Deck 1 COPY COPY Flashcards
1
Q
what medication is best for helping with sleep hygeine
A
zolpidem
2
Q
which benzo do you use for short term panic and anxiety
A
alprazolam
3
Q
do you use benzos in sleep disorders
A
maybe a long acting but not a short acting, Z drugs are better to try first
4
Q
when do you see delerium tremens
A
> 48 after last drink
5
Q
what class of drug is doxepin
A
TCA
6
Q
TCA OD signs
A
anticholinergic symptoms (mydriasis, flushed skin, tachy, HTN) + prolonged QT
7
Q
which drug to use in a patient with poor kidney function in bipolar disorder
A
valproate (not lithium)
8
Q
side effects of lithium
A
hypothyroidism, nephrogenic diabetes insipidus,
9
Q
first step in elderly patients with acute changes in memory
A
medication review
10
Q
what can MAO inhibitors lead to with wine and cheese
A
tyramine excess which causes a hypertensive crisis
11
Q
when is it considered anorexia
A
<18 BMI
12
Q
SS vs NMS reflexia
A
SS has hyperreflexia and NMS has regular reflexes
13
Q
facial features of fragile X
A
Long face, wide set ears, macrocephaly
14
Q
when does postpartum psychosis occur
A
within 2 weeks of delivery
15
Q
can steroids cause acute mood disorders`
A
yes, especially in adolescents
16
Q
if a patient has an OD on methadone, what do you do
A
naloxone and then you have to keep them in the hospital for >2 days because the half life of methadone is very long
17
Q
if a patient does not want their procedure but a POA does, what do you do
A
get an eval to determine competency
18
Q
treatment of bulemia and bing eating disorder
A
SSRI
19
Q
treatment of anorexia
A
nutriitonal therapy and occasionally olanzapine
20
Q
what class of drug is paroxetine
A
SSRI
21
Q
treatment of premature ejaculation
A
SSRI
22
Q
how to treat patients who are hyperventilating due to stress
A
reassurance and breathing retraining (no Paper bag!)
23
Q
what types of therapy besides medication help prevent relapse of schizophreniaI
A
family therapy
24
Q
imaging findings of patients with long history of schizophrenia
A
dilated ventricles
25
time range of brief psychotic disorder
1 day to 1 month
26
when do you keep patients on antidepressents indefintely
when they have had >2 relapses
27
what can you give to patients to immediately sedate if they are agitated
IM lorazepam or haldol (often given in combo)
28
dx of a patient keeps seeing herself killing mom with knife when using a knife
OCD
29
treatment of OCD
SSRI
30
can hypothyroid cause mood symptoms
yes extreme mood symptoms
31
TCA OD signs
seizures, anticholinergic effects, prolonged QT, mental status changes
32
PTSD diagnosis timeline
>1 month symptoms
33
does adjustment disorder follow violence
no just after a stressful event, violence is more liely PTSD
34
presentation of pediatric depression
often irratibility rather than depressed mood
35
signs of cannabis withdrawal
irritability, depression, anxiety, weightloss, stomach pain, headache, shakiness, fevers, chills etc.
36
after what age should an imaginary freind be considered worrisome
after age 6
37
comorbid conditions of tourettes
OCD and ADHD
38
when do you use sertraline over citalopram
recent MI history
39
main AEs of clozapine
lowers seizure threshold and can cause agranulocytosis
40
timeframe of acute stress disorder
>3 days < 1mo
41
can pregnant people take methadone
yace its safer than having them withdrawal
42
what is a nromal score on the MOCA
> or equal to 26/30
43
for a patient that just had one depressive episode how long do you trt them
6 months after remission, do not reduce the dose
44
next steps for a patient that has a SI and a plan and means
hospitalize them
45
what is considered an adequate trial on an antidepressant
>6 weeks
46
waht do you do if an SSRI doesnt work for a patient
you try another SSRI or SNRI first before moving onto other antidepressants
47
signs of NMS
fever, muscle rigidity, normal reflexes, hyperthermia, altered mental status
48
how do differentiate between meth use and schizophrenia
meth will have severe dental problems like bruxism or tooth rot dry mouth etc
49
how to differentiate between normal adolescent behavior and depression
significant change to baseline and if their irratibility/moodniness is impacting their grades and social life
50
group A personality disorders
paranoid, schizoid, schizotypal
51
paranoid personality disorder
suspcioin and distrust of others, perception of benign remarks as attacks, oversensitivity
52
schizoid personality disorder
prefers to be alone, loaner, lack of interest in social connection, constricted affect
53
schizotypal personality disorder
kinda weird, socially awkward, ecessive discomfort in social situations
54
cluster B Personality disorders
antisocial, borderline, histrionic, narcissistic
55
antisocial PD
lack of respect for others rights, lack of remorse, kids with ODD have this >18
56
borderline PD
extreme opinions, unstable emotions, difficulty maintaining relationships, high suicide attempts, intense anger, hates feeling abandoned
57
narcissistic PD
excessive need for attention, lack of empathy, taking advantage of others
58
histrionic PD
attention seeking and intensely emotional behavior, inappropriate, sexually provocative towards others
59
cluster C personality disorders
avoidant, obsessive-compulsive, dependent
60
avoidant PD
excessive shyness, sensitive to critism, low self esteem, fears relatinoships for fear of being rejected, strong desire for relationships
61
OC personality disorder
need for order and control, efficiency, low flexibility
62
dependent PD
fear of separation, excessive need for connection, difficulty diong things alone
63
signs of tardive dyskinesia
abnormal involuntary movements, tongue protrusion, foot tapping, restlessness,
64
how do you treat tardive dyskinesia
switch to a different non first gen antipsychotic (clozapine), reduce dose, use valbenazine (VMAT2 inhibitor)
65
advice for parents for chlidren with specific phobias
read them stories about it, exposure etc.
66
what type of antidperessant is paroxetine
SSRI
67
how long do you have to have SIGECAPS to be dx
>2 weeks
68
onset of NMS vs. SS
NMS can be over a couple of days (not as acute) and SS is more rapid like <24 hours
69
what is projection
this is when you attribute thoughts to another PERSON vs. displacement is a less threatening person/object
70
what is denial
avoiding anxiety provoking thoughts by not accepting reality
71
what is regression
this is when you revert to a child like state or move backwards in a maturational state
72
what is displacement
this is when you shift your focus to a less threatening person or object
73
what is intellectualization
Using abstract, rational, and/or logical reasoning to avoid affective expression and distance oneself from stress
74
what is rationalization
Offering excuses or feasible explanations in an attempt to justify behaviors, attitudes, or beliefs to avoid self-blame
75
what is reaction formation
Complete denial and/or rejection of an unacceptable impulse by acting in a diametrically opposite manner to avoid anxiety-provoking thoughts
76
what is sublimation
this is when you shift your unacceptable/unattainable thoughts to soemthing goal directed
77
what is suppression
this is when you conscoiuly suspend an anxiety provoking thought
78
what is depersonalzation/derealization disorder
persistent feelings of being unattached to self or being an outside observer to your life or experiencing the surroundings as unreal
79
what is dissociative amnesia
inability to recall information about yourself usually due to a stressor
80
what is dissociative identity disorderq
discontinuity of self and loss of personal agency with >2 alters, associated with trauma/abuse
81
signs of sleep apnea
depressed mood with normal range of affect, sleepiness, high BMI, male sex, HTN
82
what can happen with prolonged QT
patients can go into torsades
83
dx criteria for cyclothymia
>2 yrs in adults of fluctuating moods not manic or major depressive episodes by hypo of both
84
what is somatic symptom disorder
somatic symptoms (like leg pain) causing significant distress with repeated medical treatment despite negative workups
85
risk factors for somatic symptom disorder
female, lower education level, hx of chlid abuse, sexual trauma, chronic illness
86
what do you need to monitor for patients on antipsychotics
you need to check their metobolic levels (lipids, glucose, etc.)
87
highest risk antipsychotics for metabolic effects
olanzapine and clozapine
88
what is a distinguishing factor between major depressive disorder and normal stress resposne
MDD has to affect your life and ability to function in school, work, family etc.
89
what is akathesia
subjective restlessness, inability to sit still
90
how do you treat akathisia
decrease antipsychotic and add propanolol
91
how do you treat parkinsonium
this is when you use benztropine and amantadine
92
how do you treat acute dystonia
benztropine and diphenhydramine
93
reaction formation
this is when you have a position but then do the exact opposite
94
sublimation vs. reaction formation
in sublimation the behavior provides satisfaction and in reaction formation it does not
95
if a patient has increased anxiety from starting an SSRI what do you do
you decrease their SSRI dose
96
if a patient has a difficult time giving a history of events and they have been sexually abused what is the likely dx
dissociative identidy disorder
97
what do you do with an aggressive patient
first make sure their needs are met like offering food and water, keep a safe distance, keep door open
98
drugs to treat opioid withdrawal
clonidine, methadone, benzos, antiemetics, antidiarrheals
99
sleep changes in depression
decreased REM latency time, and decreased slow wave sleep (Phase III and IV)
100
treatment of depression with psychotic features
antidepressant with antipsychotic or electroconvulsive therapy
101
signs of language disorder in a child
persistent difficulties with comprehension and/or production (expression), ex grammar, syntax, content..
102
what is PMDD
pre menstrual dysphoric disorder where you get really irritable and bloaty before a period
103
what is the pathophys of NMS
decreased central dopaminergic activity
104
treatment of PTSD non medical
CBT
105
treatment of acute stress disorder
CBT
106
ways to decrease rate of rehospitalization in schizophrenic patients
LAI, family therapy
107
DMDD dx timeline
before age 10
108
treatment for acute mania
antipsychotic, lithium, valproate
109
treatment for acute dystonia
diphenhydramine
110
how to manage a patient with body dysmorphic disorder
Ask them how others would perceive of them
111
if a patient has suicidal thoughts what do you do
you need to first do a suicide risk assessment and then based on that can 302 them
112
what is kleptomania
the intense urge to steal things of small monetary value, guilt and shame usually follow
113
treatment for acute bipolar depression
quetiapine and lorasadone
114
what substance can buproprion help with
cigs
115
what substances can buprenophrine help with
cocaine, meth, opioids
116
what do you give to reinforce abstinance in a patient that has not relapsed on opioids
naltrexone
117
what drug do you use for patients with high risk OUD or in current using
methadone
118
treatment of acute serotonin syndrom
sedation with a benzo, cyproheptadine, short term antihypertensives like esmolo
119
what is bromocriptine
dopamine agonist used to treat NMS
120
if a patient failed one antipsychotic whats next
try a different class, clozapine only after two fails
121
what are the non stimulant drugs for ADHD
clonidine, guanfacine, atomoxetine
122
what are signs of adrenal insufficiency
depression, decreased body hair, craving saltiness
123
how do you test for primary adrenal insufficiency
cosyntropin test (synthetic ACTH)
124
what is the hallmark of bulemia
bing eating WITH compensatory behavior (vomiting, excess exercise, etc)
125
treatment of body dysmorphic disorder
SSRI
126
if a patient has both poor appetite and insomnia what is a good antidepressant to use
mirtazapine
127
how do you monitor opioid use in a chronic pain patient
query the prescription drug database every month
128
what is delusional disorder
when you have one specific delusion but it does not impede other functioning
129
early side effects of SSRIs
headache nausea insomnia
130
signs of suripticious sulphonylurea use
weight loss, hypoglycemia sx, high insulin and C-peptide
131
what medications can be used for alcohol use disorder
acomprosate, naltrexone
, disulfiram
132
when does postpartum depression occur
4-6 weeks post birth but up to a year after
133
treatment of postpartum depression
SSRI
134
when do postpartum blues occur
2-3 days post birth, no trt
135
what is the principle of proportionality
methods used to achieve a goal are necessary, appropriate and not excessive
136
signs of cocaine withdrawal
acute depression, hyperphagia, increased sleep, increased vivid dreaming, drug cravings
137
is there more or less slow wave sleep in depression
less
