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Psychiatry Shelf > High-Yield Facts > Flashcards

High-Yield Facts Flashcards

1
Q

DIG FAST

A 
D = Distractibility and easy frustration
I = Irresponsibility and erratic uninhibited behavior
G = Grandiosity
F = Flight of ideas
A = Activity increased with weight loss and increased libido
S = Sleep is decreased
T = Talkativeness
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2
Q

SIG E CAPS

A 
S leep changes: increase during day or decreased sleep at night
I nterest (loss): of interest in activities that used to interest them
G uilt (worthless):  depressed elderly tend to devalue themselves

E nergy (lack): common presenting symptom (fatigue)

C ognition/C oncentration: reduced cognition &/or difficulty concentrating
A ppetite (wt. loss); usually declined, occasionally increased
P sychomotor: agitation (anxiety) or retardations (lethargic)
S uicide/death preocp.

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3
Q

1 manic or mixed episode for 7 days or hospitalization

A

BPAD I

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4
Q

Hypomanic episode + MDD

A

BPAD II

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5
Q

3/7 DIGFAST x 1 week or hospitalization, 4/7 if mood is irritable

A

BPAD I

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6
Q

3/7 DIGFAST x 4 days

A

BPAD II

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7
Q

MDD criteria

A

depressed mood OR anhedonia
+
4/8 SIGECAPS x 2 weeks

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8
Q

Distinction of MDD from adjustment disorder

A

Excessive guilt, worthlessness, psychomotor retardation, suicidality

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9
Q

Time limits of Adjustment Disorder

A

3 months within stressor, persisting up to 6 months

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10
Q

Atypical depression criteria

A

Leaden paralysis, hypersomnia, hyperphagia, reactive, rejection sensitivity

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11
Q

Rx for atypical depression

A

SSRI –> another SSRI –> MAO-I

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12
Q

Worst type of schizophrenia

A

DIsorganized (negative sx difficult to treat)

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13
Q

Best prognosis of schizophrenia

A

Paranoid (positive sx easier to tx)

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14
Q

Residual schizophrenia

A

Neg > pos, “burnout”

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15
Q

5 core symptoms of schizophrenia

A

> 2 for >1 month: delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms

OR

Bizarre delusions
AH of running commentary
AH of two voices conversing 
Alienation of thought 
Magical thinking
Control
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16
Q

4 side effects of clozapine

A

Agranulocytosis (stop if WBC <1500); myocarditis; seizures; NMS

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17
Q

Side effect of lamotrigine

A

SJS, TEN

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18
Q

Side effects of Carbamazepine

A

SIADH, aplastic anemia, agranulocytosis

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19
Q

Causes of akathisia

A

Typicals, SSRIs, risperidone, aripiprazole

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20
Q

Symptoms of NMS

A

Lead-pipe rigidity, fever, autonomic instability, MS changes, leukocytosis, high CPK, rhabdomyolysis, renal failure

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21
Q

Treatment of NMS

A

Dantrolene, bromocriptine, hydration

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22
Q

Serotonin Syndrome

A

Fever, N/D, autonomic instability, myoclonus

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23
Q

Causes of SS

A

linezolid (antibiotic), tramadol (analgesic), SSRI, SNRI, TCA, MAOI), meperidine, triptans, dextromorphan, St. John’s wort

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24
Q

Treatment of HTNsive crisis

A

Phentolamine, nitroprusside

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25
Q

Indications for hemodialysis with lithium tox

A

seizure, delirium, stupor, coma

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26
Q

Mild lithium toxicity

A

Tremor, N/V, confusion, weakness, nystagmus, anorexia, stupor

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27
Q

Moderate lithium tox

A

Convulsions, oliguric renal failure

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28
Q

Severe lithium tox

A

Coma, CV collapse

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29
Q

Lithium side effects

A

Tremor, hypothyroidism, nephrogenic DI, acne, weight gain, leukocytosis, Ebstein’s anomaly in pregnancy

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30
Q

Valproate side effects

A

Thrombocytopenia, hair less, sedation, weight gain, tremor, dizziness, hepatotoxicity, pancreatitis, neural tube defects

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31
Q

Mesolimbic system

A

+ symptoms of schizo, too much DA

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32
Q

Mesocortical system

A
  • symptoms of schizo, too little DA
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33
Q

Symptoms of PTSD/acute stress disorder

A

1) re-experiencing (nightmares, flashbacks) 2) hyperarousal (hypervigilant, on edge) and 3) avoidance/numbing, but acute stress also requires symptoms of dissociation

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34
Q

MDD v. bereavement

A

The key here is severity..Symptoms suggesting that bereavement has crossed into MDD are 1) excessive guilt 2) active SI 3) worthlessness 4) psychomotor retardation, 5) AH/VH other than seeing the deceased loved one [VH can occur in up to 30% of “normal” bereavement])

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35
Q

Complicated grief

A

> 6 mo., ambivalent relationship to deceased

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36
Q

Dysthymic disorder

A

depression + 2 of (ACHEWS [allergic to happiness] ↓/↑ appetite, ↓ concentration, hopeless, ↓ energy, worthless, ↓/↑ sleep) x 2 yrs. w/o intervening period of 2 months of euthymia

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37
Q

MDD with psychotic features

A

Psychosis only during depressive episodes

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38
Q

BPAD with psychotic features

A

Psychosis in either state

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39
Q

Schizoaffective

A

> 2 weeks of psychosis without mood symptoms

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40
Q

Cyclothymia

A

persistent mood episodes on most days for ≥ 2 yrs. straight without an intervening period of 2 mos. euthymia.

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41
Q

Social phobia

A

Intense fear of negative evaluation + avoidance

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42
Q

Panic disorder

A

Untriggered/unexpected panic attacks and >1 mo where pt worries about another attack

43
Q

Avoidant PD

A

Highly rejection-sensitive and avoidant for this reason

44
Q

Somatization criteria

A

pt unconsciously somatizes emotional distress. Has several physical sx which he/she does feel. Need 4 pain, 2 GI, 1 neurological, 1 sexual symptom per DSM-IV.

45
Q

Hypochondriac criteria

A

cognitive. Pt experiences a certain symptom, thinks of its worst possible cause & worries (is a physical symptom, but assumes worst case)

46
Q

Factitious criteria

A

pt consciously produces symptoms (physical or psychological ones) for primary gain (= unconscious emotional reasons, such as attaining the ‘sick role’ or getting attention)

47
Q

Malingering criteria

A

pt consciously produces symptoms for secondary gain (get “three hots and a cot” i.e. room and board, avoid jail time, secure disability benefits, procure abusable meds etc.)

48
Q

BDD vs. delusional d/o somatic subtype

A

Emotional distress/suicidality determines

49
Q

Reactive attachment disorder

A

two subtypes (both manifesting < 5 y/o. Either the child will not attach or the child will attach readily & indiscriminately to just about everyone.

50
Q

Autism vs. Asperger’s

A

Communication skills

51
Q

Rett’s

A

Decline after 5-6 mo., wringing of hands, usually female

52
Q

Disintegrative disorder

A

Decline after 2 yrs + autism, usually male

53
Q

MCC of genetic MR

A

Fragile X

54
Q

Treatment for OCD

A

Anafranil, Luvox, Prozac, Paxil, Zoloft

55
Q

Timescale for vaginisimus

A

6 months

56
Q

Neuroimaging in autism

A

Increased total brain volume

57
Q

Neuroimaging in OCD

A

Abnormalities in OF cortex and striatum

58
Q

Neuroimaging in panic disorder

A

Decreased volume of amygdala

59
Q

Neuroimaging in PTSD

A

Decreased hippocampal volume

60
Q

Neuroimaging in schizophrenia

A

Enlargement of cerebral ventricles

61
Q

Weight gain receptor association

A

Histaminic and 5HT2c-R

62
Q

Sedation receptor association

A

Histaminic R

63
Q

Chance of BPAD if first degree relative has it

A

5-10%

64
Q

Chance of BPAD if both parents have it

A

60%

65
Q

Chance of BPAD if monozygotic twin has it

A

70%

66
Q

Chance of BPAD for general population

A

1%

67
Q

Interpersonal psychotherapy

A

Time-limited, relationship/life role/grief conflicts, current

68
Q

Supportive psychotherapy

A

Ongoing, lower functioning/crisis/psychotic/cog impaired patients – focus on building defense mechanisms and reinforces coping skills

69
Q

Psychodynamic psychotherapy

A

Ongoing, higher functioning/neurotic – focus on past relationships/conflicts, transference utilized, break down defense mechanisms

70
Q

Motivational interviewing

A

Variable length; substance abuse disorder; address ambivalence to change

71
Q

CBT

A

Time-limited; persistent maladaptive thoughts, avoidance, ability to participate; identify/challenge maladaptive thoughts, change emotions/behaviors from those thoughts, behavioral tehcniques (breathing, exposure, visualization, etc.)

72
Q

DBT

A

Variable; BPD; acceptance & change, improve emotion regulation, mindfulness, distress tolerance, group therapy component

73
Q

Biofeedback

A

Variable; prominent physical sx; improve awareness/control over physiological reactions, lower stress levels, integrate body/mind

74
Q

GAD criteria

A

Excessive anxiety >6 mo, 3 or more sx (restless, fatigue, conc difficulties, irritability, muscle tension, sleep disturbance), significant distress/impairment

75
Q

GAD treatment

A

First line: CBT, SSRIs/SNRIs

Second line: benzos, busipirone

76
Q

Alcoholic withdrawal: 6 hours

A

Anxiety, tremulousness, sweating, palpitations

77
Q

Alcoholic withdrawal: 12-48 hours

A

Single seizure, multiple in small period of time

78
Q

Alcoholic withdrawal: 12-24 hours

A

Auditory/visual/tactile hallucinations with normal VSs

79
Q

DTs (48-96hrs)

A

Fever, HTN, tachy, diaphoresis, hallucinations, disorientation

5% mortality rate

80
Q

Specific phobia incidence

A

10% of population

81
Q

Short acting benzos

A

Lorazepam, alprazolam

82
Q

Bupropion prevents reuptake of. . .

A

Nor, Ser, Dop

83
Q

SAD PERSONS

A

Sex, age, depression, previous attempt, EtOH, rational thought loss, social support (lacking), organized plan, no spouse, sickness or injury

84
Q

Common findings in anorexic patients

A

Osteoporosis, elevated chol/carotene levels, cardiac arrhythmias (prolonged QT), euthyroid sick syndrome, hypothalamic-pituitary axis dysfunction, hyponatremia (2/2 excess water drinking), hypochloremic met alkalosis (vomiting)

85
Q

Panic attack treatment

A

Benzos –> SSRIs (long term)

86
Q

Psychiatric complication of: sympathomimetics

A

Anxiety, psychosis

87
Q

Psychiatric complication of: analgesics

A

Psychosis

88
Q

Psychiatric complication of: antibiotics

A

Psychosis, agitation/confusion/delirium, depression, sedation

89
Q

Psychiatric complication of: anticholinergics

A

Psychosis, sedation

90
Q

Psychiatric complication of: anticonvulsants

A

Psychosis

91
Q

Psychiatric complication of: antihistamines

A

Psychosis, sedation

92
Q

Psychiatric complication of: corticosteroids

A

Psychosis, agitation/confusion/delirium, depression

93
Q

Psychiatric complication of: antiParkinsonian agents

A

Psychosis, agitation/confusion/delirium, depression, anxiety

94
Q

Psychiatric complication of: antipsychotics

A

Agitation/confusion/delirium

95
Q

Psychiatric complication of: antidepressants

A

Agitation/confusion/delirium

96
Q

Psychiatric complication of: antiarrhythmics, cardiac glycosides

A

Agitation/confusion/delirium

97
Q

Psychiatric complication of: antineoplastics

A

Agitation/confusion/delirium

98
Q

Psychiatric complication of: NSAIDS

A

Agitation, anxiety, depression

99
Q

Psychiatric complication of: antiasthmatics

A

Agitation, anxiety

100
Q

Psychiatric complication of: antihypertensives

A

Agitation, depression

101
Q

Psychiatric complication of: thyroid hormone

A

Agitation, anxiety

102
Q

Psychiatric complication of: calcium channel blockers

A

Depression

103
Q

Psychiatric complication of: peptic ulcer drugs

A

Depression

104
Q

Psychiatric complication of: hypoglycemics

A

Anxiety

Psychiatry Shelf (1 decks)

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