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Psychiatry & Behavioral Health > EOR Review > Flashcards

EOR Review Flashcards

1
Q

Duration required for Dx of MDD…

A

2 depressive episodes > 2 weeks

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2
Q

ADHD sxs must be present by what age?

A

7 yo

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3
Q

ADHD dx requires sxs in how many settings?

A

2 or more

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4
Q

Tx for panic d/o vs panic attack…

A

panic d/o = SSRI

panic attack = BZs

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5
Q

Duration required for panic d/o dx

A

2+ attacks x at least 1 month

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6
Q

Persistent depressive d/o (dysthymia) requires duration of…

A

2+ years (not severe sxs)

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7
Q

One of the strongest risk factors for developing ADHD is…

A

1st degree relative w/ ADHD

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8
Q

_______ a defense process by which an unacceptable feeling is unconsciously replaced with a course of action that is constructive and personally and socially acceptable.

A

Sublimation

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9
Q

________is the defense mechanism of conscious or unconscious separating of mental contents (thoughts, feelings, fantasies) from the individual’s awareness, which is disowned and separated from one’s personality.

A

dissociation

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10
Q

________ is the unconscious defense mechanism by which an unacceptable impulse or idea is attributed to others or the external world.

A

projection

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11
Q

________ is an unconscious defense mechanism by which unacceptable feelings, ideas, or impulses are transformed into their exact opposites.

A

reaction formation

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12
Q

Mood stabilizer useful to control anger in borderline personality d/o…

A

lamotrigine/topiramate

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13
Q

Describe the following lab abnormalities in anorexia nervosa…

LH/FSH
TSH
ESR
WBC
Potassium
BUN
A 
Low FSH/LH
Low TSH
Low ESR
Low WBC
Low Potassium

HIGH BUN

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14
Q

4 major sxs of narcolepsy…

A

excessive daytime sleepiness

cataplexy

sleep-related hallucinations

sleep paralysis

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15
Q

5 stages described by Kubler-Ross theory of dying patients…

A

Denial, anger, bargaining, grieving, and acceptance

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16
Q

Blockage of which receptors in which brain area lead to EPS when administering typical antipsychotics like haloperidol?

A

D2 receptors in nigrostriatal tract

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17
Q

Blockage of which receptors in which brain area give typical antipsychotics their therapeutic effects?

A

D2 receptors in mesolimbic tract

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18
Q

pathological, parrot-like, and apparently senseless repetition or echoing of a word or phrase spoken by a person or heard on TV; the repetition/echoing is done without actual comprehension.

A

echolalia

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19
Q

the inability to read and understand written language

A

alexia

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20
Q

The substitution of a similar sounding word for another

A

paraphasia

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21
Q

difficulty performing a learned motor activity despite having the understanding, muscular capacity, coordination, and normal sensations to do so.

Inability to execute purposeful movement

A

apraxia

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22
Q

dextroamphetamine acts as an adrenergic agonist on which 3 receptor types?

A

DA, 5-HT, NE

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23
Q

Anorexia Nervosa can cause dysfunction in which brain region?

A

hypothalamus

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24
Q

Isoniazid overdose antidote…

A

pyridoxine (1:1)

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25
Q

________ differentiates Wernicke’s Encephalopathy from acute alcohol intoxiation… otherwise, the signs and sxs are quite similar

A

ophthalmoplegia (paralysis/weakness of eye muscles)

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26
Q

Wernicke’s encephalopathy results from a deficiency in _______ which can occur with chronic etoh abuse

A

thiamin

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27
Q

initial tx of choice for postpartum depression is…

A

supportive psychotherapy

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28
Q

Duration of sxs for brief psychotic disorder, schizophreniform disorder and schizophrenia…

A

brief psychotic: 1 mo

Schizophreniform: >1 mo, < 6 mo

schizophrenia: > 6 mo

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29
Q

systematic desensitization is a type of _______ therapy

A

behavioral

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30
Q

postpartum blues should resolve by _______ and should not meet criteria for MDD

A

2 weeks (peak day 5)

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31
Q

Tx for TCA toxicity…

A

sodium bicarb (until pH 7.5-7.55)

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32
Q

_______ is marked by marked incongruence between his experienced and assigned gender for over 6 months

A

gender dysphoria

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33
Q

2 medications used for maintenance tx of alcohol use disorder…

A

naltrexone, acomprosate

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34
Q

Divalproex (Depakote) should not be used in elderly patients who already have _______.

A

poor liver function

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35
Q

In pregnant patients, lithium levels must be monitored weekly beginning at week…

A

34

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36
Q

________ is a disorder where real neurological symptoms without a medical or neurological cause are experienced by a patient.

Often, this includes weakness, paralysis, seizures, ALOC, numbness, deafness, blindness, etc

A

Functional neurological symptom disorder (conversion disorder)

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37
Q

Maintenance opioids are only appropriate for use after…

A

failure of other treatment

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38
Q

Which 3 antidepressant types (all classes) are most strongly associated with weight gain

A

mirtazapine (atypicals)
TCAs
MAOIs

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39
Q

M/c side effects of mirtazepine

A

increased appetite/weight gain
dry mouth
somnolence

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40
Q

3 TCAs with strongest anticholinergic/antihistamine action, leading to weight gain and sedation as side effects…

A

clomipramine, imipramine, doxepin

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41
Q

Serious side effect of clozapine…

A

agranulocytosis

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42
Q

Cluster A personality disorders… described as:

A

weird

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43
Q

Cluster B personality disorders… described as:

A

wild

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44
Q

Cluster C personality disorders… described as:

A

worried

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45
Q

Which personality disorder?

pervasive distrust and suspiciousness such that other’s motives are interpreted as malevolent

A

Paranoid Personality Disorder

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46
Q

Which personality disorder?

Pervasive pattern of detachment from social relationships and a restricted range of expression.

Do not desire close relationships.

A

Schizoid Personality Disorder

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47
Q

Which personality disorder?

Pervasive pattern of social and interpersonal discomfort with reduced capacity for close relationships

cognitive or perceptual distortions, magical thinking and eccentricities

A

Schizotypal Personality Disorder

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48
Q

Which personality disorder?

Pervasive disregard for and the violation of the rights of others

H/o Criminality

A

Antisocial Personality Disorder

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49
Q

Which personality disorder?

Pervasive pattern of instability of interpersonal relationships, self image, and affect.

Marked impulsivity

A

Borderline Personality Disorder

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50
Q

Which personality disorder?

Pervasive pattern of excessive emotionality and attention seeking

A

Histrionic personality

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51
Q

Which personality disorder?

pervasive pattern of grandiosity, need for attention, lack of empathy

A

narcissistic personality disorder

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52
Q

Which personality disorder?

pervasive pattern of social inhibition, feelings of inadequacy, hypersensativity to negative evaluation

A

Avoidant Personality Disorder

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53
Q

Which personality disorder?

pervasive and excessive need to be taken care of that leads to submissive and clinging behavior

fears of separation

A

dependent personality disorder

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54
Q

Which personality disorder?

Pervasive pattern of orderliness, perfectionism, and control at the expense of flexibility, openness and efficiency

A

obsessive compulsive personality disorder.

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55
Q

________ is the subjective feeling of restlessness, need to walk, inattention, sweating

A

akathesia

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56
Q

3 drug classes that can cause akathesia

A

antipsychotics
antidepressants
sympathomimetics

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57
Q

TOC for akathesia

A

beta blockers (propranolol)

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58
Q

Patients with eating disorders (esp. bullemia/anorexia) are likely to have mothers with which psychiatric disorder?

A

OCD

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59
Q

GAD requires ___ of 6 sxs to be present for how long?

A

3/6 sxs x 6 months

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60
Q

6 sxs for GAD dx…

A 
restlessness
fatigue
poor concentration
irritability
muscle tension
sleep disturbance
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61
Q

Carbamazepine is metabolized by the liver and induces CYP____

A

CYP3A4

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62
Q

Which 2 medications are the only FDA approved medications for tx of PTSD?

A

paroxetine, sertraline

63
Q

________ disease presents like alzheimers, but is characterized by well-formed visual hallucinations, parkinsonism, and fluctuating attention.

A

lewy body disease

64
Q

eosinophilic colitis is associated with which 2 mood stabilizers?

A

clozapine and valproate

65
Q

What Dx?

Showing of one’s gentials to unsuspecting person x 6 months or greater

A

Exhibitionistic Disorder

66
Q

Female sexual interest/arousal disorder requires _____ of 6 sxs to which cause distress to be present for how long?

A

3/6 x 6 months

67
Q

Absence of….
interest in sexual activity

sexual/erotic thoughts or fanticies

initiation of sexual activity/not receptive

excitement/pleasure

sexual interest/arousal in response to internal or external stimuli

genital or non-genital stimulations

A

female sexual interest/arousal disorder

68
Q

Over a period of at least 6 months, recurrent and intense sexual arousal from either the use of nonliving objects or a highly specific focus on nongenital body part(s), as manifested by fantasies, urges, or behaviors.

A

Fetishistic disorder

69
Q

lack or absence of sexual fantasies and desire for sexual activity in males x 6 months causing distress…

A

male hypoactive sexual desire disorder

not caused by other mental d/o, or medication

70
Q

Sexual arousal by prepubescent children (generally 13 years or younger) x 6 months and has acted on urges or caused marked distress

A

pedophilic disorder

71
Q

Arousal from being threatened or hurt during sexual activities x 6 months

A

sexual masochism disorder

72
Q

Recurrent and intense sexual arousal from observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity x 6 months with action on thoughts or causing significant distress

A

voyeuristic d/o

73
Q

Tx of voyeuristic d/o

A

therapy, +/- antipsychotics/antidepressants

74
Q

tx of sexual paraphilia

A

behavioral therapy

+/- SSRI (impulse control), antiandrogens

75
Q

Tx of male hypoactive sexual desire disorder

A

psychotherapy +/- testosterone for short term

76
Q

Tx of female sexual interest/arousal disorder

A

psychotherapy

77
Q

Patient consciously reports false symptoms, or induces symptoms, with the goal of playing the “sick role

A

Factitious disorder

78
Q

Tx of factitious disorder

A

psychiatrist and PCP intervention

if imposed on child, remove child from home

79
Q

Obsession with the idea of having a serious but undiagnosed medical condition despite repeated negative workups…

A

illness anxiety disorder

80
Q

duration required for diagnosis of illness anxiety disorder…

A

6 mo

81
Q

Tx of illness anxiety disorder

A

regularly scheduled appointments with PCP

CBT

82
Q

1+ real sx experienced by patient which causes significant disruption x 6 months, despite negative workups

A

somatic sx disorder (somatization d/o)

83
Q

Tx of somatic symptom disorder

A

frequent visits to PCP, psychotherapy

84
Q

physical sxs with no cause on workup, no intentional falsification of sxs by patient

A

somatic sx disorder

85
Q

neurologic sxs or deficits with no cause on workup and no intentional falsification by patient

A

functional neurologic disorder

86
Q

preoccupation with having undiagnosed serious illness without intentional falsification

patient believes they are ill

A

illness anxiety disorder

87
Q

intentional falsification of symptoms for primary gain/assume sick role

A

factitious disorder

88
Q

intentional falsification of symptoms for external gain (money, shelter, etc)

A

malingering

89
Q

self-harming is common in which personality disorder?

A

borderline personality disorder

90
Q

Splitting is a defense mechanism used in _______ personality disorder where a person idealizes someone at once as “all good” or “all bad”

A

borderline personality disorder

91
Q

A major difference between OCD and obsessive-compulsive personality disorder is that obsessive compulsive personality disorder is ego________, meaning patient is unaware the behavior is causing issues.

A

ego-syntonic

92
Q

_________ is a cluster A personality disorder where patients are able to function in society, but is associated with development of schizophrenia

A

schizotypal

93
Q

Delusional disorder is characterized by _______ delusion, meaning it is false, but is plausible despite being highly unlikely

A

nonbizarre delusion

94
Q

Dx of delusional d/o requires at least _____ delusion lasting ______ month(s) without other psychotic sxs nor significant impairment in function

A

1 delusion x 1 month

95
Q

Good or bad prognosis for schizophrenia?

negative sxs
gradual onset early in life

A

bad

96
Q

patient presents with psychotic sxs and hx of predominant mood sxs.

A

schizoaffective d/o

97
Q

To diagnose schizophrenia, sxs must be present for ____ months and include one of which three sxs?

A

6+ months

include:
delusions
hallucinations OR
disorganized speech/thought processes

98
Q

Which medications are best for managing negative sxs of schizophrenia?

A

atypical antipsychotics

99
Q

Which medications are best for managing positive symptoms of symptoms of schizophrenia, but tend to have more side effects?

A

typical antipsychotics (DA antagonists)

100
Q

Which antipsychotic?

-greater incidence of movement d/o (EPS)

A

risperidone

101
Q

Which antipsychotic?

-lower incidence of movement d/o (EPS)

A

quetiapine

102
Q

Which antipsychotic?

-high incidence of weight gain and DM

A

olanzapine

103
Q

Which antipsychotic?

  • risk of agranulocytosis and myocarditis
  • used for refractory schizophrenia
  • decreased suicide risk
A

clozapine

104
Q

Which antipsychotic?

  • high risk of prolonged QTI
  • must be taken with food
  • less likely to cause weight gain
A

ziprasidone

105
Q

Which antipsychotic?

  • partial D2 agonist
  • less potential for weight gain and sedation
  • increased akathisia risk
A

Aripiprazole

106
Q

Which antipsychotic?

  • safe in pregnancy
  • can also be used for bipolar depression
A

lurasidone

107
Q

The following are _____ TCAs:

Amitriptyline
imipramine
clomipramine

A

tertiary TCAs

108
Q

unique indication for clomipramine…

A

OCD

109
Q

unique indiction for imipramine

A

nocturnal eneuresis

110
Q

The following are _____ TCAs:

desipramine
nortriptyline

A

secondary

111
Q

Secondary TCAs act on the _______ receptor to increase the concentration of…

A

NERT, NE

112
Q

Tertiary TCAs act on the ____ and ______ receptors to increase the concentration of which neurotransmitters?

A

SERT and NERT

5HT and NE

113
Q

3 major types of side effects of TCAs

A

sedation (H1 blockade)
Atropine-like SFx (M blockade)
orthostatic hypotension (Alpha 1 blockade)

114
Q

6 signs/sxs of serotonin syndrome

A 
skin flushing
hyperthermia
agitation
rigidity
seizure
coma
115
Q

the 3 most common causes of death from TCA… (3 Cs)

A

convulsion
coma
cardiotoxicity

116
Q

5HT2 receptors impact which 3 behaviors?

A

mood
feeding
reproduction

117
Q

DA receptors impact which behaviors

A

cognitive function
awakeness
motivation

118
Q

MAOIs act on which 3 neurotransmitters via blockade of monoamine oxidase?

A

DA, 5HT2, NE

119
Q

MAOIs are effective for what type of depression?

A

atypical depression (improve mood in response to positive events)

120
Q

The following three MAOIs are (selective/non-selective)

isocarboxazid
phenelzine
tranylcypromine

A

nonselective (inhibit MAO A and MAO B)

121
Q

nonselective MAOIs bind irreversibly and increase levels of…

A

5HT, NE, DA

122
Q

The following two MAOIs are (selective/non-selective)

selegiline
rasagiline

A

selective (inhibit MAO B)

123
Q

selective MAOIs only increase which neurotransmitter?

A

DA

124
Q

2 major side effects of MAOIs

A

hypertensive crisis

serotonin syndrome

125
Q

how long must MAOIs be stopped before switching ot a medication like an SSRI?

A

2 weeks

126
Q

Tx of MAOI induced hypertensive crisis…

A

phentolamine

127
Q

These two types of presynaptic neurons also have alpha 2 receptors

A

NE, 5HT

128
Q

Mirtazapine blocks which 4 receptor types?

Blockade of which receptor give it its therapeutic effect?

A

alpha 2
5HT2a
5HT3a
H1

alpha 2 blockade (reduces inhibition of presynaptic neuron)

129
Q

Mirtazapine is a partial serotonin antagonist, and its blockade of 5HT2a and 5HT3a leads to increased binding to ______ receptors, which are linked to depression

A

5HT1a

130
Q

mechanism of action for bupropion…

A

blockade of NERT and DART receptors on presynaptic neuron

131
Q

High levels of dopamine in the ______ pathway are responsible for the positive sxs of schizophrenia

A

mesolimbic

132
Q

low levels of DA in the ______ pathway are responsible for the negative sxs of schizophrenia…

A

mesocortical

133
Q

Haloperidol and fluphenazine are considered ______ potency antipsychotics

A

high potency

134
Q

chlorpromazine, thiothixene and thioridazine are considered _____ potency antipsychotics

A

low potency

135
Q

Typical antipsychotics stimulate the release of ______ in the ______ region, resulting in galactorrhea, gynecomastia and oligomenorrhea

A

prolactin release in tuberoinfundibular pathway

136
Q

How does NMS differ from serotonin syndrome?

A

serotonin syndrome: hyperreflexia, dilated pupils

NMS: hyporeflexia, normal puils

137
Q

Tx for NMS…

A

dantrolene

138
Q

This typical antipsychotic causes corneal deposits…

A

chlorpromazine

139
Q

this typical antipsychotic causes retinal deposits

A

thioridazine

140
Q

DA in the mesolimbic pathway influence which behaviors?

A

motivation and desire

141
Q

DA in the mesocortical pathway influences which behaviors?

A

emotions

142
Q

DA in the nigrostriatal pathway influences which behavior?

A

involuntary movements, coordination

143
Q

DA in the tuberoinfundibular pathway has what effect?

A

release DA to limit secretion of prolactin

144
Q

Atypical antipsychotics block ______ in the mesolimbic pathway to alleviate positive symptoms and block ____ receptors in the mesocortical pathway to alleviate negative symptoms

A

D2, mesolimbic

5HT2a, mesocortical

145
Q

Which atypical antipsychotic is most likely to cause hyperprolactinemia?

A

risperidone

146
Q

dystonia is an EPS characterized by onset of hours-days with muscle spasm such as torticolis or oculogyric crisis where eyes are fixed in an upward and lateral gaze.

Tx for dystonia is…

A

Anticholinergics: benztropine or diphenhydramine

147
Q

1st line tx of opioid abuse…

A

methadone/suboxone

148
Q

AMS, coma with normal vitals and normal pupils suggests overdose of…

A

benzos (ACDC = amnesia, confusion, disinhibition/dizziness/drowsiness/disorientation, cognitive impairment

149
Q

Sialorrhea (drooling) is a unique side effect of which antipsychotic and can be treated with ______

A

clozapine, glycopyrrolate

150
Q

nortriptyline is an inhibitor of reuptake of NE and 5HT. The exertion of NE reuptake inhibition occurs in which brain region?

A

locus coeruleus (location of most NE neurones)

151
Q

3 main mood stabilizers…

A

lithium, carbamazapine/oxcarbazapine, valproate

152
Q

2 main side effects of mirtazapine, which can be advantageous depending on presentation of depression

A

sedation

weight gain

153
Q

the antidepressant with the least likely side effects of sexual dysfunction…

A

trazodone (SFx: priapism)

bupropion decreased sexual side effects, but trazodone has none

154
Q

Haloperidol is used in acute agitation, but is contraindicated for patients with which condition?

A

parkinson’s disease

Psychiatry & Behavioral Health (7 decks)

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