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Designated study period: daily cards > March 23 - Behavioral Science > Flashcards

March 23 - Behavioral Science Flashcards

1
Q

Alcohol withdrawal: four stages

A

Mild withdrawal: 6-24 hours; anxiety, insomnia, tremors, sweating, palpitations, GI upset, in tact orientation

Seizures: 12-48 hours
Alcoholic hallucinosis: 12-48 hours

Delirium tremens: 48-96 hours; confusion, agitation, fever, tachycardia, HTN, diaphoresis

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2
Q

Mania vs hypomania

A

Mania: more severe symptms, last at least 1 wk or require hospitalization; impair function (usually can’t work); +/- psychotic features

Hypomania: less severe, lasts at least 4 days, doesn’t cause marked impairment or require hospitalization, no psychotic features

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3
Q

Bipolar I vs bipolar II vs cyclothymic

A

Bipolar I: manic episode +/- depressive episodes
Bipolar II: hypomanic episode + major depressive episode
Cyclothymic: 2 yrs fluctuating mild hypomanis and depressive symptoms

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4
Q

Acute alcohol intoxication and medical decision making

A

Lack decision making capacity. Should reassess capacity once sober

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5
Q

Schizoid vs schizotypal

A

Schizoid: prefer to be loner, detached, unemotional
Shizotypal: eccentric, odd thoughts, perceptions, and behavior but no frank delusions or hallucinations, rarely have close interpersonal relationships because of social anxiety that doesn’t decrease with familiarity

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6
Q

Informed consent

A

Accurate description of intervention.
Alternative treatments, risks, and benefits
Assessment of patient’s understanding and preference
Need to have adequate knowledge of procedure in order to consent

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7
Q

OD deaths

A

Most common cause is opioids (prescription and heroin)

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8
Q

Stimulant intoxication symptoms

A

Paranoia, restlessness, hypervigilence, tachycardia, HTN, diaphoresis. Can get transient paranoid psychosis

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9
Q

Differentiating stimulant-induced psychosis from mania/psychotic disorder

A

Prominent physical signs, lack of psych history

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10
Q

Brief psychotic disorder

A

Diagnosis of exclusion - have to rule out substance abuse and medical conditions. Acute onset of over 1 psychotic symptom. Lasts 1 day to 1 month with complete resolution.

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11
Q

Delusional disorder

A

Over 1 delusion lasting at least a month.

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12
Q

Olanzapine

A

2nd generation antipsychotic with high risk of metabolic side effects

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13
Q

Lithium monitoring

A

Routine monitoring of BUN/Cr and thyroid function due to risk of impaired renal function and hypothyroidism

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14
Q

Risperidone

A

2nd gen antipsychotic with highest risk of increase prolactin

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15
Q

Acute stress disorder vs PTSD

A

Acute stress disorder lasts 3 days to 1 month

PTSD lasts longer than 1 month

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16
Q

Adjustment disorder with depressed mood

A

Diagnosed if don’t meet full criteria for ME=DE

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17
Q

Somatic symptom disorder

A

Preoccupation with unexplained medical symptoms and excessive healthcare use. Manage with regular visits to same provider and avoidance of unnecessary diagnostic testing and specialist visits. Refer to mental health provider only once physican-patient relationship well established

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18
Q

Treatment of drug-induced parkinsonism

A

Benztropine or trihexyphenidyl (centrally-acting anticholinergics_

19
Q

PCP vs cocaine vs methamphetamine intoxication

A

PCP: violence, hallucinations, dissociation, amnesia, nystagmus, ataxia

Cocaine: chest pain and seizures

Methamphetamine: violence, psychosis, diaphoresis, choreiform movements, tooth decay

20
Q

Different mood stabilizers and their side effects

A

Lithium

  • treats both mania and depression
  • can cause hypothyroidism, tremor, diabetes insipidus

Valproate

  • hepatotoxicity, NTDs
  • treats mania, seizures

Carbamazepine

  • causes agranulocytosis, SIADH/hyponatremia, NTDs
  • treats mania, seizures

Lamotrigine

  • causes rash and SJS
  • treats depressive episodes, focal seizures
21
Q

Citalopram

A

SSRI

22
Q

Trazodone MOA and side effects

A

MOA: serotonin modulator. Antagonizes serotonin receptors, inhibits serotonin reuptake.

Side effects: blocks alpha1 receptors caushing othostatin hypotension. blocks H1 receptors causing sedation. Most serious side effect is priapism (painful erection)- drug should be avoided in sickle cell disease and multiple myeloma which predispose to priapism

23
Q

Paranoid personality disorder vs delusional disorder

A

Paranoid personality is pattern of suspiciousness without clear delusions
Delusional disorder is delusions over 1 month without other psychotic symptoms or otherwise bizarre behavior that impairs function

24
Q

Addressing a possible opioid use disorder

A
  1. validate patient’s concern about pain control
  2. engage in discussion about how patient is using the med
  3. Explore reasons for escalting use
25
Q

Reducing prescription transcription errors

A

Avoid abbreviations and trailing zeros

26
Q

Imipramine

A

TCAD

27
Q

Climipramine

A

TCAD

28
Q

Duloxetine

A

SNRI

29
Q

Fluvoxamine

A

SSRI

30
Q

Paraxetine

A

SSRI

31
Q

R vs L frontal lobe damag

A

L frontal lobe: apathy and depression

R frontal lobe: disinhibited behavior

32
Q

Clozapine use

A

Superior in treating resistance schizophrenia

33
Q

Hospice criteria

A

Provided to terminally ill with less than 6 mos to live when aggressive, curative treatments no longer beneficial or desired

34
Q

Relationships between doctors and patients

A

Never ethical. Shouldn’t suggest that a relationship could exist if patient found a different doctor becuase would encourage them to stop seeing you

35
Q

Effective discharge

A

Collaboration between social work, nurse, and physician to talk about meds, follow up, functional status

Discharge checklist with dtailed med instructions, follow up appts, pending labs, emergency contact number

36
Q

Declining a gift of vale

A

Express gratitude, explain why can’t accept, avoid any implication that gift was given to gain preferential treatment

37
Q

Provide discharge checklist to help prevent readmission

A

Detailed med instructions, follow up appointments, pending lab tests, emergency contact number

38
Q

Capitation

A

Payor pays fixed, pretermined fee to over all med services. Payment structure of HMO

39
Q

Global payment

A

Insurer pays single payment to cover all expenses associated with an incidence. Common for elective surgeries.

40
Q

Point of service

A

PCP required, need referral for specialty consults. Allowed to see provider outside network but at higher cost (distinguishes from HMO)

41
Q

Treatment of friends

A

Should be limited to emergencies when no other physician available

42
Q

Suspected IPV

A

ensure privacy, nonjudgemental, empathic, open-ended questioning. No pressure to disclose, report, or leave partner. Assess safety and ask about emergency safety plan.

43
Q

Schizoaffective disorder

A

MDE or manic episode concurrent with schizophrenia symptoms. Distinguished from depression/bipolar with psychotic features by lifetime history of delusions or hallucinations over 2wks without depression or mania (in depression/bipoarl with psychotic features, psychotic symptoms only occur during mood episodes)

Designated study period: daily cards (32 decks)

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