Module 3 Part 2 Flashcards
What is medication tolerance?
Medication tolerance occurs when the body becomes accustomed to a medication, requiring either a higher dose for the same effect or switching to a different medication altogether.
This phenomenon is common in long-term medication use.
What is Kindling in the context of seizures?
Kindling is a neuronal membrane threshold sensitivity dysfunction process that lowers the seizure threshold.
It refers to the nervous system’s memory of past withdrawal experiences, leading to increased severity of future withdrawals.
Define addiction.
Addiction is a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.
Examples include alcohol, tobacco, opioid, and cocaine addiction.
What does high potency in medication mean?
High potency means that a low dose of the medication is required to achieve its result.
An example is Haldol.
What does low potency in medication mean?
Low potency means that a high dose of the medication is required to achieve its result.
An example is Chlorpromazine.
What is ADHD?
ADHD is a persistent pattern of inattention or hyperactivity, impulsivity, or both, that interferes with functioning and development.
It affects individuals’ ability to focus and control their impulses.
List the symptoms of inattention in ADHD.
- Fails to give attention to details
- Difficulty sustaining attention
- Does not listen when spoken to
- Disorganized
- Avoids tasks that require attention
- Loses things
- Distracted
- Forgetful
These symptoms can significantly impact academic and social performance.
List the symptoms of hyperactivity and impulsivity in ADHD.
- Fidgets
- Leaves seat
- Runs or climbs
- Unable to engage in quiet activities
- On the go
- Talks excessively
- Difficulty waiting for turns
- Interrupts others
These behaviors can disrupt classroom and social settings.
What areas of the brain are affected by ADHD?
- Frontal cortex
- Basal ganglia
- Reticular activating system
Each area contributes to different functions such as motor control, learning, emotions, and the ability to focus.
What neurotransmitter dysfunctions are associated with ADHD?
- Dopamine dysfunction
- Norepinephrine dysfunction
- Serotonin dysfunction
These neurotransmitters play critical roles in attention and impulse control.
What are the first-line treatments for ADHD?
- Stimulants (Amphetamine and methylphenidate)
- Non-stimulants (Guanfacine and Clonidine)
Stimulants are often the first choice, but non-stimulants may be used if side effects are intolerable.
What is a common symptom of borderline personality disorder?
Extreme mood swings.
Individuals with BPD often experience intense emotional fluctuations.
What therapy is most effective for treating Borderline Personality Disorder?
Dialectical Behavior Therapy (DBT) - Marsha M. Linehan.
DBT focuses on emotion regulation, interpersonal effectiveness, and distress tolerance.
What are the symptoms of Antisocial Personality Disorder?
- Reckless disregard for the welfare of others
- Lack of remorse
- Indifference to the feelings of others
- Failure to conform to social norms
- Deceitfulness
- Impulsivity
This disorder is characterized by a pattern of manipulation and violation of others’ rights.
What are the diagnostic criteria for Autism Spectrum Disorder?
- Persistent deficits in social communication and interaction
- Stereotyped or restrictive, repetitive behaviors
- Hyper or hypo sensory input
These symptoms affect daily functioning and social interactions.
What tools are used for Autism screening?
- Modified Checklist for Autism in Toddlers (M-CHAT)
- Autism Diagnostic Observation Schedule-Generic (ADOS-G)
- Age and Stage Questionnaires (ASQ)
These tools help identify children who may need further evaluation for Autism.
What is Rett syndrome?
Rett syndrome is a neurodevelopmental disorder that primarily affects girls and is characterized by normal growth followed by specific deficits.
Symptoms include loss of purposeful hand skills, deceleration of head growth, and severely impaired language development.
What is Disruptive Mood Dysregulation Disorder (DMDD)?
A diagnosis of depressive disorders in children and adolescents characterized by persistent and long-lasting dysregulation of mood, regular intense temper outbursts, and extreme irritability.
Treatment may include mood stabilizers, antipsychotics, and SSRIs.
What is the mnemonic for remembering the physical exam findings of Rett syndrome?
HANDS-RISC.
Each letter represents a specific finding associated with the syndrome.
What age must a child be diagnosed with DMDD?
Between 6 - 17 years old
DMDD diagnosis typically occurs in children between the ages of 6 to 18.
What is the mnemonic used to remember the diagnostic criteria for depressive disorder in children and adolescents?
DICED
DICED stands for Depression, Irritability, Chronic dysregulated mood, Episodes of intense temper Outbursts, and Screening for a family history of bipolar disorder.
What are the diagnostic criteria for Intermittent Explosive Disorder (IED)?
- Verbal aggression twice weekly for 3 months
- 3 episodes in 12 months involving damage to property
- Outbursts last less than 30 minutes
- Rage, irritability, increased tension, racing thoughts, increased energy, tremors, palpitations, chest tightness
Symptoms include temper tantrums, shouting, arguing, and assaulting others.
Which disorder is characterized by losing temper frequently and defying rules?
Oppositional Defiant Disorder (ODD)
ODD includes symptoms like easily irritated, experiencing anger, blaming others, and annoying others intentionally.
What does the mnemonic ‘ODD BAD 4(6) REAL’ represent?
ODD: Oppositional Defiant Disorder
BAD: Blames, Argues, Defiant
4(6): 4 Symptoms for at least six months
REAL: Resentful/Angry, Easily Annoyed, Annoys others, Loses Temper
What are non-pharmacological treatment options for ODD?
- Therapy as the primary approach
- Child and parent problem-solving skills training
- Family therapy to enhance child management skills
- Adolescent transitions program targeting mood and aggression
What is Conduct Disorder?
A repetitive and persistent pattern of behavior in which the rights of others, social norms, or rules are violated
Criteria include aggression towards animals or people, stealing, running away, physical cruelty, destruction of property, deceit, and lack of remorse.
What is the mnemonic ‘ASTRA-PCDL’ used for?
Criteria for conduct disorder:
* Aggression
* Stealing
* Running away
* Animal cruelty
* Property destruction
* Deceit and theft
* Lack of remorse
What are common pharmacological treatments for Conduct Disorder?
- SSRIs
- Mood stabilizers
- Antipsychotics
- Alpha agonists like Clonidine and Guanfacine
What is Fragile X syndrome characterized by?
- Large head
- Elongated face
- Hyperextensible joints
- Abnormally large testicles
- Short stature
What does the mnemonic ‘L-E-H-A-S’ stand for in Fragile X syndrome?
Large head, Elongated face, Hyperextensible joints, Abnormally large testicles, Short stature
What is the leading cause of disability worldwide?
Major Depressive Disorder (MDD)
According to the WHO, depression is the leading cause of disability.
What does the acronym SIGECAPS represent?
- Sleep
- Interest
- Guilt
- Energy
- Concentration
- Appetite
- Psychomotor retardation
- Suicide
What pharmacological management is considered first-line treatment for MDD?
SSRIs (Selective Serotonin Reuptake Inhibitors)
SSRIs are typically the first-line treatment for Major Depressive Disorder.
What is a key safety concern for antidepressants in patients under 24 years old?
Black box warning for increased risk of suicidality
All antidepressants for patients under 24 years include a Black box warning.
What common side effect should be emphasized when educating a patient about Sertraline (Zoloft)?
Sexual dysfunction
Sexual dysfunction is a common side effect of Sertraline, impacting treatment adherence.
What are common adverse effects of Electroconvulsive Treatment (ECT)?
- Cardiac arrhythmia
- Headaches, muscle aches, drowsiness
- Short-term memory disturbance, confusion
What mnemonic helps remember risk factors for suicidality?
MAD SPARROW 55
M: Male gender (45 or older), A: Age (55 or older for females), D: Divorced, single, or separated, S: Substance abuse, P: Psychiatric disorder, A: Alone, R: Recent loss, R: Race (White), O: Older age risks, W: Physical illness.
What is the primary distinction between Bipolar I and Bipolar II disorders?
Bipolar I includes manic episodes; Bipolar II includes hypomanic episodes
Bipolar I is more severe compared to Bipolar II.
What is the gold standard treatment for manic episodes in Bipolar Disorder?
Lithium
Lithium is the first-line treatment for managing manic episodes and for prophylaxis.
What is the minimum duration for a hypomanic episode?
Minimum 4 days
What is the minimum duration for a manic episode?
Minimum 1 week
What neurotransmitters are involved in mood disorders?
- GABA
- Glutamate
- Dopamine
- Serotonin
- Norepinephrine
Which pharmacological treatment is used for bipolar depression?
- Lamotrigine
- Lurasidone
- Olanzapine & Fluoxetine
- Divalproex sodium
- Carbamazepine
What is the most likely diagnosis for a patient exhibiting pressured speech, irritability, and heightened energy levels?
Bipolar disorder
Symptoms such as these are indicative of a manic episode.
What medication is used to treat manic episodes of bipolar disorder?
Bamazepine
Bamazepine is specifically indicated for managing manic episodes.
Name four types of nonpharmacological management for bipolar disorder.
- Cognitive Behavioral Therapy (CBT)
- Behavioral Therapy
- Interpersonal Therapy
- Support Groups
What is the most likely diagnosis for a patient exhibiting insomnia, difficulty concentrating, heightened energy levels, pressured speech, irritability, and inflated self-esteem?
Bipolar disorder
The symptoms are indicative of a possible manic episode.
Which medication has the greatest potential for providing neuroprotective benefits to patients with bipolar disorder?
Lithium
Lithium enhances neural plasticity and promotes cellular resilience.
What is the most appropriate medication to prescribe for a patient with bipolar I disorder accompanied by psychotic features?
Quetiapine (Seroquel)
Quetiapine effectively treats both manic and psychotic symptoms.
What are the normal values for Free T4?
0.8 to 2.8 ng/dl
Free T4 assesses thyroid status and rules out hypo-/hyperthyroidism.
What is the normal range for thyroid-stimulating hormone (TSH)?
0.5-5.0 mu/L
TSH is assessed first for diagnosing primary hypothyroidism.
What mnemonic can help remember hypothyroid symptoms?
COLD W MEMORY
This mnemonic stands for Cold sensitivity, Confusion, Decreased libido/appetite, Weight gain, Memory loss, Lethargy, Headaches, Slow/clumsy movements, and Constipation.
What are the symptoms associated with hyperthyroidism?
- Heat sensitivity
- Irritability & emotional lability
- Short attention span
- Fatigue
- Tremors
- Insomnia
- Impotence
- Weight loss
Which laboratory finding is most indicative of hypothyroidism?
Decreased thyroxine (T4) level and increased thyroid-stimulating hormone levels
Hypothyroidism results in high TSH due to low thyroid hormone production.
What are the normal values for aspartate aminotransferase (AST) and alanine aminotransferase (ALT)?
- AST: 5-40
- ALT: 5-35
What findings are indicative of a patient with alcohol use disorder exhibiting increased liver function values?
Increased MCV and elevated triglyceride levels
Alcohol use disorder can lead to liver damage, affecting MCV and triglyceride levels.
What is the definition of conversion disorder?
Patients report unexplainable symptoms, such as paralysis, paresthesia, blindness, or mutism
Symptoms often begin suddenly after a stressful experience.
What is the most likely diagnosis for a patient who is blind without physiological explanation and is unconcerned about it?
Conversion disorder
The patient’s emotional distress regarding his mother’s death suggests a psychological cause.
What triggers adjustment disorder?
Stressful events
Examples include loss of a pet or a parent’s divorce.
What are the symptoms of Adjustment Disorder with Depressed Mood?
- Depression
- Tearfulness
- Hopelessness
What is the hallmark of PTSD?
Re-experiencing a highly traumatic event with increased arousal and avoidance symptoms
Symptoms must persist for more than one month.
What are the approved medications for PTSD?
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Prazosin for nightmares
What is the gold standard for treating OCD?
Cognitive Behavioral Therapy (CBT)
CBT is highly effective for managing OCD symptoms.
What is the primary neurotransmitter involved in Tourette syndrome?
Dopamine
Norepinephrine and serotonin are also involved.
What is the hallmark of Tourette syndrome?
Involuntary, repetitive movement and vocalization
Motor and vocal tics must occur many times a day for more than one year.
What pharmacological treatments are available for Tourette syndrome?
- Atypical antipsychotics (e.g., haloperidol, Pimozide, Aripiprazole)
- Clonidine
- Guanfacine
What neurotransmitters play a role in the pathophysiology of Tourette syndrome?
Dopamine, norepinephrine, serotonin
These neurotransmitters are implicated in the symptomatology of Tourette syndrome.
What are motor tics?
Sudden, brief, intermittent movements
Motor tics are commonly observed in individuals with Tourette syndrome.
True or False: Tics in Tourette syndrome result from a medical condition or medication/drug use.
False
Tics are not attributable to any medical condition or substance use.
What are some pharmacological management options for Tourette syndrome?
Atypical antipsychotics such as haloperidol, Pimozide, Aripiprazole
These medications are often used to manage symptoms of Tourette syndrome.
What non-pharmacological approaches can be effective in managing Tourette syndrome?
Behavioral therapy, cognitive-behavioral therapy (CBT)
These therapies can help in reducing the impact of tics.
What is Persistent/Chronic Motor or Vocal Tic Disorder?
Presence of either motor or vocal tics for more than one year
An example includes excessive blinking.
Fill in the blank: A child developing tics after starting Vyvanse should have the medication _______.
discontinued
Discontinuation allows for alternative treatment options such as guanfacine.
What is the age of onset for males with schizophrenia?
18-25
This age range is commonly associated with the onset of symptoms in males.
What are positive symptoms of schizophrenia?
Hallucination, Delusion, Referential thinking, Hostility, Grandiose, Mania, Suspiciousness
These symptoms result from excess dopamine in the mesolimbic pathway.
What are negative symptoms of schizophrenia?
Affect flattening, Alogia, Avolition, Apathy, Abstract thinking, Anhedonia, Attention deficit
These symptoms are linked to decreased dopamine in the mesocortical pathway.
What is Assertive Community Treatment (ACT)?
Community-based programs that support patients post-hospitalization
ACT includes case management, problem solving, and social skills training.
What routine monitoring should be conducted for schizophrenia patients?
Serum glucose and lipids, weight, BMI, waist-to-hip ratio, liver and kidney functions, complete blood count
These assessments help monitor for potential side effects of medications.
What is the correct management for a child with tics after starting Vyvanse?
Discontinue Vyvanse, prescribe guanfacine extended-release (Intuniv) and monitor the patient.
This approach minimizes risks while managing symptoms.
True or False: Schizophrenia is associated with excess serotonin levels.
False
Schizophrenia is linked to excess dopamine and decreased serotonin.
What is an example of an atypical antipsychotic medication?
Risperidone
Atypical antipsychotics are commonly used in the treatment of schizophrenia.
What mnemonic can help remember the positive symptoms of schizophrenia?
HI-GRID-SAM
This mnemonic stands for Hallucination, Delusion, Referential thinking, Hostility, Grandiose, Mania, Suspiciousness.
What mnemonic can help remember the negative symptoms of schizophrenia?
AA-A4
This mnemonic stands for Affect flattening, Alogia, Avolition, Apathy.
