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step3 > 2014-03-07 USMLE Psych - USMLE Psych > Flashcards

2014-03-07 USMLE Psych - USMLE Psych Flashcards

1
Q

Age of onset of schizophrenia

A

Men 15-25

Women 25-35

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2
Q

Prevalance of schizoprenia

A

1% in most cultures

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3
Q

List the differences between psychotic disorders

A

6 month = schizophrenia

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4
Q

Why are atypical antipsychotics preferred for maintainence therapy in psychotic disorders?

A

less EPS and better effect on negative symptoms

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5
Q

Onset of dystonia if EPS reaction?

A

hours to days

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6
Q

Treatment of acute dystonia

A
  • anithistamines (diphenhyd)

- anitcholinergics (benztropine, trihexyphenidyl)

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7
Q

Onset of akathisia if EPS reaction

A

within days

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8
Q

Treatment of akathisia

A

can try b-blockers

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9
Q

Onset of parkinsonism if EPS reaction

A

within months of treatment

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10
Q

Parkinsonism from EPS most common in

A

older women

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11
Q

Acute dystonia from EPS most common in

A

young men

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12
Q

Onset of tardive dyskinesia if EPS reaction

A

after years of treatment

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13
Q

Treatment of tardive dyskinesia

A
  • none

- likely stop antipscyhotic and switch to atypical

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14
Q

Features of neuroleptic malignant syndrome

A
  • rigidity
  • high fever (up to 107)
  • high CPK
  • sweating
  • myoglobinuria
  • mutism
  • altered mental status (agitated of obtunded)
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15
Q

Treatment of neuroleptic malignant syndrome

A
  • stop antipsychotic
  • supportive care for fever and renal
  • consider giving dantrolene
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16
Q

classic side effect of thorazine

A

retinal pigment deposits

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17
Q

classic side effect of clozapine

A

agranulocytosis

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18
Q

Classic side effects of chlorpromazine

A
  • jaundice

- photosensitivity

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19
Q

3 classic side effects of SSRIs

A
  • insomnia
  • anorexia
  • sexual dysfunction
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20
Q

Firs line treatment of depression

A

therapy and SSRIs

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21
Q

Mechanism of action of TCAs

A
  • NE reuptake block
  • serotonin reuptake block
  • a-adrenergic block
  • AchM block
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22
Q

Why do TCAs cause orthostatic hypotension?

A

a-adrenergic block

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23
Q

MAOIs may be good for

A

atypical depression (eating and sleeping more)

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24
Q

TCA overdose most concerning for

A

cardiac arrhythmias

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25
Q

MAOIs + tyramine =

A

HTN crisis

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26
Q

Age of onset of bipolar disorder

A

16-30 years old

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27
Q

1st line agents for bipolar disorder

A
  • lithium
  • valproic acid
    (carbamezapine 2nd line)
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28
Q

What is bipolar II?

A

hypomania with major depression

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29
Q

What is cyclothymia

A

2 years of hypomania with depressed mood without major episodes of either

30
Q

4 classic side effects of lithium

A
  • renal (DI)
  • thyroid
  • tremor
  • CNS effects
31
Q

Classic side effect of valproic acid

A

liver dysfunction

32
Q

Classic side effect of carbamazepine

A

bone marrow depression

33
Q

10 major risk factors for suicide

A
  • age above 45
  • substance use
  • h/o violence
  • prior attempts
  • male
  • psych history
  • recent loss
  • loss of health
  • unemployment/retirement
  • not married/partnered
34
Q

Greatest age risk for suicide

A

over 65 (15-24 also high)

35
Q

Normal grief can last up to

A

1 year

36
Q

Typical age for panic disorder

A

20-40

37
Q

Treatment of panic disorder

A

SSRIs (fluoxetine)

38
Q

Panic disorder is associated with

A

agoraphobia

39
Q

Describe conversion discorder

A
  • ppt event

- unexplanable neuro symptoms

40
Q

Key features of somatization disorder

A

multiple complaints in multiple organ systems with negative workup

41
Q

Treatment of somatoform disorders

A
  • frequent clinic visits and/or therapy
42
Q

Difference between factitious disorder and malingering

A

factitious disorder the patient wants to assume role of the patient. It’s intentional but no monetary or other gain.

43
Q

Key features of paranoid personality disorder

A
  • everyone’s out to get them

- law suits

44
Q

Key features of schizoid personality disorder

A
  • loner and not interested in having friends
45
Q

Key features of schizotypal personality disorder

A
  • bizarre beliefs

- bizarre way of talking but no psychosis

46
Q

Key features of avoidant personality disorder

A
  • inferiority complex

- has no friends but wants them

47
Q

Key features of histrionic personality disorder

A
  • center of attention
  • seductive
  • dramatic and attention seeking
48
Q

Key features of narcissistic personality disorder

A
  • no empathy
  • use others for own gain
  • sense of entitlement
49
Q

Key features of antisocial personality disorder

A
  • must have had conduct disorder
  • criminal
  • male
  • alcohol and drugs
  • somatization
50
Q

Key features of borderline personality disorder

A
  • unstable in every realm
  • splitting
  • 2 minutes of psychosis
  • impulsive
  • constant crisis
51
Q

Key features of dependent personality disorder

A
  • cannot be alone

- cannot do anything alone

52
Q

Key features of obsessive-compulsive personality disorder

A
  • different than OCD
  • restricted affect
  • rules are more important than objectives
53
Q

What is a dissociative fugue?

A

patients have amnesia, travel, assume new identity

54
Q

Dissociative identity disorder most likely assoicated with

A

childhood sexual abuse

55
Q

Usually onset of OCD

A

adolescents or early adulthood

56
Q

Treatment of OCD

A
  • SSRIs (fluvoxamine
  • clomipramine
  • behavioral therapy
57
Q

Features of narcolepsy

A
  • decreased REM latency (enter REM as soon as fall asleep)
  • cataplexy
  • hypnopompic or phynagogic hallucinations
58
Q

Treatment of narcolepsy

A

modafinil or amphetamines

59
Q

Formications are associated with

A

cocaine

60
Q

Cocaine withdrawl features

A
  • sleepy
  • hungry
  • irritable/depressed
61
Q

amphetamines are classically associated with ____ symptoms

A

psychotic

62
Q

Likely drug intoxication if vertical and horizontal nystagmus

A

Phencyclidine (PCP)

63
Q

Treatment of PCP overdose

A
  • urine acidification
64
Q

Is PCP toxic in overdose

A

yes. can cause dealth from consulsions, coma, respiratory arrest.

65
Q

Are there withdrawl symptoms from PCP?

A

no

66
Q

Are withdrawl symptoms from opiods dangerous?

A

no

67
Q

Typical age for use of inhalants

A

11-15 years

68
Q

Serious effects of inhalants

A
  • respiratory depression
  • arrhythmia
  • asphyxiation
  • nervous system toxic
  • nephrotoxic
69
Q

Is benzo withdrawl dangerous?

A

yes, like alcohol

70
Q

3 classic syptoms of caffeine withdrawl

A
  • headache
  • irritability
  • fatigue
71
Q

6 times when ok to break confidentiality

A
  • patient’s request
  • child abuse
  • court mandate
  • duty to warn/protect
  • reportable disease
  • danger to other

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