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psych rotation > first line, second line > Flashcards

first line, second line Flashcards

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1
Q

ASD

A
  • family education, behavior shaping, speech therapy, occupational therapy, educational planning
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2
Q

ADHD

A
  • first - amphetamine, methylphenidate
  • second - atomoxetine
  • third - bupropion, imipramine
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3
Q

tourette’s

A
  • first - controversial, some say clonidine/guanfacine, while others prefer SGAs.
  • second - FGA (haloperidol)
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4
Q

schizoaffective

A
  • first - SGA
  • second - mood stabilizer for mania
  • third - SSRI, only in predominantly depression if SGA doesn’t stabilize mood
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5
Q

schizophrenia

A
  • first - SGA

- second - FGA

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6
Q

bipolar (child)

A
  • first - lithium only drug approved for 12-18 years old
  • second - lithium, carbamazepine, valproate
  • third - SGA
  • fourth - SSRIs/bupropion - be careful!
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7
Q

cyclothymia

A
  • first - lithium, valproate

- second - SGAs

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8
Q

MDD w/psychotic features

A
  • first - SSRI + SGA

- second - switch SSRI for different antidepressant

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9
Q

MDD

A
  • first - SSRI, SNRI, bupropion, mirtazipine
  • second - TCA
  • third - MAOI
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10
Q

dysthymia

A
  • first - SSRI, SNRI
  • second - TCA
  • third - MAOI
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11
Q

premenstrual dysphoric disorder

A
  • first - SSRI
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12
Q

panic disorder

A
  • first - SSRI, SNRI
  • second - CBT
  • short term - benzo, beta-blocker
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13
Q

specific phobia

A
  • first - psychotherapy (CBT with exposure)

- second - bentos acutely, SSRIs

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14
Q

separation anxiety disorder

A
  • first - psychotherapeutic modalities directed toward individual, family, and school.
  • second - SSRIs, never monotherapy
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15
Q

social anxiety disorder

A
  • first - CBT
  • short term - benzos/beta blockers
  • long term - SSRI/SNRI
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16
Q

GAD

A
  • first - CBT + SSRI

- second - switch SSRI for SNRI or TCA

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17
Q

OCD

A
  • CBT (exposure/response) + SSRI
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18
Q

PTSD

A
  • first - sertraline or paroxetine
  • second - prazosin for hyperarrousal
  • third - SGAs
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19
Q

adjustment disorder

A
  • first - supportive psychotherapy
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20
Q

acute stress disorder

A
  • first - support

- second - sedatives or hypnotics

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21
Q

dissociated identity disorder

A
  • first - psychodynamic psychotherapy

- second - SSRIs

22
Q

conversion disorder

A
  • first - reassurance and education

- second - CBT/PT

23
Q

illness anxiety disorder

A
  • first - schedule frequent, regular clinic appointments to assure complaint is taken seriously
  • supportive counseling
24
Q

somatic symptom disorder

A
  • validate
  • biofeeback for muscle pain and headaches
  • SSRI/TCA
25
Q

factitious disorder

A
  • form alliance with patient
26
Q

bulimia nervosa

A
  • nutrition rehab +CBT + SSRI
27
Q

anorexia nervosa

A
  • nutritional rehab, inpatient
  • psychotherapy not enough
  • family treatment
  • limited evidence for olanzapine
28
Q

enuresis

A
  • psychoeducation, supportive psychotherapy, behavior modification
  • DDAVP, only for 7 years and older
29
Q

insomnia disorder

A
  • sleep hygiene education, relaxation training, CBT

- ramelteon, trazodone, benzo receptor agonists

30
Q

non-REM sleep terror

A
  • protect child, do nothing
31
Q

conduct disorder

A
  • MST
32
Q

alcohol use disorder

A
  • wernicke - thiamine
  • craving - naltrexone, acamprosate
  • behavior - disulfiram
33
Q

cocaine use disorder

A
  • narcotics anonymous
34
Q

opioid withdrawal

A
  • clonidine can reduce withdrawal symptoms, but not cravings
  • naltrexone can make withdrawal symptoms worse
  • methadone can be used in place of or in addition to clonidine
  • buprenorphen can be used instead of methadone
35
Q

tobacco use disorder

A
  • NRT

- buproprion, varenicline

36
Q

PCP intoxication

A
  • keep safe
  • no antipsychotics
  • benzos are safe
37
Q

alcohol withdrawal

A
  • high dose benzo, slowly taper
38
Q

benzo withdrawal

A
  • benzo, slowly taper
39
Q

amphetamine intoxication

A
  • no treatment

- time, keep safe

40
Q

delirium

A
  • behavioral intervention
  • antipsychotic, be careful with long QTc or torsade
  • avoid benzos, unless benzo or alcohol withdrawal
41
Q

neurocognitive disorders

A
  • workup for medical causes
  • alzheimers - cortical atrophy, ACh inhibitors
  • vascular - deep white matter infarcts
  • picks - frontotemporal atrophy
  • hydrocephalus - lumbar puncture
  • aggression - low dose antipsychotics
  • avoid benzos
42
Q

schizoid personality disorder

A

nothing

43
Q

anti-social personality disorder

A

SSRIs and mood stabilizers for aggression

44
Q

avoidant personality disorder

A
  • psychodynamic or CBT
45
Q

OCPD

A
  • psychodynamic psychotherapy
46
Q

histrionic personality disorder

A
  • group therapy
47
Q

dependent personality disorder

A
  • psychodynamic psychotherapy
48
Q

schizotypal personality disorder

A
  • low dose antipsychotics if needed
49
Q

narcissistic personality disorder

A
  • group therapy
50
Q

borderline

A
  • DBT

psych rotation (2 decks)

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