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FAM MED SHELF > BEHAVIORAL/PSYCH > Flashcards

BEHAVIORAL/PSYCH Flashcards

1
Q

Requires the presence of excessive worry about numerous aspects of daily life on more than not for at least 6 months w/inability to control symptoms w/3 other symptoms (irritability, muscle tension, sleep problems, poor concentration, fatique, restlessness).

A

GAD, generalized anxiety disorder

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2
Q

Dx of MDD icludes 2+ weeks of what symptoms?

A

SIGECAPS:
sleep, interest/anhedonia, guilt, energy, concentration, appetite, psychomotor, suicide

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3
Q

The pt is excessively preoccupied w/one or more somatic symptoms like back pain that gets worse w/stress. These symptoms may or may not originate from an underlying disease.

A

Somatic symptom disorder

Tx includes frequent follow ups

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4
Q

Clinical manifestations of autism present when

A

typically in the first 2 years of life

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5
Q

__________________ refers to a persistent emotional and bahavioral problems such as purposeful agression towards people and animals in children and adolescents.

A

Conduct disorder

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6
Q

Adjustment disorder symptoms typically last ______________

A

less than 6 months

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7
Q

Rapid onset of cognitive deficits associated with MDD in the elderly is likely

A

pseudodementia , treat w/ SSRIs

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8
Q

What is general first line tx for social phobias like public speaking?

A

BBlockers

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9
Q

Panic attacks, we tx with…

A

Benzos and or CBT

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10
Q

First line tx for GAD

A

CBT and then SSRI if needed

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11
Q

Must start within 3 months of stressor and not last beyond 6 months

A

adjustment disorder

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12
Q

_________________ worrying about most things throughout the day on most days of the month that produces no acute issue but provokes chronic loss of function.

A

Generalized anxiety disorder (GAD)

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13
Q

What would we give in the setting of a panic attack to hault the symptoms?

A

Lorazepam, alprazolam, or some other kind of benzo

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13
Q

A young woman with no medical history that sounds like a myocardial infarction relieved with benzodiazepines is classic for

A

panic attacks

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14
Q

TRUE OR FALSE: All SSRI/SNRI medications are first line for MDD, are indistinguishable from one another, and areequally efficacious.

A

true

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15
Q

The patient will experience a depressed mood for >2 yearsbut without symptoms >2 months at a time. This patient will be functioning but will have depressed mood. This is the person you get the feeling is depressed, but doesn’t meet the severe symptoms of an MDEpisode

A

Dysthymia-Persistent Depressive Disorder

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16
Q

How do we treat dysthymia?

A

SSRI

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17
Q

Kids having constant irritability with recurring behavioral outbursts, disproportionate to situations. Happens at least 3x per week, andis evident before 10 years old(manifests ages 6-18)

A

Disruptive Mood Dysregulation Disorder

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18
Q

Women must have at least 5 symptoms in the week before onset of menses, start to improve within a few days of onset, and they must beabsent in the week postmenses

A

Premenstrual dysphoric disorder

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19
Q

When suspecting MDD or Dysthymia, what must you rule out?

A

Hypothyroid

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20
Q

What are symptoms of bipolar i

A
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21
Q

What is the diagnostic criteria for Bipolar I

A

To be classified as Bipolar I, the patient must have “E” with another 3 symptomsfor at least one week. Bipolar disorder has equal rates in men and women. Suicide is 15x higher in bipolar patients. Bipolar can be characterized as mania, but may also have modifiers for catatonia, rapid cycling, peripartum, and psychotic features

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22
Q

What do we qualify as Bipolar II?

A

Bipolar II is hypomania AND major depression. There must be a current or previous major depressive episode to be diagnosed bipolar. Hypomania is defined by all the same symptoms of mania, except they are less severe (not as impairing), and for less time (at least 4 days).

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23
Q

How do we dx cyclothymia

A

Bipolar I is mania. Bipolar II is hypomania with depression. Cyclothymia is Bipolar II, just not as bad. Patients have had at least 2 years of hypomanic and a major depressive episode, plus symptoms that fails to meet the criteria for Bipolar II.

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24
Q

Why do we avoid intidepressants in bipolar disorders?

A

A manic episode can be provoked (revealing the underlying bipolar disorder) by use of them. Even if major depressive episode is predominating, if it’s known they’re bipolaravoid SSRIs

25
Q

_________________is the classic mood stabilizer. It has a narrow therapeutic index, can rapidly become toxic in renal failure, and has a dirty side effect profileincluding diabetes insipidus, vomiting / abdo pain, and progresses to encephalopathy, ataxia, and hyperreflexia.

A

Lithium

26
Q

What am I: valproate

A

mood stabilizer, used to tx bipolar disorders

27
Q

What am I: carbamazepine

A

mood stabilizer, used to tx bipolar disorders

28
Q

What am I: lamotrigine

A

mood stabilizer, used to tx bipolar disorders

29
Q

What am I: quetiapine

A

antipsychotic

30
Q

How long and how many sigecaps do you need to have to be dx’d w/MDD?

A

greater than or equal to 2 weeks w/5Sigecaps

31
Q

How does suicidal ideation change out approach to MDD?

A

SI+–>Plan+–> hospitalize
SI+–>no Plan–> contract for safety
NO SI–> psychotherapy

32
Q

What am I: haloperidol

A

bezo

Emergency anti-agitation treatment in patients with acute mania is IM or IV benzos or antipsychotics, of which lorazepam and haloperidol are the most common.

33
Q

The fastest, most effective method of improving depression is actually

A

electro-convulsive therapy

34
Q

If there’s mostly depression but the emphasis remains focused on the deceased(it’s NOT pervasive in all their life), or the duration has exceeded 12 months but they don’t meet depression criteria, call it

A

Persistent Complicated Bereavement Disorder

35
Q

How might you be able to tell the difference between MDD and PCBD on exam?

A

For test purposes, think bereavement that is longer than 12 months, but not MDD. This is persistent complex bereavement.

36
Q

Watch out for questions with young females and weight. Young female, concern with weight, frequency diarrhea…

A

MIGHT BE BULEMIA
be able to ID metabolic acidosis

Loss of bicarbonate in the stool through induced diarrhea provokes acidemia. Because this acidemia is not caused by an increase in cations (such as in DKA or lactic acidosis), there is no anion gap (Na - [Cl + HCO3] < 12), as in this patient, whose anion gap is 10. Once you have found non-gap acidosis, you use the urine gap to determine if there is a renal tubular acidosis (which can be induced through diuretic use) or not. If not, then you are left with diarrhea. A positive gap is renal tubular acidosis, a negative gap is diarrhea.

37
Q

How can you tell the difference between anorexia nervosia w/binging versus bullemia nervosa?

A

Look for out of control binging to pin bullemia.

Distinguishing among the different eating disorders can be difficult.

Anorexia: Look for LOW WEIGHT/BMI, behaviors are ego-SYNTONIC.

Bulimia: Can be NORMAL weight, binge-purge behaviors, but ego-DYSTONIC.

Although there may be binge-purge behaviors in anorexia, the difference is that, in bulimia, the patient feels “out of control” during the binging episodes, and so uses the purging behaviors to compensate for an initially unwanted behavior (the binge). As such, they may maintain a normal weight, and these behaviors are often ego-dystonic (they do not want to be doing this). In contrast, patients with anorexia are typically very underweight, and their behaviors (whether restriction or binge/purge) are ego-syntonic.

38
Q

When might you see an eating disorder w/acidosis?

A

In the setting of bullemia SPECIFICALLY W/PURGING via LAXATIVES

39
Q

Escitalopram, fluoxetine, paroxetine, sertraline

A

SSRIs

Escaping florence paradoxically on the sertraLINE railroad

40
Q

Des/Venlafaxine, Duloxetine

A

SNRIs

Sir SnRi De Venlafax is deluxe
SNRI des venlafaxine dueloxetine

41
Q

Mirtazapine and trazadone are what?

A

Serotonin Modulators

Mirta and Traz were terrible moderators for the trampoline competition

42
Q

Mood stabilizer, spina bifida

A

Valproate, mood stabilizer teratogen that can cause spina bifida

43
Q

Carbamazepine

A

Mood stabilizer (third choice), teratogenic

44
Q

Issues w/SSRIs

A

Sex dysfunction

45
Q

Convulsions, cardiac, coma

A

TCAs

46
Q

Hypertensive emergency w/eating wine and or cheese

A

MAOi’s

47
Q

Atypical antidepressant and seizures

A

Bupropion

48
Q

Teratogen, Nephrotoxic, Nephrogenic Diabetes insipidus

A

Lithium

49
Q

First line and second line agents

A

First: Li, valproic
Second: Quetiapine, Lamotrigine

50
Q

What 3 major tests need to be done before starting Lithium?

A
  1. Pregnancy Test
  2. Creatinine
  3. TSH
51
Q

Prophylactically using a a medium-acting _________________ can prevent the syndrome of alcohol withdrawal.

A

benzodiazepine like chlordiazepoxide

52
Q

Mental health med and seizures associated with WITHDRAWAL

A

Benzos!

and alcohol

53
Q

Before starting an atypical antipsychotic, what must you always obtain first ?

A

ECG, they can cause QTc prolongation

54
Q

Major side effect of quetiapine

A

drowsiness

55
Q

what major side effect does olanzapine have

A

DM and weight gain

56
Q

What are extrapyramidal effects?

A

Akathisia, acute dystonia, dyskinesis, tardice diskinesia

57
Q

What medications do we worry about for extrapyramidal effects?

A

Antipsychotics, think antipsychotics–>dopamine modification–>parkinson like side effects

58
Q

Don’t give the antipsychotic ________________ in a patient w/exisiting concern for metabolic syndrome

A

Olanzapine

Olanzapine sounds similar to ozempic

59
Q

Last resort, failed 4 previous medications

A

Clozapine

60
Q

What major things do you need to remember/look out for in order to spot substance use disorder

A

1Controlling use, 2social impairment, 3risk-taking, and 4physical/pharm changes

61
Q

Major side effect to keep an eye on for venlafaxine

A

HIGH BLOOD PRESSURE

Recall venlafaxine is an snri
Sir SnRi De Venlafax is deluxe
SNRI des venlafaxine dueloxetine

FAM MED SHELF (34 decks)

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