Good Sam Pimp Qs Flashcards

1
Q

Psychotic

A

hallucination, delusion or thought d/o

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2
Q

delusion

A

fixed, false, idiosyncratic belief

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3
Q

hallucination

A

sensation/perception w/o stimulus

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4
Q

thought d/o

A

lack of connection btwn thoughts

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5
Q

What neuroleptic med is derived from clozapine

A

olanzapine

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6
Q

What study should you order before prescribing neuroleptics?

A

EKG (d/t risk of QTx prolongation → should be <450)

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7
Q

tardive dyskinesia

A

abrnml uncontrollable mvt of head, face and neck

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8
Q

when is pt at risk for tardive dyskinesia

A

after 3 mo on neuroleptic rx

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9
Q

what 2 neuroleptics are least likely to cause tardive dyskinesia and EPS

A

Quetiapine and Clozapine

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10
Q

Why is Quetiapine less likely to cause EPS?

A

less dopamine antagonism (targets other NTs)

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11
Q

What neuroleptic is associated with the most wt gain?

A

Olanzaline

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12
Q

2 BBW for all neuroleptics

A

higher risk of death in elderly, QTc prolongation

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13
Q

6 SE of clozapine

A

agranulocytosis, heart failure, tachycardia, seizures, higher risk of death in elderly, QTc prolonfation

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14
Q

How often do you check CBC for a pt on Clozapine

A

q wk for 1st 6 mo then q 2 wks for next 6 mo then q mo

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15
Q

Neuroleptic malignant syndrome

A

agitation/confusion, HTN, rigidity, ↑ CK, ↑ WBC

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16
Q

How do you distinguish NMS from serotonin syndrome

A

w/ lead pipe rigidity

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17
Q

3 criteria for depression

A

persistently low mood, persistently low mental/physical energy, persistently low self attitude

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18
Q

Best time to take sertaline

A

after breakfast

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19
Q

Which antidepressant is best for chronic neuropathic pain?

A

SNRI (duloxetine but caution in liver failure)

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20
Q

SNRI (venlafaxine) SE at high doses

A

HTN crisis

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21
Q

What is trazodone

A

mild antidepressant that is good for sleep induction

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22
Q

SE of trazodone

A

priapism

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23
Q

Low vs high dose mirtazapine

A

Low (<15 mg) targets histamine, indicated for insomnia

High (>15 mg) targets serotonin and NE receptors, indicated for depression

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24
Q

SSRI SE

A

hyponatremia (rare_

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25
Q

OCD

A

exposure is the cure, avoidance is the disease

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26
Q

Hallmark of OCD

A

sx are egodystonic (pt has good insight but x reporting is dec d/t shame)

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27
Q

tx for OCD

A

exposure response prevention therapy + SSRI

28
Q

5 sx of PTSD

A

exposure, intrusion sx, avoidance, behavior/mood changes, hyperarousal

29
Q

tx for PTSD

A

CBT, SSRIs, prazosin (or clonidine)

30
Q

2 SSRI that are FDA approved to treat PTSD

A

sertaline, paroxetine

31
Q

off label use of gabapentin

A

anxiety

32
Q

2 psych indications for propranolol

A

panic attacks, performance anxiety

33
Q

SE of propranolol

A

agranulocytosis

34
Q

3 tx for depressive episodes in bipolar d/o

A

quetiapine, olanzapine, lurasidone

35
Q

unique SE of depakote (valproic acid

A

pancreatitis

36
Q

2 indications for carbamezapine

A

epilepsy, bipolar d/o

37
Q

SE of carbamezapine

A

agranulocytosis

38
Q

diff btwn heroin and buprenorphine

A

buprenorphine is a partial mu agonist

heroin is a full agonist

39
Q

danger of buprenorphine

A

precipitating withdrawal

40
Q

3 benzos indicated for alc withdrawal and why

A

lorazepam, oxazepam, temazepam

metabolized via glucuronidation not via liver

41
Q

how many calories qualifies as a binge

A

2000

42
Q

most deadly psych d/o

A

anorexia

43
Q

orthorexia

A

obsessing over eating foods that pt thinks are healthy

44
Q

CXR shows cardiomegaly → what psych d/o should be on ddx

A

purging (specifically ipecac abuse - med that causes vomiting)

45
Q

signs of purging on BMP

A

hypokalemia

↑ CO2

46
Q

psych d/o on ddx of pt c/o ortho hypotension

A

eating d/o

47
Q

what to watch w/ re-feeding syndrome

A

phosphate, potassium, and magnesium levels

48
Q

HM biochem feature of refeeding syndrome

A

hypophosphataemia

49
Q

tx for borderline personality d/o

A

dialectical behavorial tx

50
Q

delirium

A

fluctulating levels of consciusness

51
Q

consciousness

A

quality of mental life that varies on sepctrum from comatose to alert

52
Q

dementia

A

progressive deterioration/impairment in global intellectual fn from previously established baseline level

53
Q

greatest risk of falls in elderly

A

benzos

54
Q

off label use of mirtazapine

A

nausea in elderly

55
Q

best tx for hallucinations secondary to parkinson’s dz

A

quetiapine

56
Q

first line tx for agitation sexondary to dementia

A

SSRI

57
Q

first line tx for agitation secondary to delirium

A

non-pharm interventions (2nd line = trazodone)

58
Q

when to treat dementia

A

when it interferes w/ IASLs

59
Q

what is rivastigmine

A

acetylcholinesterase inhibitor (other is donepazil) indicated for dementia tx

60
Q

Why is rivastigminr CI in pt on beta blockers

A

risk of bradycardia

61
Q

how to differentiate Alzheimer’s from vascular dementia

A

vascular is stepwise, Alzheimer’s is progressive

62
Q

Why not give elderly pts benzos

A

inc agitation, fall risk, cognitive decline

63
Q

Reversible cause of dementia

A

hypothyprod, B12 or folate deficiency, syphilis (RPR screening, requires confirmation)

64
Q

Which 2 anticonvulsants increase SI

A

lamotrigine, topiramate

65
Q

which anticonvulsants cause weight loss

A

zonisamide

66
Q

Capacity

A

ability to:

express/sustain a choice
understand relevant info
appreciate situation and consequences
manipulate info readily