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Psychiatry > Defense Mechs and Drugs > Flashcards

Defense Mechs and Drugs Flashcards

1
Q

Transferring feelings to a more acceptable object

A

Displacement

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2
Q

Altering perception of upsetting reality to be more acceptable

A

Distortion

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3
Q

Separating a thought from it’s emotional components

A

Isolation of affect

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4
Q

Avoiding conflict by expressing hostility covertly

A

Passive aggresion

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5
Q

Intellectualization vs Rationalization

A

Intellectualization: using intellect to avoid uncomfortable feelings (learning a lot about a disease you have)
Rationalization: justifying behavior to avoid difficult truths

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6
Q

Responding in a manner opposite to one’s actual feelings

A

Reaction formation

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7
Q

Transferring emotional conflicts into physical symptoms

A

Somatization

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8
Q

Channeling impulses into socially acceptable behaviors

A

Sublimation

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9
Q

Suppression vs Repression

A

Suppression: putting unwanted feelings away to cope with reality
Repression: blocking unwanted feelings from entering consciousness

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10
Q

Avoid what meds in bipolar disorder

A

TCAs and SSRIs (can trigger mania)

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11
Q

Drug that can precipitate Lithium tox? use what instead?

A

NSAIDs

Use aspirin or sulindac instead

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12
Q

Lithium MOA and therapeutic levels

A

Supreses inosital triphosphate

Level: 0.6-1.2

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13
Q

Preferred treatment for bipolar in 1st trimester of pregnancy

A

Clonazepam

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14
Q

Valproate AE

A

Elevated LFT, hepatitis, skin rash

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15
Q

SJS from what bipolar med

A

Lamotrigine

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16
Q

Most common AE of Carbamezapine

A

Rash

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17
Q

Valproate therapeutic levels? Carbamezapine?

A

V: 6-12
C: 60-120

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18
Q

Atypical lab in MDD

A

Dexa suppression test –> failure to suppress

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19
Q

Think what with leaden paralysis in morning? best tx?

A

Atypical depression

Best tx is MAOis

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20
Q

SSRI w/ most DDI

A

Paroxetine

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21
Q

SSRI you don’t have to taper

A

Fluoxetine

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22
Q

SSRO w/ fewest DDI

A

Citalopram

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23
Q

SSRI discontinuation syndrome most common with what SSRIs

A

Sertraline and Fluvoxamine

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24
Q

SSRI good for old skinny ladies? why?

A

Mirtazepine

Increases appetite and sleep

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25
Q

Antidepressant to avoid in HTN patients

A

Venlafaxine

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26
Q

Drug for TCA overdose

A

IV NaHCO3 (helps metabolic acidosis and is cardioprotective)

27
Q

Two low potency antipsychotics

A

Chlorpromazine and Thioridazine

28
Q

Chlorpromazine AE

A

Purple grey metallic rash and jaundice

29
Q

Prolonged QTC and pigmented retinopathy with what antipsychotic

A

Thioridazine

30
Q

Akathisia tx

A

Propranolol (1st line) or benzo

31
Q

Atypical AP with highest risk for EPS and inc prolactin

A

Risperidone

32
Q

Weight neutral AAP but prolongs QTc

A

Ziprazodone

33
Q

Weight neutral AAP that increases akathesia

A

Ariprazole

34
Q

1 AE with olanzapine

A

Sedation (but don’t forget about weight gain)

35
Q

AAP that causes orthostatis and cataracts

A

Quetiapine (alpha blocking properties)

36
Q

Panic attack drug regimen

A

SSRIs long term, benzos short term if no hx of addiction

37
Q

Benzo withdrawal features

A

Seizures, fever, confusion, and hypertension

38
Q

OCD tx

A

Clomipramine is gold standard

SSRIs are first line

39
Q

Adjustment disorder vs Acute stress disorder

A

Acute stress must be life threatening

40
Q

Anorexia labs

A

Hypotension, bradycardia, hypothermia

41
Q

Long term complication of anorexia

A

Osteoporosis

42
Q

Most common cause of death in anoerexia

A

Heart disease, then suicide

43
Q

Labs of refeeding syndrome

A

Low PO4, lost Mg, Low Ca and fluid retention

44
Q

What stage of sleep is night terrors

A

Slow wave (stage 3)

45
Q

Look for what in a histrionic patient

A

Substance abuse or eating disorder

46
Q

Ego syntonic vs Ego dystonic

A

syntonic doesn’t think its their fault

dystonic realizes it is

47
Q

2 biggest risk factors for delerium

A

Age, then underlying dementia

48
Q

Alzheimer’s gene

A

APP (on chr 21), Apo E 2

49
Q

3 AchI drugs for alzhemiers

A

Donezepil, rivastigmine, galantamine

50
Q

Tx for frontotemporal dementia

A

Olanzepine for severe disinhibition

51
Q

Lewy body dementia path? Tx?

A

Intra-cytoplasmic Alpha-synuclein inclusions in neocortex

Give AchI

52
Q

EEG of CJD

A

Triphasic bursts

53
Q

What can B-blockers do in EtOH withdrawal

A

Mask signs of autonomic hyperactivity, but can follow hyperreflexia to dose benzes during withdrawal

54
Q

Best benzos to give liver dz patients

A

Lorazepam, oxazepam, or temazepam (LOT)

55
Q

WK caused by lack of

A

Thiamine (please don’t miss that)

56
Q

Why can pupils be dilated in heroin OD

A

Hypoxia 2/2 respiratory depression can cause

57
Q

Cocaine or amphetamine withdrawal can cause

A

SI, Hypersomnia, depression, and anergia

58
Q

Best 1st step for suspected cocaine/amphetamine intox

A

EKG the urine too screen

59
Q

Tx for tachycardia in cocaine tox

A

CCB

NO b-blockers

60
Q

Eriskson stages

A

65: integrity vs despair

61
Q

Degrees of ID

A

Mild: 55-70
Mod: 40-55
Severe: 25-40
Profound:

62
Q

Dx if ADD like symptoms but only in one setting

A

Normal, age appropriate behavior

63
Q

Tourettes dx criteria

A

At lest once a day for 1 year without a tic free period longer than 3 months

64
Q

First test for a 6 year old that stools in her clothes once every 2 weeks

A

Check for fecal retention

Psychiatry (6 decks)

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