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Psych Clerkship > Differential Diagnosis and Management Questions > Flashcards

Differential Diagnosis and Management Questions Flashcards

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1
Q

An acute dystonic reaction in which there is a spasm of the muscles of extraocular motion

A

Oculogyric crisis

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2
Q

Muscle spasm that cause abnormal positioning of the head; abnormal, asymmetrical head or neck position, which may be due to a variety of causes

A

Torticollis

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3
Q

Spasmodic torticollis in which the head is drawn back

A

Retrocollis

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4
Q

Spasm of the jaw muscles

A

Trismus

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5
Q

Pt complains that she cannot stop looking up and eyes are deviated upward bilaterally on exam.

A

Oculogyric crisis

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6
Q

What should you use to treat symptoms of a patient with schizoaffective disorder with depressive sx?

A

Antipsychotic + Antidepressant

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7
Q

What should you use to treat postpartum depression with psychotic features?

A

Antidepressant (such as SSRI) and antipsychotic

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8
Q

What is a common psychotic symptom of postpartum depression?

A

Hearing a child crying

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9
Q

Bilateral abducens nerve palsy, horizontal nystagmus, ataxia, and global confusion + apathy

A

Wernicke encephalopathy

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10
Q

What causes Wernicke encephalopathy?

A

Thiamine – B1 – deficiency

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11
Q

Unstable vital signs, tremulousness, agitation

A

Alcohol withdrawal

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12
Q

Diarrhea, cheilosis, glossitis, but no neurological abnormalities

A

Folic acid deficiency

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13
Q

Dementia, Incontinence, Gait disturbance (Classic triad)

A

Normal pressure hydrocephalus

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14
Q

What should you do if you suspect Wernicke syndrome

A

Administer IV thiamine! - many sequelae of thiamine deficiency are reversible with this treatment

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15
Q

Is mistakenly administrating thiamine harmful?

A

Normal pressure hydrocephalus

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16
Q

Should a patient with Wernicke encephalopathy be given glucose?

A

No! Giving patient glucose prior to administering thiamine can worsen the Wernicke encephalopathy

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17
Q

Are the delusions in delusional disorder typically bizarre or non-bizarre?

A

Non-bizarre

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18
Q

How are delusional disorders typically treated?

A

Give an antipsychotic

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19
Q

What is tegretol?

A

Anti-epileptic used to treat bipolar disorder

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20
Q

What causes malignant hyperthermia?

A

Resembles NMS but follows administration of inhaled anesthetic agents.

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21
Q

Are command auditory hallucinations a psychiatric emergency?

A

Yes

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22
Q

What do you do if you have a patient with command auditory hallucinations

A

Start on a neuroleptic

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23
Q

What is a neuroleptic?

A

Antipsychotic

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24
Q

If a patient has bipolar disorder and is in a manic state but is disrupted and agitated what should you administer?

A

First give an antipsychotic and benzodiazepine; then give a mood stabilizer

25
Q

How long does it take for mood stabilizers like carbemazepine or lithium to work?

A

At least a week

26
Q

What are therapeutic lithium levels?

A

0.8 – 1.2 mEq/L

27
Q

Can haldol cause muscle stiffness?

A

Yes, it can be a parkinsonian side effect

28
Q

How do you treat the muscle stiffness caused by haldol?

A

Either lower the haldol or give an anticholinergic medication

29
Q

What is baclofen?

A

A muscle relaxant

30
Q

A reaction that may occur in a patient who witnesses or experiences a traumatic event (which must involve death, threatened death, or serious injury). Sx – hyperarousal states, dissociative states, and intrusive re-experiencing of events.

A

Acute stress disorder

31
Q

PTSD-like symptoms for x weeks or less is acute stress disorder. What is x?

A

4 weeks / 1 month

32
Q

Desire to rub one’s genitals against a nonconsenting person?

A

Frotteurism

33
Q

The desire to watch people undress without their consent.

A

Voyeurism

34
Q

Having intense fantasies or urges toward nonhuman objects that involve humiliation or pain, or toward nonconsenting persons

A

Paraphilias

35
Q

Desire to expose one’s genitals to a nonconsenting person

A

Exhibitionism

36
Q

Maladaptive behavioral or emotional symptoms after a stressful life event – sx begin within 3 months and end within 6 months and cause significant impairment in daily function or interpersonal relationships.

A

Adjustment disorder

37
Q

Can an adjustment disorder diagnosis be made when a diagnosis of MDD be made?

A

Noooo

38
Q

Do anxiety disorders ever result in unconsciousness?

A

No

39
Q

How long is schizophreniform disorder?

A

1 month to 6 months

40
Q

How long is brief psychotic disorder?

A

< 1 month

41
Q

How long is schizophrenia?

A

> 6 months

42
Q

Agitation, pacing, psychosis, tachycardia / vital sign instability, tics and spasms, vertical nystagmus

A

PCP intoxication

43
Q

Pinpoint pupils –> diffuse crampy abdominal pain, flu-like syndromes → yawning, dilated pupils, fever, tachy, high blood pressure

A

Opiate withdrawal

44
Q

Yawning, rhinorrhea, muscle aches, diarrhea, lacrimation, and fever

A

Opiate withdrawal

45
Q

How do you manage opiate withdrawal?

A

Clonidine (a centrally acting alpha 2 agonist) or methadone (a synthetic long-acting opiate), lorazepam (to treat vital signs), loperamide (diarrhea)

46
Q

Can TCAs or neurolpetics cause life-threatening withdrawal symptoms?

A

No

47
Q

Tremors, anxiety, auditory / visual / tactile hallucinations, autonomic hyperactivity, seizures

A

Withdrawal of benzos or barbiturates

48
Q

How long do some of the common side effects (diarrhea, constipation, nausea, headache) of SSRIs usually last?

A

Several days

49
Q

Onset of emotional or behavioral disturbances within 3 months of a significant life event that may manifest as marked change in an individual’s ability to function in school, work, or interpersonal relationships. Less than 6 months I think.

A

Adjustment disorder

50
Q

Difference between normal bereavement and MDD

A

MDE – if depressive sx last longer than 2 months after the person died, if the survivor has guilt surrounding anything other than actions they should have taken to prevent the death, if the survivor has prominent hallucinations, psychomotor retardation, or thoughts of wanting to end their life.

51
Q

Best treatment for PCP intoxication

A

A dark, quiet room with minimal stimulation

52
Q

What are three FDA approved medications for bipolar depression?

A

Seroquel, Latuda, and Zyprexa

53
Q

Seroquel

A

Quetiapine

54
Q

Lamotrigine

A

Lamictal

55
Q

Quetiapine

A

Seroquel

56
Q

Lamictal

A

Lamotrigine

57
Q

Most appropriate treatment for patient with MDD with psychotic features?

A

ECT or antidepressant + antipsychotic

58
Q

How do you tell if an elderly patient has dementia versus depression?

A

Patients with dementia confabulate when they don’t know an answer; patients with depression just say they don’t know.

59
Q

Social anxiety disorder treatments?

A

1st line – behavioral (CBT), Short term – benzos. Long-term: Sertraline and fluoxetine, SNRI (venlafaxine)

Psych Clerkship (1 decks)

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