Ethics/Radiology/Psychiatry Flashcards
What is one exception to partial emancipation of minors to make their own medical decisions (e.g. sex, reproductive health, substance abuse)?
Abortion needs to be disclosed to parents in 36 states
If the parents of a child are Jehoviah’s Witness can they deny life-saving therapy for their child?
No
Can a pregnant women refuse therapies which would assist the fetus while pregnant?
Yes. But once the fetus is out then she can’t refuse life-sustaining treatment for it
True/False
To be useful a living will needs to be clear and precise
True
When is a court order an acceptable tool?
After all other options have been exhausted, including an ethics consultation
Is physician-assisted suicide and euthanasia ever the right answer (that is the intent to end life)?
No
Do you need the consent of the father for an abortion?
No
When can you break patient confidentiality?
When there is direct harm to others (e.g. physical harm in setting of psychiatric patient or communicable diseases like HIV)
Can physicians refuse to treat certain patients?
It is legal for them to do so but not always ethical
Lytic bone lesions may be caused by what cancer?
Multiple myeloma
Primary bone cancer
Lung, renal, thyroid, or breast mets
Blastic bone lesions may be caused by what cancer?
Breast, prostate, or lymphoma mets
Paget’s Disease
Medulloblastoma in peds
What is the preferred therapy for delusional disorders and personality disorders?
Psychotherapy
What are other tests which should be included your diagnostic work-up to rule out non-psych related diagnoses?
TSH VDRL/RPR HIV BMP (Calcium and other metabolic disorders) Temporal lobe epilepsy hx
Besides psychosis, what are two other indications for the use of antipsychotics?
1) Sedating effect when BZDs contra-indicated
2) Huntington’s Disease or Tourette’s
Major side effect of clozapine
Agranulocytosis (Check a CBC once/week)
What are adverse effects seen with low-potency antipsychotics?
Orthostatic hypotension (from alpha blockade effect) Dry mouth, urinary retention, blurry vision, delirium (anticholinergic effect)
Adverse effects of thioridazine
Prolongs QT and arrhythmias
Abnormal retinal pigmentation
What are adverse effects of some antipsychotics which are a major reason for male non-compliance?
Impotence and inhibition of ejaculation
What is the major advantage and disadvantage of use of typical high-potency antipsychotics (e.g. haloperidol and fluphenazine)?
Advantage: fewer side effects related to alpha blockade and anticholinergic effect; higher potency
Disadvantage: higher association with EPS symptoms
What is the major advantage and disadvantage of low-potency typical antipsychotics (e.g. thioridazine, chlorpromazine)?
Advantage: Less likely to cause EPS symptoms
Disadvantage: Greater sedating effect and risk of orthostatic hypotension and anticholinergic effects
What is the major benefit of atypical antipsychotics such as risperidone, quetiapine, olanzapine, and clozapiine?
Greater effect on negative symptoms and has less risk of EPS
Which antipsychotic has the greatest risk of weight gain?
Olanzapine
How do you treat acute dystonic reactions or bradykinesia which occurs while on antipsychotics?
Reduce dose
Anticholinergics (i.e. benztropine, diphenhydramine, trihexyphenidyl)
How do you manage akathisia which may result from antipsychotics?
Reduce dose
BZD may help
Switch to a newer antispsychotic (e.g. risperidone)
