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Psychiatry > Master Review Section > Flashcards

Master Review Section Flashcards

1
Q

ADR of thioridazine

A
  • abnormal retinal pigmentation after years of use
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2
Q

What are some common noncompliance issues for antipsychotics in males?

A
  • impotence and inhibition of ejaculation due to alpha blocker effect
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3
Q

What is a common noncompliance issue for antipsychotics in females?

A
  • weight gain due to hyperprolactinemia
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4
Q

What is the first choice medication for treating schizophrenia when sedation is a problem?

A
  • risperidone (minimal sedation effects)
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5
Q

Risperidone affects which receptors?

A
  • 5HT
  • D1
  • D2
  • alpha 1
  • alpha 2
  • H1
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6
Q

Tx for tardive dyskinesia

A
  • valbenazine
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7
Q

MOA of valbenazine

A
  • reversible reduction of dopamine release by selectively inhibiting presynaptic human vesicula rmonoamine transporter type 2
  • VMAT2
  • ultimately reduces the levels of dopamine available
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8
Q

What are some EPS that can occur in the first week of using an antipsychotic?

A
  • muscle spasms

- difficulty swallowing

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9
Q

What are some EPS that can occur with using antipsychotics within weeks?

A
  • bradykinesia
  • rigidity
  • tremors
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10
Q

Weeks to chronic use of antipsychotics can lead to what specific EPS?

A
  • akathisia aka motor restlessness
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11
Q

Why are anticholinergics first line for EPS?

A
  • blocking D2 receptors increases cholinergic activity in the nigrostriatal.
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12
Q

What is the main difference between BZDs and barbiturates?

A
  • BZDs work by increasing the frequency of chloride ions via GABA
  • Barbiturates potentiate GABA by increasing the duration of chloride ions
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13
Q

Why is buspirone more favorably used people who have to operate heavy machinery for a living?

A
  • there is no additive effect when used with other sedative-hypnotics
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14
Q

Tx for hoarding disorder

A
  • CBT with clomipramine or SSRIs
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15
Q

In pregnant women who have severe depression, if ECT fails, what is the next line of treatment?

A
  • esketamine
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16
Q

Tx for seasonal affective disorder

A
  • phototherapy or sleep deprivation
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17
Q

Rapid cycling bipolar is indicated by?

A

> 4 episodes of mania per year

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18
Q

How long do the symptoms of mania need to be present in order to diagnose bipolar disorder?

A
  • 1 week
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19
Q

What is the most common ADRs of lurasidone?

A
  • weight gain

- sedation

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20
Q

In severely manic patients who are noncompliant, what would be the treatment?

A
  • IM depot phenothiazine
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21
Q

What is the most common cause of progression to rapid cycling bipolar?

A
  • use of antidepressants
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22
Q

How should you manage rapid cycling bipolar?

A
  • gradually stop all antidepressants, stimulants, caffeine, benzos, and alcohol
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23
Q

What other medical conditions predispose a patient to rapid cycling bipolar?

A
  • hypothyroidism
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24
Q

What drug has been shown to prevent suicidal ideation in bipolar disorder?

A
  • lithium
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25
Q

A known patient on lithium is now pregnant. How will you manage her?

A
  • discontinue the lithium; choose ECT therapy for the first trimester patients with manic episodes
  • use lamotrigine in 2nd or 3rd trimester
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26
Q

What is the preferred tx in cyclothymic disorder?

A
  • divalproex
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27
Q

Patient with hallucinations who has recently had a baby and is depressed. What should be treated for first?

A
  • always treat the more dangerous symptoms first. This patient has hallucinations, which can be treated with antipsychotics.
28
Q

What is the biggest complication of ECT?

A
  • transient memory loss, which worsens with prolonged therapy and resolves after several weeks
29
Q

Why wouldn’t you want to preform ECT on a patient with a brain tumor or space occupying intracranial lesion?

A
  • ECT induces transient intracranial pressure
30
Q

Which SSRI is not safe in pregnancy?

A
  • paroxetine
31
Q

Patient has attempted suicide by overdosing on TCAs. What is the next step?

A
  • give sodium bicarbonate; it alkalines the blood to remove TCAs from the myocardial sodium channels
32
Q

Second line therapy for rapid cycling bipolar disorder when lithium fails?

A
  • divalproex
33
Q

What is third line if lithium and divalproex fail for rapid cycling bipolar?

A
  • carbamazepine
34
Q

What is important to note about carbamazepine?

A
  • It’s a CYP450 induces, so it increases the clearance of warfarin, phenytoin, theophylline, and valproic acid
35
Q

Tx for illness anxiety disorder

A
  • CBT
36
Q

Besides giving olanzapine to help an anorexic patient gain weight, what should also be prescribed?

A
  • fluoxetine because it helps prevent relapses
37
Q

Define disruptive mood dysregulation disorder

A
  • children with a pervasively angry or irritable mood involving frequent aggressive outbursts that are out of proportion to the stressor
38
Q

In terns of mood presentation, what is the main difference between intermittent explosive disorder and disruptive mood dysregulation disorder?

A
  • A patient with intermittent explosive disorder will return to normal mood after the explosive episode
  • A patient with disruptive mood dysregulation disorder will not return to normal mood after the outburst.
39
Q

Tx for gambling disorder

A
  • group psychotherapy
40
Q

Brain bleeds in a small infant due to abuse is called?

A
  • shaken baby syndrome
41
Q

Vitamin C helps to promote excretion of what type of drug intoxication?

A
  • cocaine/amphetamines
42
Q

MOA of cocaine

A
  • blocks the reuptake of NE, serotonin, and dopamine
43
Q

MOA of amphetamines

A
  • induces the release of dopamine
44
Q

If a patient has track marks on their arms, what should you order to look for?

A
  • HIV serology
  • hep B antigen
  • hep C antigen
  • PPD
45
Q

Most effective tx for alcoholics?

A
  • group psychotherapy aka AA
46
Q

Disulfiram inhibits acetaldehyde dehydrogenase. As a result acetaldehyde builds up and causes?

A
  • vomiting
  • headache
  • tachycardia
  • sweating
47
Q

Inpatient management of those withdrawing from alcohol should have what given to them?

A
  • thiamine
  • magnesium
  • B12
  • folate
  • BZD
48
Q

K2 is what type of drug?

A
  • synthetic cannabinoid
49
Q

Symptoms of caffeine withdrawal?

A
  • headache
  • depression
  • anxiety
  • fatigue
  • difficulty concentrating
50
Q

Tx for the various paraphilic disorders?

A
  • mild–> psychotherapy and aversive conditioning

- severe–> antiandrogens or SSRIs

51
Q

recurrent urges to observe an unsuspecting person who is engaging in sexual activity or disrobing

A
  • voyeurism
52
Q

recurrent urges or arousal toward prepubescent children

A
  • pedophilia
53
Q

recurrent urge to expose oneself to strangers

A
  • exhibitionism
54
Q

involves the use of nonliving objects usually associated with the human body

A
  • fetishism
55
Q

recurrent urge or behavior involving touching or rubbing against a nonconsenting partner

A
  • frotteurism
56
Q

recurrent urge or behavior involving the act of humiliation

A
  • masochism
57
Q

recurrent urge or behavior involving acts in which physical or psychological suffering of a victim is exciting to the patient

A
  • sadism
58
Q

Which two antipsychotics can lead to QT prolongation and therefore are at higher rate of mortality in an overdose?

A
  • quetiapine (seroquel)

- ziprasidone (geodon)

59
Q

Cogentin aka benztropine MOA

A
  • AcH antagonist
60
Q

What is the therapeutic range for lithium?

A

0.6 to 1.2 mmol/L

61
Q

Which antidepressant is safe while being on heparin or warfarin?

A
  • mirtazapine
62
Q

Before prescribing olanzapine, what things should be checked?

A
  • glucose
  • TGs and cholesterol

*olanzapine aka zyprexa causes weight gain (metabolic syndrome)

63
Q

Vistaril is the brand name for?

A
  • hydroxyzine
64
Q

Vyvanse is the brand name for?

A
  • Lisdexamfetamine
65
Q

Nuplazid is the brand name for ?

A
  • pimavanserin
66
Q

Lithium and depakote need to be checked for how long when a patient first starts them?

A
  • 4-5 days

Psychiatry (15 decks)

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