FA Psychiatry Flashcards
Signs of physical abuse
Spiral fractures* Burns Subdural hematomas Patterned marks and bruising Rib fractures Retinal hemorrhage or detachment
Neuro findings in ADHD
Decreased frontal lobe volume/metabolism
NT change: Alzheimer
Decreased ACh
NT change: Depression
Decreased NE, 5HT and DA
NT change: HD
Decreased GABA
Decreased ACh
Increased DA
NT change: PD
Decreased DA
Increased 5-HT
Increased ACh
NT change: Schizophrenia
Increased DA
NT change: Anxiety
Increased NE
Decreased 5HT and GABA
Destroyed in Korsakoff amnesia?
Mamillary bodies
What diagnostic test will be abnormal in delirium?
EEG (vs. normal in dementia)
Formication is seen in…?
Cocaine use and OH withdrawal
Decreased dendritic branching is seen with what disorder?
Schizophrenia
Sleep changes in depression
EMA Decreased slow-wave sleep Decreased REM latency Increased REM early in sleep Increased total REM Repeated nighttime awakenings
Postpartum blues timeline
Starts 2-3 days after delivery
Resolves within ten days
(seen in 50-85%)
Postpartum depression timeline
Starts within 4 weeks of delivery
Lasts 2 weeks to a year or more
What are the ABC cluster personality traits?
A = awkward
Paranoid
Schizoid
Schizotypal
B = B movies (dramatic) Histrionic Borderline Antisocial Narcissistic
C = Cowardly
Avoidant
Obsessive-compulsive
Dependent
Cause of narcolepsy
Decreased orexin production in lateral hypothalamus
Treatment of narcolepsy
Daytime stimulants (amphetamines, modafinil) Nigh-time sodium oxybate (GHB)
Treatment of restless leg syndrome?
DA agonists (pramipexole)
Mechanisms of antipsychotics
Block D2 and increased cAMP
Evolution of EPS symptoms (4’s)
4 hours acute dystonia
4 days akathisia
4 weeks parkinsonism
4 years TD
Treatment NMS
Bromocriptine (DA agonist) or dantrolene
High potency typical antipsychotics
Trifluoperazine
Fluphenazine
Haloperidol
*EPS symptoms
Low potency typical antipsychotics
Chlorpromazine
Thioridazine
*anticholinergic, antihistamine and alpha1 blockade
Chlorpromazine vs. thioridazine eye effects
Chlorpromazine - corneal deposits
Thioridazine - retinal deposits
Clozapine SE
WG
Seizures
Agranulocytosis
Wet pillow syndrome
Buspirone MOA
5HT1a (partial agonist)
Lithium toxicity effects
Tremor Sedation Edema Heart block Hypothyroidism Polyuria (ADH antagonist)
Mirtazapine: MOA, effects (aside from decreasing depression)
alpha 2 antagonist (increased release of NE and 5HT)
Potent 5HT2/3 antagonism
Sedation and increased app/WG
Trazadone: MOA and SE
Blocks 5HT2 (autoreceptor) and alpha1 adrenergic receptors SE: priapism, sedation and postural hypotension
Treatment of serotonin syndrome
cyproheptadine
SNRIs and indications/SE
Venlafaxine - GAD and panic disorder
Duloxetine - diabetic neuropathy
SE - increased BP
SSRIs
Citalopram
Sertraline
Fluoxetine
Paroxetine
MAOIs
Tranyylcypromine
Phenelzine
Isocarboxazid
Selegiline
TCAs
Amitriptyline Nortriptyline Imipramine Desipramine Clomipramine Doxepin Amoxapine
TCA MOA
Block reuptake of 5HT and NE
Amitriptyline (tertiary) vs. nortriptyline (secondary) - which has more anticholinergic effects
Amitrptyline
Treatment of TCA toxicity (cardio)
NaHCO3