Exam Guru Flashcards
Distinguish PMDD from PMS?
- treat PMDD?
Severity - major impairment dysfunction in occupational or social arenas.
SSRI - serotonin hypothesis (5-HT adversely affected by ovarian steroid levels)
Nicotine withdrawal:
HA, difficulty concentrating
Constipation
Irritable
Fatigue
What increased in GAD?
Cortisol - stress hormone
Increased GC levels produces/exacerbates anxiety and depression
Caffeine intoxication:
Psychomotor agitation, restlessness Nervousness, excitement Rambling flow of thought and speech Diuresis, GI disturbance Tachycardia Flushed face Muscle twitching
Why orthostatic hypotension with risperidone?
alpha-1 antagonist
- impaires NE binding to alpha 1
Risperidone/palperidone
Clozapine / thioridazine
Schizotypal personality disorder vs. Delusional disorder vs. Paranoid personality disorder
Schizotypal: magical thinking, social isolation
Delusional disorder: 1+ month delusions with NO significant impairment…single fixed delusion
Paranoid personality: >1 delusion
ECT primarily helps with…
Mood disorders
Psychotic disorders
(NOT anxiety or OCD)
Hx unrelated symptoms in different organ systems
No clear pathology on physical examination
Somatic symptom disorder
- underlying psychosocial stressor
Females before age 30!!
Around time of first pregnancy!!!
Single pseudo-neurological symptom in response to psychological stress…
Conversion disorder
the symptom is often severe
How treat somatic symptom disorder?
Regular monthly follow-up visits with same primary care physician for education
Buprenorphine
Partial opiate agonist
- poor binding so hard to OD
- also blocks other opiates from binding
Slow onset of action like Methadone
Psilocybin
Psychedelic compound - mushrooms
- visual hallucinations (aware not real)
- no respiratory depression
Which has higher teratogenatic effects, lithium or carbamazepine?
Carbamazepine - neural tube defects
Lithium less but Epstein’s anomaly - 1st trip = atrialization of right ventricle.
Haldol good in pregger
Bupropion good for depression and also…
Desire to quit smoking
Lack of sexual side effects
Lack of erection, neurotransmitter?
Point & Shoot
- Point = Parasympathetic = erection = ACh
- so Anti-cholinergic activity can cause erection problems
Fear of having panic attack in public place - difficult to escape?
Agoraphobia
1+ month recurrent panic attacks, worry about future attacks, change of behavior to avoid attacks.
Panic disorder
Treat panic disorder?
SSRI, BDZ, psychotherapy
Avoidant personality disorder?
Desire relationships
Fear rejection
Social anxiety
Adverse effect of bupropion?
Lower seizure threshold
Dilated pupils
Can see sounds
Tremor
What drug? How reverse?
LSD - serotonin hallucinations
Give 5-HT blocker like ziprasidone (2nd gen AS)
Which two BDZ’s give for DT’s in pt w/ bad liver?
Lorazepam & Oxazepam
- metabolized by glucuronidation
Low body weight Intense fear of gaining weight Amenorrhea in females Hypotension Bradycardia
Anorexia nervosa
- can’t use bupropion due to lowering seizure threshold
- can’t use in weight disorders - tonic-clonic seizures
What med lowers BP and decreases incidence of nightmares in pt’s w/ PTSD?
Prazosin (and terazosin)
- alpha blocker, so lowers BP
- decreases nightmares
How treat PTSD?
SSRI + cognitive behavioral therapy
Bulimia nervosa develop what acid-base abnormality?
Non-anion gap
Metabolic alkalosis
- with respiratory compensation
What 2 things do you always see in bulimia nervosa?
Binge eating
Normal or increased BMI
Drug used for GAD that has little to no sexual side effects?
Mirtazapine: alpha 2 antagonist
- atypical antidepressant
- appetite stimulation
- sedation
Describe GAD?
Excessive anxiety and worry in everyday life situations
Insomnia + unsatisfying sleep
May have panic attacks
Muscle tension, irritability
