FARR Psychiatry Flashcards
First-line pharmacotherapy for depression.
SSRIs.
Antidepressants associated with hypertensive crisis.
MAOIs.
Galactorrhea, impotence, menstrual dysfunction, and ↓ libido.
Patient on dopamine antagonist.
A 17-year-old girl has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Conversion disorder.
Name the defense mechanism:
■ A mother who is angry at her husband yells at her child.
■ A pedophile enters a monastery.
■ A woman calmly describes a grisly murder.
■ A hospitalized 10-year-old begins to wet his bed.
Displacement
Reaction formation
Isolation
Regression
Life-threatening muscle rigidity, fever, and rhabdomyolysis.
Neuroleptic malignant syndrome.
Amenorrhea, bradycardia, and abnormal body image in a young female.
Anorexia.
A 35-year-old man has recurrent episodes of palpitations, diaphoresis, and fear of going crazy.
Panic disorder.
The most serious side effect of clozapine
Agranulocytosis.
A 21-year-old man has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.
Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms).
Key side effects of atypical antipsychotics.
Weight gain, type 2 DM, QT prolongation.
A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine.
Medication to avoid in patients with a history of alcohol withdrawal seizures.
Neuroleptics.
A 13-year-old boy has a history of theft, vandalism, and violence toward family pets.
Conduct disorder.
A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction.
Rett’s disorder.
A patient hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?
Acute mania. Start a mood stabilizer (e.g., lithium).
After a minor fender bender, a man wears a neck brace and requests permanent disability.
Malingering.
A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C-peptide.
Factitious disorder (Munchausen syndrome).
A patient continues to use cocaine after being in jail, losing his job, and not paying child support.
Substance abuse.
A violent patient has vertical and horizontal nystagmus.
Phencyclidine hydrochloride (PCP) intoxication.
A woman who was abused as a child frequently feels outside of or detached from her body.
Depersonalization disorder.
A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus.
Frotteurism (a paraphilia).
A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine).
A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life.
Dissociative fugue.
GAD Hx/PE:
Presents with anxiety on most days (six or more months) and with three or more somatic symptoms (restlessness, fatigue, difficulty concen-
trating, irritability, muscle tension, disturbed sleep).
GAD Tx:
Lifestyle changes, psychotherapy, medication. SSRIs, venlafaxine, and
buspirone are most often used (see Table 2.14-1). Benzodiazepines may
be used for immediate symptom relief.
I Taper benzodiazepines as soon as long-term treatment is initiated (e.g.,
with SSRIs) in light of the high risk of tolerance and dependence. Do not stop benzodiazepines “cold turkey,” as patients may develop po- tentially lethal withdrawal symptoms similar to those of alcohol with- drawal.
I Patient education is essential.
