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Psychiatry > Board Exam > Flashcards

Board Exam Flashcards

1
Q

What are the extrapyramidal side effects of neuroleptics?

A

Parkinsonism; dystonia; akathisia

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2
Q

What is used to treat akathisia?

A

Benzodiazepines and beta blockers (propranolol)

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3
Q

How is tardive dyskinesia treated?

A

D/c or lower antipsychotic and switch to a different antipsychotic

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4
Q

What are the typical antipsychotics? High and low potency?

A

High potency: haldol, fluphenazine, trifluoperazine, pimozide; Low potency: chlorpromazine and thioridazine

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5
Q

How are panic attacks treated?

A

CBT and pharmacotherapy (SSRIs first-line, can use TCAs if ineffective)

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6
Q

Up to 65% of patients with panic attacks have what comorbid disorder?

A

Major depression; other comorbid conditions: anxiety disorders (esp agoraphobia), bipolar disorder, alcohol use disorder

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7
Q

What medication is FDA approved for bulimia nervosa?

A

Fluoxetine

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8
Q

How is GAD treated?

A

Psychotherapy (CBT) and pharmacotherapy (SSRI, SNRI)

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9
Q

What is thought to be the cause of tardive dyskinesia?

A

Increased sensitivity of the dopamine receptors

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10
Q

What is seen on polysomnography in narcolepsy?

A

Decreased REM latency

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11
Q

What is deficient in the CSF of patients with narcolepsy?

A

Hypocretin

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12
Q

What is the drug of choice in treatment of cataplexy?

A

Sodium oxybate

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13
Q

Which TCA could be used to treat OCD?

A

Clomipramine (most serotonin selective)

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14
Q

What factors can increase Lithium levels?

A

Dehydration, NSAIDs, ASA, decreased kidney function, thiazide diuretics, salt deprivation, sweating (salt loss)

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15
Q

What symptoms are seen in lithium toxicity?

A

Course tremor, altered mental status, convulsions, delirium, coma, death

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16
Q

What ECG rhythm can be seen in lithium toxicity?

A

2nd degree AV heart block

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17
Q

What is the treatment for PTSD?

A

First-line is antidepressant; can us prazosin (alpha 1 antagonist) targets nightmares

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18
Q

What is the most effective treatment for adjustment disorder with depressed mood?

A

Supportive psychotherapy

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19
Q

What is the treatment of serotonin syndrome?

A

Stop offending agent; supportive; benzodiazepines. Can use cyproheptadine (serotonin antagonist)

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20
Q

52 year old homeless man with alcoholism is brought to the emergency departmetn by polic after being found agitated and confused. He feels nervous and could use a drink. Temp 37, HR 120, RR 20, BP 138/86. He is trembling. Hct 30%. Urinalysis shows 7 WBC/hpf and many oxalate crystals. What is the most likely cause?

A

Ethylene glycol toxicity

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21
Q

How is gambling disorder treated?

A

CBT and self help groups; SSRIs and naltrexone have been used to help

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22
Q

What is the MOA of buproprion?

A

Inhibits reuptake of NE and DA

23
Q

What is buspirone used to treat?

A

FDA-approved non-benzo anxiolytic; used to treat GAD w/o comorbid depression or panic sxs

24
Q

What is the first line treatment of GAD?

A

SSRIs or SNRIs

25
Q

Patient with new medication to treat asthma develops psychosis, what is the likely cause?

A

Glucocorticoid-induced psychosis = med-induced psychotic disorder

26
Q

What is the drug category of clozapine?

A

Second generation antipsychotic

27
Q

What drugs can cause lithium toxicity due to drug interaction?

A

Thiazide diuretics, NSAIDs, ACE inhibitors, tetracyclines, metronidazole

28
Q

What medications can cause a decrease in serum lithium levels?

A

Theophylline and potassium sparing diuretics (spironolactone)

29
Q

If a patient uncharacteristically has a rapid response to venlafaxine, what psychiatric diagnosis should you consider?

A

Bipolar; typical response to venlafaxine is 2 weeks

30
Q

What is the treatment of neuroleptic malignant syndrome?

A

Stop neuroleptics, start fluids, administer dantrolene or bromocriptine if refractory

31
Q

What is a distinguishing factor between neuroleptic malignant syndrome and serotonin syndrome?

A

NMS - has lead pipe rigidity; Serotonin syndrome has GI sxs, hyperreflexia and myoclonus

32
Q

What is the most consistently replicated neuroimaging finding in schizophrenia?

A

Enlargement of lateral cerebral ventricles

33
Q

What type of therapy is helpful in borderline PD?

A

DBT

34
Q

What are the indications for hospitalization in patients with anorexia nervoas?

A

Dehydration, unstable VS (hypotension, bradycardia HR <40, hypothermia), cardiac dysrhythmias, electrolyte disturbances, organ involvement, very low weight

35
Q

What is the primary pharmacotherapy treatment of bulimia nervosa?

A

Fluoxetine

36
Q

What is the primary pharmacotherapy treatment for anorexia nervosa?

A

Olanzapine

37
Q

What is the treatment for anorexia nervosa?

A

CBT, Nutritional rehab, olanzapine for severe cases

38
Q

What labs need to be monitored with valproate?

A

CBC (for platelets) and LFTs

39
Q

What medication is used to treat PMS/PMDD?

A

Fluoxetine

40
Q

What is the defense mechanism reaction formation?

A

Responding in a manner opposite to one’s actual feelings

41
Q

What are non-stimulant options to treat ADHD?

A

Atomoxetine (NE reuptake inhibitor); buproprion and TCAs

42
Q

QRS duration of >100 msec in TCA toxicity is an indication for what treatment?

A

Sodium bicarbonate

43
Q

What is the MOA of buproprion?

A

NE and DA reuptake inhibitor

44
Q

What are common adverse effects of mirtazapine?

A

Sedation and weight gain

45
Q

What antipsychotics have the highest potential for increasing prolactin?

A

High potency 1st gen (haloperidol and fluphenazine) and risperidone and paliperidone

46
Q

What are the key features of illness anxiety disorder?

A

Fear of having a serious illness despite few or no symptoms and consistently negative evaluations

47
Q

During what phase of sleep do nightmares occur?

A

REM sleep

48
Q

What is nightmare disorder?

A

Recurrent awakenings due to highly disturbing and frightening dream content; patients are able to recall dreams, awaken from dreams, and are able to be consoled (compared to sleep terror disorder)

49
Q

During what phase of sleep do sleep terrors occur?

A

Non-REM

50
Q

How is kleptomania treated?

A

CBT, SSRIs, opioid antagonist, lithium, anticonvulsants

51
Q

What is the first line treatment for panic disorder and agoraphobia?

A

SSRI and CBT

52
Q

What is the treatment for postpartum depression?

A

SSRIs (sertraline for breast feeding)

53
Q

What is social anxiety disorder?

A

Anxiety restricted to social and performance situations, fear of scrutiny and embarrassment.

Psychiatry (3 decks)

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