narrowing of joint space and possible osteophytic lipping·
Grade 2: definite osteophytes, definite narrowing of joint space·
Grade 3: moderate multiple osteophytes, definite narrowing of joints space,
some sclerosis and possible deformity of bone contour·
Grade 4: large osteophytes, marked narrowing of joint space, severe sclerosis
and definite deformity of bone contour
The patient in the question is 65 yr old & is having swollen & painful knee.
The best treatment here is Total knee replacement.
Treatment options for OA
Chapter 15 Pediatrics
Chapter 16 Dermatology
b. Facultative tuberculides:
1.Erythema nodosum
2. Erythema induratum (Nodular tuberculid)
Most common type of cutaneous TB: Lupus vulgaris (Apple jelly
nodules) (PGI Dec 2006)
Lupus vulgaris: Cutaneous TB characterized by erythematous, annular,
irregularly indurated plaque with central scarring.
(AIIMS Nov 2001, Nov 2003)
Erythematous lesion with central crusting: Cutaneous Leishmaniasis
Lesion with central clearing: Tinea corporis
Cutaneous TB secondary to underlying TB lymphadenitis: Scrofuloderma
(AI 1999)
Chapter 17 Anaesthesiology
273. Spinal anesthesia is given at: (AI 1997)
A. L1-L2
B. L2-L4
C. S1
D. Thoracic segment
Ref: Morgan’s Anaesthesiology 3rd. 253
Exp:
-Spinal anesthesia is usually performed at the level of the L3 or L4 vertebrae
in the adult patient, because the spinal needle is introduced below the level at
which the spinal cord ends (lower border of L1).
-In children, as spinal cord extends upto upper border of L3, spinal
anesthesia is given at L4-L5 interspace.
274. Epileptogenic anesthetic agent of the following is:
A. Desflurane
B. Halothane
C. Sevoflurane
D. Ether
Ref: Web. http://www.ncbi.nlm.nih.gov/pubmed/14581667
Sevoflurane consistently produces cortical epileptiform discharges and is dose
dependently epileptogenic at surgical levels of anesthesia.
Inhalational anesthetic agents C/I in patients with h/o epilepsy: Enflurane &
Etomidate (AIIMS 2003)
275) A. Ketamine
RADIODIAGNOSIS 283
Chapter 18 Radiodiagnosis
285) A. 2.5-5 Gy
284 Rapid Review AIPGMEE 2011
286. Aortic knuckle shadow on chest X-ray, PA view is obliterated by
consolidation of which portion of lung?
A. Upper lingula
B. Lower lingula
C. Apex of lower lobe
D. Posterior part of upper lobe
Ref: Thoracic Imaging by W.Richard Webb & Charles B. Higgins P.39 &
P.43, Fig 2-19
Exp:
On PA/AP chest radiograph, obscuration of specific contours can be
related to abnormalities in specific lobes. (*AIIMS May 2008)
· Right Superior mediastinum (SVC) = Right upper lobe
· Right heart border = Right middle lobe
(*Silhouette sign)
· Right hemidiaphragm = Right lowerlobe
· Left superior mediastinum = Left upper lobe
(aortic knuckle)
· Left heart border = Lingular segments of
left upper lobe
(Silhouette sign)
· Left hemidiaphragm/ Desc. Aorta = Left lower lobe
Chapter 19 Psychiatry
293. A 40yr old female patient presented with depressed mood, loss of
appetite and no interest in surroundings for the past 1yr. There is associated
insomnia. These symptoms followed soon after a business loss 1yr
back.Which of the following statements is true regarding the management
of this patient?
A. No treatment is necessary as it is due to business loss
B. SSRI is the most efficacious of the available drugs
C. Antidepressant treatment is based on the side effect profile of the drugs
D. Combination therapy of 2 anti depressant drugs
Ref: Kaplan & Sadock’s 10th 559
Exp:
This lady is having depression, and needs antidepressant medication.
Selection of Initial Medication
The available antidepressants do not differ in overall efficacy, speed of
response, or long-term effectiveness.
Antidepressants, however, do differ in their pharmacology, drug-drug
interactions, short- and long-term side effects, likelihood of discontinuation
symptoms, and ease of dose adjustment.