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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
Indications for hemodialysis with lithium tox
seizure, delirium, stupor, coma
26
Mild lithium toxicity
Tremor, N/V, confusion, weakness, nystagmus, anorexia, stupor
27
Moderate lithium tox
Convulsions, oliguric renal failure
28
Severe lithium tox
Coma, CV collapse
29
Lithium side effects
Tremor, hypothyroidism, nephrogenic DI, acne, weight gain, leukocytosis, Ebstein's anomaly in pregnancy
30
Valproate side effects
Thrombocytopenia, hair less, sedation, weight gain, tremor, dizziness, hepatotoxicity, pancreatitis, neural tube defects
31
Mesolimbic system
+ symptoms of schizo, too much DA
32
Mesocortical system
- symptoms of schizo, too little DA
33
Symptoms of PTSD/acute stress disorder
1) re-experiencing (nightmares, flashbacks) 2) hyperarousal (hypervigilant, on edge) and 3) avoidance/numbing, but acute stress also requires symptoms of dissociation
34
MDD v. bereavement
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])
35
Complicated grief
>6 mo., ambivalent relationship to deceased
36
Dysthymic disorder
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
37
MDD with psychotic features
Psychosis only during depressive episodes
38
BPAD with psychotic features
Psychosis in either state
39
Schizoaffective
>2 weeks of psychosis without mood symptoms
40
Cyclothymia
persistent mood episodes on most days for ≥ 2 yrs. straight without an intervening period of 2 mos. euthymia.
41
Social phobia
Intense fear of negative evaluation + avoidance
42
Panic disorder
Untriggered/unexpected panic attacks and >1 mo where pt worries about another attack
43
Avoidant PD
Highly rejection-sensitive and avoidant for this reason
44
Somatization criteria
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
Hypochondriac criteria
cognitive. Pt experiences a certain symptom, thinks of its worst possible cause & worries (is a physical symptom, but assumes worst case)
46
Factitious criteria
pt consciously produces symptoms (physical or psychological ones) for primary gain (= unconscious emotional reasons, such as attaining the ‘sick role’ or getting attention)
47
Malingering criteria
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
BDD vs. delusional d/o somatic subtype
Emotional distress/suicidality determines
49
Reactive attachment disorder
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
Autism vs. Asperger's
Communication skills
51
Rett's
Decline after 5-6 mo., wringing of hands, usually female
52
Disintegrative disorder
Decline after 2 yrs + autism, usually male
53
MCC of genetic MR
Fragile X
54
Treatment for OCD
Anafranil, Luvox, Prozac, Paxil, Zoloft
55
Timescale for vaginisimus
6 months
56
Neuroimaging in autism
Increased total brain volume
57
Neuroimaging in OCD
Abnormalities in OF cortex and striatum
58
Neuroimaging in panic disorder
Decreased volume of amygdala
59
Neuroimaging in PTSD
Decreased hippocampal volume
60
Neuroimaging in schizophrenia
Enlargement of cerebral ventricles
61
Weight gain receptor association
Histaminic and 5HT2c-R
62
Sedation receptor association
Histaminic R
63
Chance of BPAD if first degree relative has it
5-10%
64
Chance of BPAD if both parents have it
60%
65
Chance of BPAD if monozygotic twin has it
70%
66
Chance of BPAD for general population
1%
67
Interpersonal psychotherapy
Time-limited, relationship/life role/grief conflicts, current
68
Supportive psychotherapy
Ongoing, lower functioning/crisis/psychotic/cog impaired patients -- focus on building defense mechanisms and reinforces coping skills
69
Psychodynamic psychotherapy
Ongoing, higher functioning/neurotic -- focus on past relationships/conflicts, transference utilized, break down defense mechanisms
70
Motivational interviewing
Variable length; substance abuse disorder; address ambivalence to change
71
CBT
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
DBT
Variable; BPD; acceptance & change, improve emotion regulation, mindfulness, distress tolerance, group therapy component
73
Biofeedback
Variable; prominent physical sx; improve awareness/control over physiological reactions, lower stress levels, integrate body/mind
74
GAD criteria
Excessive anxiety >6 mo, 3 or more sx (restless, fatigue, conc difficulties, irritability, muscle tension, sleep disturbance), significant distress/impairment
75
GAD treatment
First line: CBT, SSRIs/SNRIs | Second line: benzos, busipirone
76
Alcoholic withdrawal: 6 hours
Anxiety, tremulousness, sweating, palpitations
77
Alcoholic withdrawal: 12-48 hours
Single seizure, multiple in small period of time
78
Alcoholic withdrawal: 12-24 hours
Auditory/visual/tactile hallucinations with normal VSs
79
DTs (48-96hrs)
Fever, HTN, tachy, diaphoresis, hallucinations, disorientation 5% mortality rate
80
Specific phobia incidence
10% of population
81
Short acting benzos
Lorazepam, alprazolam
82
Bupropion prevents reuptake of. . .
Nor, Ser, Dop
83
SAD PERSONS
Sex, age, depression, previous attempt, EtOH, rational thought loss, social support (lacking), organized plan, no spouse, sickness or injury
84
Common findings in anorexic patients
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
Panic attack treatment
Benzos --> SSRIs (long term)
86
Psychiatric complication of: sympathomimetics
Anxiety, psychosis
87
Psychiatric complication of: analgesics
Psychosis
88
Psychiatric complication of: antibiotics
Psychosis, agitation/confusion/delirium, depression, sedation
89
Psychiatric complication of: anticholinergics
Psychosis, sedation
90
Psychiatric complication of: anticonvulsants
Psychosis
91
Psychiatric complication of: antihistamines
Psychosis, sedation
92
Psychiatric complication of: corticosteroids
Psychosis, agitation/confusion/delirium, depression
93
Psychiatric complication of: antiParkinsonian agents
Psychosis, agitation/confusion/delirium, depression, anxiety
94
Psychiatric complication of: antipsychotics
Agitation/confusion/delirium
95
Psychiatric complication of: antidepressants
Agitation/confusion/delirium
96
Psychiatric complication of: antiarrhythmics, cardiac glycosides
Agitation/confusion/delirium
97
Psychiatric complication of: antineoplastics
Agitation/confusion/delirium
98
Psychiatric complication of: NSAIDS
Agitation, anxiety, depression
99
Psychiatric complication of: antiasthmatics
Agitation, anxiety
100
Psychiatric complication of: antihypertensives
Agitation, depression
101
Psychiatric complication of: thyroid hormone
Agitation, anxiety
102
Psychiatric complication of: calcium channel blockers
Depression
103
Psychiatric complication of: peptic ulcer drugs
Depression
104
Psychiatric complication of: hypoglycemics
Anxiety

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