Deck 2 COPY COPY Flashcards
what antipsychotic can you use for anorexia trtment
olanzapine
treatment of PTSD
SSRI
even if a patient denies a suicide attempt but they seemly had an attempt what do you do
you must commit them
treatment of sleep terrors
reassurance
do children remember their dreams in sleep terrors
no
if a patient is tolerating an SSRI but isnt getting full symptom relief whats next
augment their therapy with an antidepressant of another class like bupropion
what is considered a pathologic score on the MOCA
<24
signs of korsakoff syndrome
retro and anterograde amnesia, lack of insight, apathy, confabulation
what is the best way to handle a concerned parent
first address their concerns outright
what does PTSD put you at increased risk of
suicidal ideation and attempts
what do patients who experience sexual assault often get dx with alter on
PTSD
if a patient has signs of depression in an interview what should you inquire about in the current visit
suicidality
how do you treat tourettes
antidopaminergic and alpha-2 antagonits medications
what drug class is phenelzine
it is an MAO inhibitor
signs of tourettes
vocal and motor tics
vocal tics examples
grunting, throat clearings, shouting swear words, barking, yelling etc
motor tic examples
facial grimacing, blinking, shoulder shruggin, tongue protrusion
what is schizoaffective disorder
this is when you have concaminant psychosis and mood disorder (mania or depression) and then other periods of time with psychotic symtoms in the absense of mood symptoms
schizophreniform disorder
this is when you have psychosis and schizophrenic like symptoms for <6months
schizoid vs. schizotypal
schizoid is just a loaner schizotypal is weird and uncomfortable in social situations
if a patient is on hospice care, what do you do in terms of pain
you can keep increasing their morphine despite respiratory rate
signs of antidepressant discontinuation syndrome
flu like symptoms, insomnia, nausea, imbalance, electric shock like feeling, hyperarousal, dysphoria, irritability
most common psychiatric complication of MS
depression
how long do you have to have an adequate trial of SSRI
4-6 weeks at a therapeutic dose
mechanism of buprenorphine
partial mu-opioid agonist
benefits and disadvantages of buprenorphine
patients dont have to have undergone complete withdrawal, lower risk of overdose
mechanism of methadone
full mu agonist, very long acting
benefits and disadvantages of methadone
more instances of overdose, better patient retention
for a patient with premenstrual syndrome whats the best first step
do a menstrual diary to see when their symtoms start
treatment of severe PMS/PMDD
SSRI
if a patient is stable on lithium do you switch them
noooo
signs of PCP ingestion
violence and nystagmus
diagnosis of postpartum depression
same as MDD = SIGECAPS
if a patient has new onset rash after new med what is it
lamotragineeee
withdrawal symptoms of benzo use
diaphoresis, hypertension, tachycardia, seizures, AMS, tremors, anxiety, insomnia depressed mood
benzo AE after stopping abruptly
seizures
how do you treat delusional disorder
antipsychotic
difference between delusional disorder and schizophrenia
delusional disorder is when everything else in life is giong great except for the fact that they have this delusion
types of delusional disorder
percusatory, erotomanic, grandiose, jealous, somatic (body)
symptoms of alcohol withdrawal
tremors, anxiety, agitation, diaphoresis, seizures, tachycardia
syptoms of opioid withdrawal
nausea, vomiting, cramping, muscle aches, yawning, piloerection, lacrimation, hyperactive bowel sounds
symptoms of stimulant withdrawal
psychomotor slowing, increased appetite, hypersomnia, acute depression (crash)
nicotine withdrawal symtoms
dysphoria, irritability, increased appetite, anxiety
cannabis withdrawal symptoms
irritability, depression, anxiety, weightloss, stomach pain, headache, shakiness, fevers, chills etc.
characteristic feature of binge eating disorder
feelings of losing self control
how do you treat drug induced parkinsonism
benztropine and amantadine
differentiation between PCP and canthinone intoxication
PCP has nystagmus and is shorter acting
treatment of MDD with psychotic features
SSRI with antipsychotic OR electroconvulsive therapy
features of GAD in children
perfectionism, irritability, difficulty concentrating
signs of PTSD
hypervigilant, nightmares, emotional detachment, avoidant behavior, derealization
what is a common history finding of people with PTSD
trauma
treatment of specific phobia
exposure therapy
what drug can cause hyperparathyroidism
lithium
what drug can cause hypercalcemia
lithium via hyperparathyroid I
differentiation between narcissistic PD and OC personality disorder
OCpd is more preoccupied iwth order and diong things a certain way because of order and efficiency. narcissistic wants to do things a certain way because they are motivated by praise and attention
what do you use bromocriptine for
NMS
signs of lithium toxicity
tremors, AMS, confusion, hyperreflexia,
how long do you treat someone with schizophrenia
forever
what is schizoaffective disorder
this is when you have schizophrenic like symptoms during a major depressive or manic episode but you ALSO have schizophrenic symptoms by themselves for >2 weeks without depressive symptoms
if a patient continues to have hallucinations after a depressive or manic episode what is the dx
schizoaffective
what is the major qualifiying symptom of bipolar disorder
abnormally elevated moood
signs of OCD
persistant intrusive anxiety provoking thoughts, urges or images, responses to the obsessions that are unrealistic
how do you treat acute panic episode
benzo
what do you do if an SSRI precipitates a manic episode
D/C the SSRI, if the sx persist then you can add an antipsychotic
signs of cushing syndrome
central obesity, depression, proximal muscle weakness, purple striae
how long is the “normal” grief reaction
12 months great than that is persistant complex bereavement disorder
treatment of persistant complex bereavement
psychotherapy
at what point does grief become PCBD
> 12 months of dysfunction
benzo and opioid prescribed together
NO
what else should patients be prescribed if they are on long term opioid therapy for chronic pain
naloxone
naloxone vs. naltrexone
naloxone is short acting used for OD’s, naltrexone is for long acting alcohol and opioid use disorder
oculogyric crisis
sustained upward contraction of the eyes due to acute dystonia
parent management training
used when a child has ADHD symptoms but is only impulsive at home
what is does solitary play indicate
autism spectrum disorder
signs of antisocial PD
violates the rights of others, impulsive, consistently irresponsible
what must you have to have antisocial PD
must have hx of conduct disorder in children
what antidepressant do you use if you have sexual dysfunction
bupropion
difference between bupropion and buspirone
bupropion is for MDD and smoking cessation, buspirone is an anxiolytic
side effects of buporpion
no weight gain, no sexual dysfunction, does lower seizure threshold in bulemic people
acute stress disorder vs. adjustment disorder
adjustment is due to a life event and the person is signifantly impacted, acute stress disorder is like mini PTSD where you have flashbacks
histrionic PD
excessive emotionality, sexually seductive, dramatic emotions
which antipsychotic do you use for parkinsons trtment induced psychosis
quetiapine or clozapine
which mood stabilizer can cause liver damage
valproate
