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Lange3 Flashcards

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1
Q

What type of therapy is effective in Bulimia Nervosa?

A

CBT

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2
Q

What is the comorbidity of childhood anxiety disorders (overanxious disorder, separation anxiety disorder, panic disorder) and MDD?

A

50%

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3
Q

What is the rate of Rett disorder in the monozygotic twin of a girl with Rett disorder?

A

100%

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4
Q

Approximately ___% of children with learning disorders have a comorbid psychiatric disorder.

A

50%! This includes, most commonly, ADHD, anxiety, and depressive disorders

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5
Q

___% of children with enuresis have a comorbid mental disorder.

Do more boys or more girls have enuresis?

A

20% Boy > girls

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6
Q

A child should be able to count to 50 at what age?

A

5

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7
Q

What is a frequent adverse effect of clonidine?

A

sedation

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8
Q

People with BPD showcase which defense mechanisms?

A

splitting, projective identification, denial

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9
Q

What is the mainstay of treatment for catatonia?

A

1) benzodiazepenes or

2) ECT, if unsuccessful

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10
Q

What is Mobius Syndrome?

A

congenital absence of the facial nerves and nuclei with resulting bilateral facial paralysis

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11
Q

Punchdrunk syndrome is an acquired movemetn disorder associated with traumatic damage to which part of hte brain?

A

substantia nigra

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12
Q

Frontal release signs (primitive reflexes) and perseveration are nonspecific findings common in

A

demented patients

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13
Q

Cerebellar atrophy is seen in

A

alcoholic patients, congenital disorders

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14
Q

In GAD, symptoms of anxiety last at least ___ months.

A

6

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15
Q

In borderline patients, DBT should be used in conjunction with (group/individual) therapy.

A

Individual. Though group therapy is a component of DBT, it should be used in conjunction, not as a replacement to individual therapy.

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16
Q

How do you differentiate impulse control disorder fro OCD?

A

impulses not as ego-dystonic (distressing); no obsessional, non-enacted (thinking) component

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17
Q

The 3-month mortality rate of patients with one episode of delirium is _____%. The 1-year mortality may be as high as _____%

A

3 month: 23 to 33%

1 year: 50%

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18
Q

What percentage of depressed patients eventually commit suicide? What percentage will attempt?

A

30% will attempt, 15% will be successful

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19
Q

How long does an untreated MDE last?

A

between 6 and 13 months; with treatment, that can decrease to 3 months

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20
Q

The best psychotherapy for panic disorder is

A

CBT

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21
Q

What percentage of cases of impotence in the age group 30 to 50 has a psychological etiology?

A

90%!!! After 50, it becomes increasingly medically-related

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22
Q

What class of antidepressants has the highest potential to induce a manic switch?

A

TCAs!

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23
Q

What is the difference between localized amnesia and selective amnesia?

A 
localized = memory loss surrounding a discrete period of time
selective = inability to recall certain aspects of an event, though other memories of the event may be intact
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24
Q

What is the difference between catalepsy and cataplexy?

A 
cataLEPSY = immobility seen in catatonic states
cataPLEXY = transient loss of motor tone assoc. with strong emotions
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25
Q

List the following benzodiazepines in order from least to most potent:
oxazepam, alprazolam, clonazepam, diazepam, chlordiazepoxide, lorazepam

A

chlordiazepoxide –> oxazepam –> diazepam –> lorazepam –> alprazolam –> clonazepam

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26
Q

Acute renal failure requiring dialysis is caused by lithium levels greater than

A

2

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27
Q

Though clonidine is firstline in treating mild Tourette’s, more severe Tourette’s might be better treated with

A

D2 antagonsits through antipsychotic medication

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28
Q

The only medication that may improve the symptoms of tardive dyskinesia is

A

clozapine

29
Q

What provides the most IMMEDIATE relief of symptoms of GAD?

A

benzodiazepines (e.g. lorazepam)!! (SSRIs and buspirone take a few weeks for effect).

30
Q

What is the most common ECG change inflicted by lithium use?

A

T wave depression or inversion. The changes are usually not clinically significant. Can cause SA block or AB block, but these are usually due to underlying cardiac disease.

31
Q

In refractory OCD, what can be used to augment SSRIs?

A

2nd gen antipsychotics like risperidone!

32
Q

Which receptor is most likely responsible for clozapine’s efficacy?

A

D4

33
Q

Compare imipramine and nortryptiline in terms of their effects on alpha1-receptors (and orthostatic hypotension, as a result).

A

Imipramine (3* amine) blocks multiple receptors and has many side effects

Nortryptiline (2* amine) has less alpha1-blocking potency and tends to be better tolerated

34
Q

Compare NALOXONE and NALTREXONE.

A 
naloxone = opiate antagonist to reverse opiate intoxication
naltrexone = opioid antagonist that can decrease the number of days a person with alcohol dependence drinks and can increase the time before relapse of heavy drinking
35
Q

What is the usual dose range for lorazepam?

A

2 to 6 mg/day for anxiety, divided over 2-3 doses

36
Q

Why isn’t flumazenil given to a patient that has severely altered consciousness when dextrose, thiamine, and naloxone are?

A

flumazenil can lower the seizure threshold, so it should not be used before obtaining more history

37
Q

What is buprenorphine?

A

A mixed opioid agonist-antagonist which suppresses opioid withdrawal and blocks the effects of other opioids

38
Q

T/F: Risperidone can cause orthostatic hypotension, weight loss, and anticholinergic effects.

A

FALSE! While it can cause orthostatic hypotension, it does not cause appreciable anticholinergic effects and it causes weight GAIN.

39
Q

What is topiramate and what is it used for? Side effects?

A

An anticonvulsant used in the treatment of bulimia and binge eating; decreases frequency of binge episodes and leads to weight loss. Can also be used in bipolar. Can result in renal stones (1.5% risk_ and cognitive impairment

40
Q

Which drug, when used in combination with citalopram, can lead to a prolongation of the QTc?

A

pimozide, first generation antipsychotic

41
Q

What can be used to help with the sialorrhea resulting from clozapine? (30% of patients)

A

clonidine!

42
Q

How does clozapine affect the heart?

A

Causes a persistent sinus tachycardia; can be treated with propanolol.

NOTE: clozapine can cause orthostatic hypotension via alpha receptor blockade, so labetalol (mixed a and b antagonist) would not be a good treatment choice!

43
Q

Which of the atypical antipsychotics are least likely to cause metabolic syndrome, including weight gain, hyperlipidemia, hypercholesterolemia, and insulin resistance? Which are the most likely?

A

least likely: ziprasidone, aripiprazole
medium: risperidone and quetiapine
most likely: clozapine and olanzapine

44
Q

Which medication can be used to treat middle insomnia (frequent awakening during the night)?

A

Zaleplon, a non-benzo hypnotic

45
Q

Why should you use olanzapine, and not haldol, in a delirious patient with a prolonged QTc?

A

haldol can also lengthen the QTc (should be less than 440)

46
Q

How do buspirone and citalopram affect warfarin?

A

can lead to decreased efficacy of warfarin! watch PT/PTT and INR

47
Q

What is the difference between nymphomania and satyriasis?

A

insatiable sexual desire in women (nymph) vs men (satyr)

48
Q

Obstructive jaundice, including fever, nausea, malaise, and pruritus, can result from use of which drug?

A

chlorpromazine

49
Q

alpha1-receptor blockade resulting in orthostatic hypotension is particularly troublesome in which antipsychotics?

A

chlorpromazine and clozapine

50
Q

While alcohol withdrawal with focal seizures can occur within ___ hours of cessation of drinking, DTs occur starting ___ hours after cessation of drinking.

A

withdrawal = 48; DTs = 72

51
Q

Oxcarbazepine can result in

A

hyponatremia! (2.5% of cases)

52
Q

Technique in which group members are used as the audience adn the cast in reenactments of scenarios and conflict in order to explore individual problems in a group setting:

A

psychodrama

53
Q

Common technique where each group member is asked to introduce themselves, state how they are feeling, or otherwise specifically respond:

A

go-around

54
Q

When a patient relives an emotional or traumatic experience to get rid of or purge negative emotions and move forward:

A

abreaction

55
Q

What is the difference between the techniques of “reframing” and “clarification”?

A

reframing: examining how patient’s thoughts or beliefs about themselves may be skewed
clarification: further details about a patient’s experience or situation they are describing

56
Q

Are reflexes reduced or increased during a trance state like hypnosis?

A

Reduced

57
Q

In which type of therapy is a single, focal area of conflict identified?

A

brief psychodynamic therapy

58
Q

____________ is one’s tendency to relate events to oneself without any reason for doing so

A

personalization

59
Q

What is “selective abstraction”?

A

A term from cognitive therapy where the details of a scenario are taken out of context and believed while everything else contrary about the scenario is ignored

60
Q

In paradoxical therapy the therapist suggests that the patietn engage in the behavior with negative connotations (phobia or compulsion). Who was it developed by?

A

Bateson

61
Q

When expression of emotion elicits emotional response in other members of the group:

A

contagion

62
Q

When the group recreates a family of origin or the original dynamics of a conflict which helps a patietn work through their original conflict:

A

corrective experience

63
Q

When group emmbers test norms and compete with each otehr to establish autonomy:

A

differentiation

64
Q

What is the “real relationship” in psychodynamic therapy?

A

the relationship between a psychoanalyst and patient which is not influenced by transference

65
Q

Made many contributions to psychiatry and neurology with a special interest in describing hysteria:

A

Jean-Martin Charcot

66
Q

Known as the inventor of the “cathartic” treatment or talking therapy:

A

Josef Breuer

67
Q

Known as the developer of self-psychology:

A

Heinz Kohut (helped direct approaches to treatment of narcissism, selfobject transferences’ of mirroring and idealization, need self-esteem mirrored back, identify with larger whole)

68
Q

Father of modern hypnosis:

A

Anton Mesmer

PSYCH (12 decks)

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