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Pass Program > Chapter 11: Behavioral Science > Flashcards

Chapter 11: Behavioral Science Flashcards

1
Q

Fluoxetine, Sertraline and Escitalopram are all which kind of medication?

A

SSRI

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2
Q

SE of SSRI

A

sexual dysfunction (anorgasmia);GI distress; SIADH; prolonged QT interval

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3
Q

Venlafaxine and Duloxetine are which kind of meds?

A

SNRI (serotonin norepinephrine reuptake inhibitor)

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4
Q

SE of SNRI

A

HTN, sedation, nausea

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5
Q

MOA of tricyclic antidepressants

A

serotonin and NE reuptake inhibitors

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6
Q

uses of TCA (give 6)

A
  1. Major depression
  2. OCD (Clomipramine)
  3. Chronic pain/neuropathy (Amitriptyline)
    4.Nocturnal enuresis (Imipramine)
  4. Migraine prophylaxis
  5. Nortriptyline and Desipramine best for elderly (short half-life)
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7
Q

adverse effects of TCA (give 6)

A
  1. increase dopamine (risk of mania)
  2. anticholinergic (urinary retention; tachycardia, dry mouth, hyperthermia)
    3.block alpha 1 receptors (orthostatic hypotension)
  3. block AV node conduction (prolong QT)
  4. block Na channels arrhythmia, seizure
  5. block histamine receptors (sedation)
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8
Q

management of TCA overdose

A

fluids and sodium bicarb

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9
Q

If you want to switch a pt. from SSRI to MAO inhibitor, how long should you discontinue the drug before starting MAO i?

A

4 weeks

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10
Q

If you want to switch from MAO i to SSRI, how long must the patient discontinue MAOi?

A

2 weeks

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11
Q

What are some contraindications of using MOAI?

A

tyramine consumption (wine and cheese) leads to overstimulation of sympathetic pathway; other contraindications: TCA, dextromethorphan, St. John’s wort all of these can precipitate serotonin syndrome

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12
Q

Which antidepressant can help stop smoking, and has the lowest sexual dysfunction but may lower seizure threshhold:

A

Buproprion (Wellbutrin)

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13
Q

Which antidepressant can also help with smoking cessation because it is a partial agonist at nicotinic Ach receptor, BUT has an increased risk of suicide?

A

Varenicline

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14
Q

Which mood stabilizer is the safest in pregnancy?

A

Lamotrigine

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15
Q

Which mood stabilizer is good for acute mania?

A

valproic acid

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16
Q

Which mood stabilizer could cause nephrogenic diabetes and is also a teratogen?

A

Lithium

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17
Q

Which problem is common in newborns born to mother’s who took lithium during the first trimester?

A

Ebstein’s anamoly

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18
Q

What problems could valproic acid cause in a newborn and why?

A

neural tube defects (folate deficiency)

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19
Q

Best treatment for a specific phobia

A

desensitization (CBT)

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20
Q

various treatments for generalized anxiety disorder

A

SSRI, buspirone, venlafaxine, benzodiazepine(cause sedation, do not use in elderly)

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21
Q

treatment for PTSD

A

CBT (best); SSRI, venlafaxine; Prazosin (for nightmares)

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22
Q

Brief Psychotic Disorder time period

A

more than one day, less than one month

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23
Q

Schizophreniform Disorder

A

more than 1 month, less than 6 months

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24
Q

Schizoaffective disorder

A

occurence of delusions or hallucinations + major mood disturbance (major depression or mania)

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25
Q

delusional disorder

A

a single, falsely held belief despite proof of contrary

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26
Q

delusional disorder

A

a single, falsely held belief despite proof of contrary (no impairment or dysfunction)

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27
Q

antipsychotics mainly work on which receptors

A

D2, D4

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28
Q

What is dopamine good for in the mesolimbic and mesocortical tracts?

A

hallucinations and vomiting

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29
Q

What is dopamine good for in nigrostriatal tract?

A

increases initial movement

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30
Q

What is dopamine good for in infundibular tract?

A

inhibits release of prolactin

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31
Q

Dopamine and prolactin are opposites, so if you administer antipsychotics, what will happen to prolactin and menstruation?

A

prolactin up, GnRH down= amenorrhea
TRH up, PRH up=galactorrhea

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32
Q

What kind of meds are D2 antagonists called?

A

typical antipsychotics

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33
Q

What kind of meds D4 effect is greater than D2 effect?

A

atypical antipsychotics

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34
Q

Which typical antipsychotic is an anti-emetic drug for children (D2 antagonist)?

A

Promethazine

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35
Q

Which typical antipsychotic is an anti-emetic drug for adults?

A

Prochlorperazine

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36
Q

Which typical antipsychotic has a long half-life and good for homeless or noncompliant pts?

A

fluphenazine

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37
Q

Which typical antipsychotic is best for acutely psychotic or delirious patients?

A

haloperidol (“vitamin H”)

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38
Q

What are the first line atypical antipsychotics?

A

Qetiapine and Aripiprazole

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39
Q

Which atypical antipsychotic could you use after 2 others have failed but you must watch out for agranulocytosis?

A

Clozapine

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40
Q

What is akathisia, and which med is good for it?

A

inability to stop movement; beta blocker (propranolol)

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41
Q

What is acute dystonia and which meds can be used for it?

A

sustained contraction of a muscle group; benztropine or Diphenhydramine (antihistamine)

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42
Q

What is akinesia, dyskinesia, bradykinesia and meds?

A

akinesia: the inability to start movement
dyskinesia: impairment in starting movement
bradykinesia: slow starting movement
meds: benztropine, diphenhydramine)

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43
Q

What is tardive dyskinesia and its treatment?

A

facial grimacing, tongue protrusion, lip smacking; stop current med; switch to risperidone or clozapine

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44
Q

What is it called when there is uncoupling of ETC by neuroleptic drug causing hyperthermia due to inability to release heat and since ATP is not produced, the muscles are unable to relax?

A

neuroleptic malignant syndrome

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45
Q

How do you treat neuroleptic malignant syndrome?

A

antihistamines can keep muscles from contracting; dantrolene (sequesters Ca); bromocriptine

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46
Q

What are the signs of serotonin syndrome?

A

up temp.; muscle aches; CV collapse (hypertension or hypotension)

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47
Q

treatment of serotonin syndrome

A

discontinue drug; cyproheptadine

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48
Q

Which drugs can increase GABA?

A

benzodiazepines, barbituates, zolpidem (Lanesta)

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49
Q

What effects does GABA have on body?

A

anticonvulsant, muscle relaxant, sedative, anxiolytic

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50
Q

What is the difference between MOA of benzodiazepine and MOA of barbituates?

A

benzos increase the frequency of opening Cl channels
barbs increase the duration of Cl opening

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51
Q

What is the fast acting and short half life benzo that is good for all procedures (endoscopy, colonoscopy)?

A

Midazolam

52
Q

Which benzo is good for status epilepticus?

A

diazepam or lorazepam

53
Q

Which benzo helps elderly to initiate sleep?

A

triazolam : TRIazolam “TRI” to sleep; TeMAzepam MAintain sleep

54
Q

Best benzo for anxiety in middle aged women

A

Lorazepam (8 hour half-life)

55
Q

Drug of choice for restless leg syndrome?

A

pramipexole or ropinirole

56
Q

Benzo for delirium tremens?

A

chlordiazepoxide

57
Q

benzo for delirium tremens with liver disease?

A

lorazepam

58
Q

benzo overdose med

A

flumazenil

59
Q

Which opioid doesn’t give “pinpoint pupils”?

A

Meperidine

60
Q

Which opioid is used for traveller’s diarrhea?

A

Loperamide

61
Q

Which drug is used to cause withdrawal in heroin addict?

A

Buprenorphine

62
Q

drug for opioid OD

A

Naloxone (IV); Naltrexone

63
Q

Which med. is used for neuropathy in heart disease patients?

A

gabapentin

64
Q

Name the personality disorder: distrusting and suspicious of everything

A

paranoid personality disorder

65
Q

conscious decision to socially withdrawal

A

schizoid personality disorder

66
Q

perfer to be by themselves; awkward and have magical thinking

A

schizotypal PD

67
Q

person who lies, cheats, steals destroys without remorse before age 18

A

conduct disorder

68
Q

person who lies, cheats, steals, destroys without remorse after age 18

A

antisocial

69
Q

in their mind everything is black or white; splitting (love/hate)

A

borderline PD

70
Q

sexually provocative, flirtatious

A

Histrionic PD

71
Q

think the world revolves around them

A

narcissistic PD

72
Q

avoids problems; afraid of rejection

A

avoidant PD

73
Q

need to be orderly, perfectionist, in control

A

Obsessive-compulsive PD

74
Q

needs to be taken care of by someone, clingy

A

dependent

75
Q

a disorder where a person obsesses about one illness for at least 6 months

A

illness anxiety disorder

76
Q

a physical occurence because of internal struggle

A

conversion disorder (gf loses function of legs because bf broke up with her)

77
Q

pt believes he/she has a new illness every time he/she visits the doctor

A

somatic symptom disorder

78
Q

fake illness to get attention

A

factitious disorder

79
Q

fake illness of another to get attention or gain something

A

factitious disorder imposed on another (before was called Munchhausen by proxy)

80
Q

What is dissociative identity disorder?

A

(before known as multiple personality): person creates new personality with something they cannot handle

81
Q

what is temporary loss of recall memory caused by disassociation (voluntary or involuntary)

A

dissociative amnesia

82
Q

What is it called when a person detaches self from emotions?

A

depersonalization

83
Q

What is it called when a person detaches from their surroundings, like living in a dream

A

derealization

84
Q

In which defense mechanism you don’t want to face the truth:

A

denial

85
Q

In which defense mechanism, you put off your own feelings to benefit another

A

isolation of affect

86
Q

In which defense mechanism do you pretend something is real, magical thinking

A

fantasy

87
Q

a person who does by not doing

A

passive aggressive

88
Q

Which defense mechanism do you put away feelings or emotions

A

repression

89
Q

Which defense mechanism do you revert to infantile way of acting

A

regression

90
Q

Which defense mechanism do you put your thoughts into someone else?

A

projection

91
Q

Which defense mechanism do you do the exact opposite of what you used to do

A

undoing

92
Q

Which defense mechanism do you take your feelings out on someone else?

A

displacement

93
Q

Which defense mechanism do you react opposite to how you feel?

A

reaction formation

94
Q

Which defense mechanism do you do something that you are terrified of?

A

counterphobic behavior

95
Q

Which defense mechanism do you act like someone more famous or powerful?

A

identification

96
Q

Which defense mechanism you always want everything to be ideal?

A

idealization

97
Q

Which defense mechanism do you exaggerate the positive of someone and ignore the negative?

A

idolization

98
Q

Which defense mechanism do you make something sexual out of everything that happens?

A

sexualization

99
Q

When a pt. projects to doctor feelings they have toward someone else

A

Transference

100
Q

When a doctor projects to pt. feelings they have toward someone else?

A

countertransferance

101
Q

using rational explanations to justify unacceptable attitudes, beliefs

A

rationalization/justification

102
Q

intellectual reasoning used to block confrontation with a conflict

A

intellectualization

103
Q

Mature defense mechanism where you consciously put away an emotion

A

repression

104
Q

Mature defense mechanism where you can laugh at your mistakes and use jokes to get through conflict

A

humor

105
Q

putting oneself before others

A

altruism

106
Q

making something positive out of something negative

A

sublimation

107
Q

giving to those less fortunate

A

philanthropy

108
Q

criteria for anorexia diagnosis

A

BMI less than 18.5; doesn’t want to eat (restrict calories) and excessive exercise

109
Q

treatment for anorexia

A

hospitalize, correct electrolytes, CBT, family therapy; SSRI if needed

110
Q

criteria for bulimia nervosa diagnosis

A

body weight can be normal or low; recurrent episodes of binge eating and purging; use of laxatives or excessive exercise to lose weight; occurs at least once a week for 3 months;

111
Q

treatment for bulimia

A

check electrolytes and treat; cBT; SSRI

112
Q

What is kleptomania

A

likes to steal

113
Q

What is pyromania?

A

deliberately sets on fire (fear and anxiety before act (fascination) and release of fear after the act (gratification)

114
Q

What is it called when someone pulls his/her own hair out?

A

trichotillomania

115
Q

What is intermittent explosive disorder?

A

When a person has episodes of aggressiveness that results in assault or destruction of property and they are out of proportion to the stressor

116
Q

What are the stages of sleep?

A

Stage 1 alpha and theta waves (brief) and can be easily woken
Stage 2: sleep spindles and k complexes (down HR and lasts about 20 min)
Stage 3 delta waves (transitional)
Stage 4 delta waves: hardest to be awakened; bedwetting and sleep walking happen
REM about 90 min. after initial falling asleep, saw tooth waves, dreams, eye movement; RR up; sexual arousal, muscles relaxed, brain is active

117
Q

What is Narcolepsy?

A

excessive daytime sleepiness more than 3 months

118
Q

treatment

A

better sleeping; if sleep is not a problem then modafinil (amphetamines)

119
Q

Sleep terrors stage of sleep

A

3 and 4; cannot wake up but have no memory of the event

120
Q

What stage of sleep do nightmares occur in?

A

REM

121
Q

ADHD diagnostic criteria

A

before age 12; hyperactivity and impulsivity for more than 6 months

122
Q

Treatment for Tourette’s

A

antipsychotics (haloperidol) quetiapine

123
Q

Rett syndrome

A

normal development followed by regression ages 1-5; handwringing; mostly girls because males die before birth; MECP2 mutation

124
Q

Disruptive mood dysregulation disorder

A

verbal or aggressive outburst that are out of proportion to trigger; mood is irritable and unhappy between outbursts; at least 3 times a week for more than 12 months

125
Q

Difference between delirium and dementia:

A

reversible, acute, fluctuating level of consciousness vs. insidious onset and caused by neurodegenerative disorders, personality changes

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