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1.1 RC: Recall + Thea Gilks Review Decks > Gilks Deck 2: childhood milestones, repro etc > Flashcards

Gilks Deck 2: childhood milestones, repro etc Flashcards

1
Q

at what age should a child be able to do the following:

walk

A

1 year

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2
Q

at what age should a child be able to do the following:

draw a cross and a rectangle

A

4 years

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3
Q

at what age should a child be able to do the following:

draw a circle

A

3 years

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4
Q

at what age should a child be able to do the following:

sit

A

6 months

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5
Q

at what age should a child be able to do the following:

say 10 words

A

1 year

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6
Q

at what age should a child be able to do the following:

kick a ball

A

1 year

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7
Q

at what age should a child be able to do the following:

draw a line

A

2 years

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8
Q

at what age should a child be able to do the following:

stack 6 cubes

A

2 years

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9
Q

at what age should a child be able to do the following:

tell stories, use past tense

A

4 years

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10
Q

at what age should a child be able to do the following:

gender identity

A

3 years

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11
Q

at what age should a child be able to do the following:

2 word sentences

A

2 years

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12
Q

at what age should a child be able to do the following:

parallel play

A

1 year

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13
Q

at what age should a child be able to do the following:

stack 3-4 cubes

A

1 year

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14
Q

at what age should a child be able to do the following:

babble

A

6 months

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15
Q

at what age should a child be able to do the following:

object permanence

A

1 year

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16
Q

at what age should a child be able to do the following:

run

A

2 years

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17
Q

at what age should a child be able to do the following:

stack 9 cubes

A

3 years

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18
Q

at what age should a child be able to do the following:

ride a tricycle

A

3 years

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19
Q

at what age should a child be able to do the following:

saying “no;” can be aggressive, egocentric

A

2 years

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20
Q

at what age should a child be able to do the following:

bowel and bladder control

A

3 years

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21
Q

at what age should a child be able to do the following:

complete sentences, strangers can understand

A

3 years

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22
Q

at what age should a child be able to do the following:

imaginary friends

A

4 years

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23
Q

at what age should a child be able to do the following:

hop on one foot

A

4 years

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24
Q

at what age should a child be able to do the following:

immitate adults

A

4 years

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25
Q

what milestones are associated with a 4 year old

A

o draw a cross and a rectangle
o hop on one foot
o immitate adults
o imaginary friends
o tell stories, use past tense

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26
Q

what milestones are associated with a 3 year old

A

o draw a circle
o stack 9 cubes
o ride tricycle
o bowel and bladder control
o gender identity
o complete sentences, strangers can understand

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27
Q

what milestones are associated wiht a 2 year old

A

o draw a line
o stack 6 cubes
o run
o “no”, can be aggressive, egocentric
o 2 word sentences

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28
Q

what milestones are associated wiht a 1 year old

A

o stack 3-4 cubes
o walk
o kick ball
o parallel play
o object permanence
o 10 words

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29
Q

what milestones are associate wiht a 6 month old

A

o sit
o babble

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30
Q

list 9 risk factors for torsades

A

female

older age

low potassium

low magnesium

structural cardiac disease

hepatic dysfunction

hypothyroid

other meds that increase QTc

stroke

infection

obesity

EtOH/illicit drugs

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31
Q

by how much does rising QTc increase risk for torsades

A

risk for torsades increases by 5-7% with each 10ms QTC rises (but still very very rare)

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32
Q

what is considered prolonged QTc in women

A

above 460-470 ms

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33
Q

what is considered prolonged QTc in men

A

above 450

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34
Q

when do we really start to worry abotu QTC

A

above 500ms

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35
Q

which antipsychotics have minimal effect on QTc

A

quetiapine
olanzapine
clozapine

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36
Q

which antipsychotics have minimal to no effect on QTc

A

lurasidone
aripiprazole

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37
Q

which antipsychotics have significant effect on QTc

A

haldol IV (PO/IM has moderate effect)
pimozide
ziprasidone
chlorpromazine

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38
Q

what does Parkinsonism look like

A

mask like facies

resting tremor

cogwheel rigidity

shuffling gait

bradykinesia

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39
Q

list 4 symptoms of hyperprolactinemia

A

galactorrhea

amenorrhea

gynecomastia

impotence/reduced libido

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40
Q

how are pupils affected in NMS

A

NORMAL

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41
Q

why do you get myoglobinuria in NMS

A

due to rhabdo

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42
Q

do you get myoclonus, hyperreflexia in serotonin syndrome, or in NMS

A

in serotinin syndrome

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43
Q

how might NMS present clinically

A

HYPERSALIVATION, pallor, mutism, fever, LEAD-PIPE rigidity, mental status changes, AUTONOMIC INSTABILTY, elevated creatine phosphokinase, myoglobinuria (rhabdomyolysis), AKI, NORMAL pupils

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44
Q

how might serotonin syndrome present clinically

A

anxiety, agitation, delirium, DIAPHORESIS, tachycardia, hypertension, hyperthermia, gastrointestinal distress,TREMOR, muscle rigidity, MYOCLONUS, HYPERREFLEXIA

45
Q

how might anticholinergic toxidrome present clinically

A

blurred vision, dilated pupils, constipation, dry mouth (which may chronically lead to dental caries), urinary retention, tachycardia, anhidrosis, hyperthermia, sedation, confusion/delirium

46
Q

how might lithium toxicity present clinically

A

PERSISTENT N/V, abdominal pain, coarse TREMOR, ATAXIA, NYSTAGMUS, blurred vision, hyperreflexia, fasciculations, CHOREATHETOID movements, RENAL failure, seizure, stupor/coma, death (tx of severe toxicity is dialysis)

47
Q

how might SSRI discontinuation syndrome present clinically

A

flu like symptoms

dysphoria, dizziness, gastrointestinal distress, fatigue, chills, myalgias, runny nose, sore eyes (flu-like symptoms)

48
Q

how would you rank the following medications in terms of risk of manic switch:

SSRI / Venlafaxine / TCA / MAOi / Buproprion

A

TCA > MAOi > venlafaxine > SSRI > buproprion

*conflicting evidence with venlafaxine; some studies show no increased risk of mania/hypomania with ADs–> UNCLEAR (sobs)

49
Q

what is the risk of lithium in pregnancy

A

ebsteins anomaly (1/1000)

50
Q

what is the risk of the following medication in pregnancy:

atypical antipsychotics

A

basically SAFE but small risk of PRETERM BIRTH, EPS, tremor, abnormal muscle tone, breathing/feeding difficulties, sedation

51
Q

what is the safest mood stabilizer in pregnancy

A

lamotrigine

52
Q

what is the risk of the following medication in pregnancy:

lamotrigine

A

small risk of cleft palate

53
Q

what is the risk of the following medication in pregnancy:

benzos

A

neonatal withdrawal

decreased motor tone (floppy baby syndrome)

small risk of cleft palate

excreted in breast milk

54
Q

what is the risk of the following medication in pregnancy:

imipramine

A

withdrawal symptoms

55
Q

what is the risk of the following medication in pregnancy:

valrproate

A

neural tube defects (5-10%)

fetal valproate syndrome

lower IQ in fetus

autism

56
Q

what is the risk of the following medication in pregnancy:

topiramate

A

small risk of cleft palate

57
Q

what is the risk of the following medication in pregnancy:

carbamazepine

A

cleft palate

neural tube defects

fetal carbamazepine syndrome

58
Q

what is the risk of the following medication in pregnancy:

SSRIs, SNRIs

A

30% of infants experience neonatal adaptation syndrome –> non specific symptoms (see other card)

small increased risk of PPH (2-6/1000)

59
Q

what is the risk of the following medication in pregnancy:

paroxetine

A

highest risk of CV defects of all SSRIs

higher risk compared to other SSRIs of NAS

60
Q

what is the risk of the following medication in pregnancy:

stimulants

A

basically SAFE

small increased risk of preterm birth, miscarriage, pre eclampsie, placental abruption

61
Q

which medication should be avoided in breastfeeding

A

lithium

62
Q

which medications can cause cleft palate if taken during pregnancy

A

benzos

lamotrigine

topiramate

carbamazepine

63
Q

which medications are associated with neural tube defects if taken in pregnancy

A

valproic acid > carbamazepine

64
Q

what is the risk of NTDs in mothers taking valproic acid

A

5-10%

65
Q

what is the risk of NTDs in mothers taking carbamazepine

A

1%

66
Q

which medications are associated with neonatal adaptation syndrome if taken in pregnancy

A

SSRIs, SNRIs

67
Q

which SSRI has highest risk of CV defects of all SSRIs

A

paroxetine

also higher risk of NAS

68
Q

what are the symptoms of neonatal adaptaion syndrome

A

non specific sx–> poor feeding, jitteriness, respiratory distress, temperature instability

69
Q

which medications are associated with persistent pulmonary hypertention if taken in pregnancy

A

SSRIs, SNRIs–> small risk (2-6/1000)

70
Q

which medications are associated with placental abruption/preeclampsia if taken in pregnancy

A

stimulants

71
Q

which medications are associated with floppy baby syndrome if taken in pregnancy

A

benzos

72
Q

which medications are associated with autism if taken in pregnancy

A

valproic acid

73
Q

which medications are associated with lower IQ in infants if taken in pregnancy

A

valproic acid

74
Q

is valproic acid considered safe in breastfeeding

A

yes

75
Q

are antidepressants considered safe in breastfeeding

A

yes

76
Q

is lithium considered safe in breastfeeding

A

no

77
Q

are stimulants considered safe in breastfeeding

A

yes

78
Q

are benzos considered safe in breastfeeding

A

can cause sedation in newborn–> are excreted in breastmilk

if need them, use short acting and use infrequently

79
Q

what are the most common adverse effects of ECT in pregnancy

A

premature contractions and labor in the mother

bradyarrhythmias in the fetus

NO risk of malformation

considered safe and effective in pregnancy

80
Q

what meds are first line for ADHD

A

VAC-B

Vyvanse (lisdexamphetamine)–prodrug, metabolized to make dextroamphetamine

Adderall (dextroamphetamine)

Concerta (OROS methylphenidate)

Biphentin (methylphenidate)

81
Q

what is the short acting methylphenidate

A

ritalin

82
Q

how long does the following ADHD medication last:

concerta

A

about 12 hours

83
Q

how long does the following ADHD medication last:

ritalin SR

A

8 hours

84
Q

how long does the following ADHD medication last:

ritalin IR

A

3-4 hours

85
Q

how long does the following ADHD medication last:

adderall XR

A

12 hours

86
Q

how long does the following ADHD medication last:

vyvanse

A

13-14 hours

87
Q

how long does the following ADHD medication last:

foquest

A

13-16 hours

88
Q

how long does the following ADHD medication last:

dexedrine spansules

A

6-8 hours

89
Q

how long does the following ADHD medication last:

dexedrine tablets

A

4 hours

90
Q

how long does the following ADHD medication last:

biphentin

A

10-12 hours

91
Q

rank the following ADHD meds from shortest to longest acting:

ritalin (IR and SR), vyvanse, adderall XR, biphentin, foquest, concerta, vyvanse, dexedrine (tablets and spansules)

A

ritalin/methylphenidate short acting (3-4 hours)
dexedrine tablets (4 hours)
dexedrine spansules (6-8 hours)
Ritalin SR (8 hours)
Biphentin (10-12 hours)
Adderall XR = Concerta (12 hours)
Vyvanse (13-14 hours)
Foquest (13-16 hours)

92
Q

smoking induces which CYP enzyme

A

1A2

93
Q

smoking REDUCES levels of which important medications (by inducing 1A2)

A

clozapine

olanzapine

TCAs

94
Q

fluvoxamine inhibits which CYP enzyme

A

1A2

(caffeine also)

95
Q

which medications inhibit 2D6

A

buproprion

paroxetine

fluoxetine

96
Q

which medications are metabolized by 2D6

A

abilify

risperidone

venlafaxine

vortioxetine

atomoxetine

TCAs

(expect levels to go up if also Rx buproprion, paroxetine or fluoxetine)

97
Q

which medications should not be Rx with tamoxifen

A

buproprion, paroxetine, fluoxetine–> block 2D6 which is needed to convert tamoxifen into its active metabolite

98
Q

why is carbamazepine so annoying as a drug

A

induces 3A4–> which decreases levels of a bunch of relevant psych meds including ADs, APs, benzos, zopiclone, synthetic opioids, and OCP

99
Q

fluvoxamine INHIBITS which cyp enzymes

A

1A2, 3A4, 2C19

100
Q

thiamine is reduced in which populations

A

AUD

starvation

bariatric surgery

101
Q

vitamin B3/niacin is reduced in which populations

A

AUD

vegan/veggie

starvation

102
Q

vitamin B2/riboflavin is reduced in which populations

A

AUD

starvation

103
Q

vitamin B6/pyridoxine is reduced in which populations

A

MAOis

isoniazid

levodopa

104
Q

vitamin B12/cobalamin is reduced in which populations

A

vegan/veggie

105
Q

vitamin B3/niacin deficiency causes what clinical presentation

A

pellagra –> the 5 Ds: dermatitis, diarrhea, delirium, dementia, death

*delirium responds to replacement, dementia slower to recover

106
Q

what psych syndrome is associated with vitamin B12/cobalamin deficiency

A

panic attacks
mood disturbance
cognitive slowing
rare psychosis
visual hallucinations

107
Q

what psych syndrome is associated with vitamin B6/pyridoxine deficiency

A

confusion

irritability

depression

108
Q

memory deficits in wernickes are due to damage to what brain structure

A

mamillary bodies

1.1 RC: Recall + Thea Gilks Review Decks (13 decks)

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