Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psychiatric Conditions > Clinical Questions > Flashcards

Clinical Questions Flashcards

1
Q

What is the DSM-5 Criteria for Depression Diagnosis?

A

At least 5 of the the following symptoms present for the same 2 week period WITH depressed mood:
- increased/decreased Sleep
- decreased Interest
-Guilt
- decreased Energy
- decreased Concentration
- increased/decrease appetite
- Pyschomotor agitation or retardation
- Sucidal ideation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What natural products may have increased serotonin syndrome risk with SSRI/SNRI treatment?

A

St. John’s wart
SAMe
5-HTP (hydroxytryptophan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which SSRI is the most activating and should be taken in the AM?

A

Fluoxetine (Prozac)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which SSRI is the most sedating and should be taken in the PM?

A

Paroxetine (Paxil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A 62 year old patient with depression is on Celexa 40 mg daily from another provider. Patient is also on Lipitor 20 mg daily and Zestril 10 mg daily. Patient has complaints of somnolence and fatigue. What intervention should you make?

A

Citalopram (Celexa) dose should not exceed 20 mg/day. Decrease dose to 20 mg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What concern do you have when a patient is on Phenelzine and Cymbalta at the same time?

A

SEROTONIN SYDROME
**MAO inhibitors (phelzine, tranylcypromine, and isocaboxazid) in combination with SSRI/SNRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What concern do you have when a patient’s home medications are Topamax, Inderal, and Elavil, and they are started on linezolid for an infection?

A

SEROTONIN SYNDROME
***linezolid is contraindicated with amitriptyline (Elavil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

A 24 year old patient is on Aviane, Effexor ER, Inderal, and Vasotec, which medications have a potential risk to worsen depression?

A

Aviane - birth control = DOES
Effexor (Venlafaxine) = DOES
Inderal (Propanolol) = DOES
Vasotec (Enalapril) = nope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which symptoms are from increase NE when taking SNRIs?

A

increased HR
dilated pupils
dry mouth
excessive sweating
constipation
increased BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which SNRI has the greatest risk for high blood pressure?

A

Venlafaxine (Effexor) when dosed > 150 mg per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which ART drug class has a risk of worsening depression?

A

NNRTIs (Efarirenz, Rilpivirine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which Tricyclic Antidepressants have increased anticholinergic properties with more sedation and weight gain?

A

Tertiary amines (Amitriptyline and Doxepin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What antidepressantis contraindicated for people with history of anorexia/bullemia and seizure disorder?

A

Buproprion (Wellbutrin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A 34 patient with atrial fibrillation and hypertension has just been diagnosed with depression. What is the best initial treatment for her?
(be specific)

A

Sertraline (Zoloft)

**preferred with cardiac or QT risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A patient has depression and peripheral neuropathy from diabetes what is the best treatment?

A

Duloxetine (Cymbalta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which SSRI/SNRI should NOT be used in pregnancy?

A

Paroxetine (Paxil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A patient has experience sexual dysfunction in the past with his depression treatment, which two medications could be the best option to avoid this symptom?

A

Mirtazapine (Remeron)
Buproprion (Wellbutrin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A depressed patient struggles with insomnia, which treatment should she avoid, and which treatments are the best options?

A

AVOID: buproprion and fluoxetine

BEST: paroxetine, trazodone, and mirtazapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A patient is taking Cymbalta and needs to be transitioned to Nardil. When may the patient start taking the Nardil?

A

Phenelzine (Nardil) needs to be started after at least 2 weeks AFTER discontinuing duloxetine (Cymbalta) due to Serotonin Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which antidepressive drugs need a washout period with MAO inhibitors?

A

SSRI, SNRI, TCA, and Buproprion

21
Q

What antipsychotics may have benefit in treatment resistant depression?

A

Ariprazole (Abilify)
Quetiapine (Seroquel)

22
Q

Common side effects of schizophrenia

A

Hallucinations (seeing something that is not present)
Delusions (a belief about something real that is not true)
Disorganized thinking/behavior

23
Q

Extrapyramidal Side Effects (EPS)

A

A group of side effects related to irregular movement:
- dystonias: prolonged contraction or spasms
- akathisia: restlessness with anxiety
- Parkinsonism: tremors, abnormal gait, bradykinesia
- tradive dyskinesias (TD): abnormal facial movements in tongue and mouth
- dyskinesias: abnormal movement

24
Q

Positive symptoms of Schizophrenia

A

Hallucinations
Delusions
Disorganized thinking/behavior

25
Q

Negative symptoms of Schizophrenia

A

Loss of interest
Lack of emotion
Inability to plan
Poor hygeine
Social withdrawal
Loss of motivation
Lack of speech

26
Q

Which 2nd generation antipsychotics have a higher chance of causing infertility?

A

Paliperidone (Invega)
Risperidone (Risperidol)

27
Q

Which 2nd generation antipsychotic has the highest QTc prolongation risk?

A

Ziprasidone (Geodon)

28
Q

A patient has hyperlipidemia, type 2 diabetes, and newly diagnosed schizophrenia. Their medications are Glucophage, Crestor, and Januvia. Which antipsychotic would be the best option?

A

Aripiprazole (Abilify) or
Lurasidone (Latuda) or
Ziprasidone (Geodon)

29
Q

A patient has failed both Geodon and Invega after two different 6 weeks trials. The patient is still experiencing hallucinations and disorganized thinking. What would be an appropriate next therapy?

A

Haldol or
Clozapine (Clozaril)

30
Q

A patient has Parkinson’s and his having symptoms of delusions. What would be the best treatment options?

A

Quetipine (Seroquel)

31
Q

A patient presents with depression and several maniac episodes lasting at least a week that are associated with psychosis, insomnia, and lack of attention. What would you diagnosis this as?

A

Bipolar I because of the psychosis

32
Q

A patient presents with flucuating moods of depression for 4 weeks then improved focus and energy with inflated self esteem for a week after. This week the patient feels productive and goal-oriented. What would you diagnosis this as?

A

Bipolar 2
because there is no psychosis and impairment of daily activity

33
Q

What is the 1st line treatment for acute maniac episodes?

A

Lithium
Valproate
Antipsychotic (SGA)

34
Q

What is the 1st line treatment for acute depression episodes in Bipolar Disorder?

A

Antipyschotic (Seroquel or Latuda)
Lithium
Valproate
Lamotrigine (Lamictal)

35
Q

What treatment recommendations should you AVOID in pregnancy patients with bipolar disorder?

A

Valproic Acid
Lithium
Carbamazepine

36
Q

What is the therapeutic range of lithium for the trough level?

A

0.6 - 1.2 mEq/L

37
Q

What is the DSM-5 criteria for ADD?

A

> or = 6 symptoms of inattention

38
Q

What is the DSm-5 criteria for ADHD?

A

> or 6 symptoms of inattention

AND

> or = 6 symptoms of hyperactivity

***symptoms must be present in two or more settings

39
Q

What are the first line treatment therapy for ADHD?

A

Stimulants
EX:
- Methyphenidate
- Lisdexamfetamine
- Dextroampetamine / Amphetamine

**take in the AM
C-II medications!!!

40
Q

A 16 year old male patient has tried Concerta and Adderall for his ADHD, but he has had some concerns of abuse. What is an appropriate recommendation for him?

A

Atomoxetine (Strattera)

41
Q

A 9 year old male patient has ADHD. He is currenly on Adderall, but is having trouble sleeping at night. What would be some recommendations?

A

Take 2nd dose of adderall early afternoon

Add Clonidine (Catapres) for sleep or Benadryl or Melatonin

42
Q

What drugs can cause or worsen anxiety?

A

Albuterol
Antipsychotics (Ariprazole or Haloperidol)
Buproprion
Caffeine
Illicit drugs
Levithyroxine
Steroids
Stimulantse
Theophylline

43
Q

What natural products can help with anxiety?

A

St John’s Wart
Valerian (Sedation)
Kava (liver damage!)
Passionflower

44
Q

What is the diagnotic criteria of insomnia?

A

Symptoms of poor sleep for at least 3 days per week for 3 months despite opportunities

45
Q

What natural products may be beneficial in insomnia?

A

Melatonin
Chamomile
Valerian (Sedation)

46
Q

What aredrug options for insomnia patients that need help falling asleep?

A

Escopiclone
Zolpidem
Ramelteon
Zaleplon

47
Q

What aredrug options for insomnia patients that need help STAYING asleep?

A

Eszopiclone
Zolpidem
Doxepin
Suvorexant

48
Q

A 45 yo male patient complains of inability to fall asleep. He was discharged from the hospital 2 weeks ago for with Millipred, Levoquin, Prozac, and Protonix. What medications could be making it harder to fall asleep?

A

Prozac (fluoxetine)
Millipred (Prednisolone)

Other drugs may cause insomnia:
-stimulants
-alcohol
-acetylcholinesterase inhibitors (donepezil)
-Aripiprazole
-Atomoxetine
-Buproprion
-Decongestions
-Diuretics (nocturia)
- Varenicline

49
Q

What is the recommended treatment for nacrolepsy?

A

Modafinil
Sodium oxybate
Stimulants (Adderall)

Psychiatric Conditions (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions