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Revision LMCC > High Yield: Psy 1 > Flashcards

High Yield: Psy 1 Flashcards

1
Q

Describe management: Neuroleptic malignant syndrome (2)

A
  • Discontinue antipsychotic
  • THEN administer Dantrolene
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2
Q

What’s the difference between:

  • Neuroleptic malignant syndrome
  • Seretonin syndrome
A
  • Neuroleptic malignant syndrome: no myoclonus
  • Seretonin syndrome: myoclonus
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3
Q

Name antidotes: Seretonin syndrome (2)

A

Discontinue

  • Benzos
  • Cyproheptadine
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4
Q

What type of antidepressants predisposes to tyramine crisis? (1)

A
  • MAOI (ex: phenelzine, isocarboxazid)
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5
Q

Tx: Tyramine crisis? (3)

A

Tx: Hypertensive Emergency drugs

  • Nitroprusside
  • Hydralazine
  • Labetalol
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6
Q

Name extrapyramidal sx of antipsychotics (4)

A
  • Dystonia
  • Akathisia
  • Parkinsonism
  • Tardive dyskonesia
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7
Q

Describe: Dystonia in EPS (3)

A
  • early, within hours
  • usually affects sternocleidomastoid (torticolis) -> neck turned and contracts
  • tx: benztropine or benadryl
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8
Q

Describe: Akathisia in EPS (3)

A
  • restless, keep moving, can’t sit still
  • tx: benzos or beta blockers
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9
Q

Describe tx: Parkinsonism in EPS (1)

A
  • Benztropine (due to antipsychotic drug side effect)
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10
Q

Describe: Tardive dyskenisa in EPS (3)

A
  • lip smacking
  • tx: discontinue
    • valbendazine (new)
    • switch to clozapine (least risk of causing it)
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11
Q

Describe: Clozapine (2)

A
  • agranulocytosis
    • (low granulocytes, low basophils/eosinophils/neutrophils)
    • periodic CBC
    • if infx, discontinue clozapine
  • decreases suicide risk the most
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12
Q

Name mood stabilizer that lowers suicide risk

A

Lithium

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13
Q

Describe management: Lithium toxicity (2)

A
  • Hydrate
  • Hemodyalisis
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14
Q

Name indications: Dialysis indications

A

AEIOU

  • Acidosis
  • Electrolytes (K+)
  • Intoxicants (MALE)
    • Methanol, Aspirin, Lithium, Ethylene glycol
  • Overload
  • Uremia
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15
Q

Describe management: TCA toxicity (1)

A
  • Sodium bicarbonate (flushing out TCA)
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16
Q

Describe management: Cocaine overdose (1)

A
  • benzo (IV lorazapam + observe)
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17
Q

Describe management: Alcohol withdrawal (1)

A

IV benzos

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18
Q

Describe management: Delirium tremens (1)

A
  • Benzos
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19
Q

Describe the difference between alcoholic hallucinosis and delirium tremens

A

Look for timing and vitals

  • Alcoholic hallucinosis: vitals stable, within 6-12h
  • Delirium tremens: unstable (hypertensive, tachycardia), 2-4 days after stopping
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20
Q

Describe: Phencyclidine (PCP) overdose (4)

A
  • violent
  • psychotic
  • nystagmus
  • blood test: elevated CPK
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21
Q

Describe tx: Phencyclidine (PCP) overdose (1)

A
  • tx: benzo
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22
Q

What to think of with elevated CPK (2)

A
  • PCP
  • neuroleptic malignant syndrome
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23
Q

Describe management: Benzo overdose (1)

A
  • Flumazenil (only in non-dependent user of benzo, if not can get life-threatening withdrawal)
24
Q

Describe management: Chronic Benzo withdrawal (1)

A
  • tx = benzo taper
25
Q

Describe management: Opioid overdose (1)

A

Naloxone

26
Q

Describe management: Opioid withdrawal (1)

A

Supportive

clonidine

27
Q

Name 4 pathways of antipsychotics

A
  • Mesolimbic: positive sx
  • Mesocortical: negative sx
  • Nigrostriatal: parkinson sx
  • Tuberoinfundibular: dopamine prolactin pathway (dopamin suppresses prolactin release) -> hyperprolactinima, gynecomastia
28
Q

Name antipsychotic famous for hyperprolactimia

A

Risperidone

29
Q

Name factors for bad prognosis for schizo (3)

A
  • Early onset
  • Male
  • Slow onset

(best prognosis: female, sudden, late onset)

30
Q

Describe 1st generation antipsychotic (4)

A
  • High Potency = Haloperidol, Fluphenazine
    • More frequent: EPS
  • Low Potency = HAM Block
    • antiHistamine: Drowsiness. Dry mouth, dry eyes. Blurred or double vision. Dizziness and headache. Low blood pressure.
    • Alpha 1 blockade: HTO, dizziness, headache, tachycardia, nasal stuffiness
    • antiMuscarinic: dry mouth, constipation, blurred vision, drowsiness, no/vo, abdominal discomfort, difficulty micturating, palpitations, skin reactions.
31
Q

Name 2nd generation antipsychotic (4)

A
  • risperidone
  • olanzapine
  • aripiprazole
  • ziprazadone
32
Q

Describe 2nd generation antipsychotic (2)

A
  • ex: clozapine, risperidone, olanzapine, aripiprazole, ziprazadone
  • side effects: metabolic syndrome (hyperlipidemia, hyperglycemia, obecity)
    • check BMI, blood pressure, glucose, lipids
    • most common: olanzapine (trick: O for obesity)
33
Q

Name adverse effect of thioridazine (1st gen)

A

Retinal pigmentation

34
Q

Name adverse effect of chlorpromazine

A

Corneal deposits

(chlo > corneal)

35
Q

Describe: Schizoaffective disorder (2)

A
  • Baseline schizo + (depressive or manic episodes)
  • tx: 2nd gen antipsychotics or mood stabilizer (lithium)
36
Q

What’s the timeline for:

  • brief psychotic disorder
  • schizophreniform
  • schizophrenia
A
  • brief psychotic disorder:
  • schizophreniform: 1-6 months
  • schizophrenia: > 6 months
37
Q

Describe sx: Bipolar Disorder (7)

A

3+ DIGFAST

  • Distracted
  • Insomnia
  • Grandiosity
  • Flight of ideas
  • Activity
  • Pressured Speech
  • Thoughtlessness
38
Q

What’s the difference mania and hypomania (3)

A
  • Mania Type 1
    • Requires hospitalisation
    • At least 3 sx of DIGFAST for ONE WEEK + social dysfunction
  • Hypomania Type 2
    • At least 3 sx of DIGFAST for FOUR DAYS + no social dysfunction
39
Q

Name effects: Tricyclic antidepressants (4)

A
  • HAM block
  • Tri Cs:
    • Cardiac: Long QT, arythmia
    • Convulsions
    • Coma
40
Q

Describe: Serotonin syndrome (2)

A
  • Look for someone that was started with SSRI, discontinued and started another too quickly in another class
  • When you stop SSRI, it takes a few week before washing out all serotonin
41
Q

How long does antidepressant takes to start working

A

4-6 wks

42
Q

Describe: Electroconvulsive Therapy (ECT) (3)

A
  • For emergencies, need rapid chances
  • Classic scenarios:
    • refusal eat or drink
    • high suicide risk
  • Side effect: Amnesia for 6 months that will resolve
43
Q

Describe tx of catatonia 2e to antipsychotics

A

Lorazepam

44
Q

Describe the difference between grieving and depression (2)

A
  • Grieving: good and bad days
    • normal to have guilt, wished they died instead, see the dead person
  • Depression: more bad days
    • feelings worthlessness
45
Q
A
46
Q

Describe 2ed effects of lithium (5)

A

LMNOP

  • lithium
  • movement problems
  • nephrogenic diabetes insipidus
  • hypOt4
  • pregnant defects (Ebstein’s anomaly: your tricuspid valve is in the wrong position and the valve’s flaps (leaflets) are malformed)
47
Q

How long for persistent depressive disorder?

A

2 years

48
Q

Describe: Cyclothymic disorder (3)

A
  • not quite bipolar
  • mild, not exactly hypomania or depression
  • 2 years
49
Q

Describe: Premenstrual dysphoric disorder (2)

A
  • keep menstrual diary
  • first-line tx: SSRI
50
Q

Describe tx: Acute panic attack

A
  • Acute: Benzo
  • Panic disorder: SSRI (4-6 wks to work)
51
Q

What’s the difference between acute panic attack and pheochromocytoma?

A

pheo: high TA

52
Q

What’s the tx: Public speaking phobia (2)

A
  • BBloquer (not benzo, bc sedating)
  • Only give benzo if asthma + public speaking phobia
53
Q

What’s the difference: Social anxiety disorder vs avoidant personality disorder (2)

A
  • Social anxiety disorder: fear of embaresement public
  • Avoidant personality disorder: fear of rejection, but want to make friends but don’t know what

tx: CBT

54
Q

What’s 1st line tx: OCD

A
  • Exposure response control
55
Q

What’s the therapy of borderline personality disorder?

A

Dialectical Behavioral Therapy

56
Q

What’s tx of adjustment disorder (1)

A

supportive

57
Q
A

Revision LMCC (6 decks)

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