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MTB 1 Flashcards

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1
Q

Presentation of Brief Psychotic Disorder
Time
Sx’s
TX

A

1 day -> 1 month
Delusions, hallucinations, disorganized speech, catatonic
APs

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2
Q

Presentation of Schizophreniform
Time
Sx’s
TX

A

1 month -> 6 months
Delusions, hallucinations, disorganized speech, catatonic, negative Sx’s
APs

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3
Q

Presentation of Schizophrenia
Time
Sx’s
TX

A

More than 6 months
Delusions, hallucinations, disorganized speech, catatonic, negative Sx’s. Severe level of functioning affected
APs

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4
Q

Receptors ass’d with positive sx’s of psychosis

A

Dopamine

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5
Q

Receptors ass’d with negative sx’s of psychosis

A

Muscarinic

- Atypical APs tx better

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6
Q

TX for Schizophrenia

A
  1. Hospitalize if acutely psychotic
  2. Atypical AP
  3. Emergency -> IM OZ = Olanzapine or Ziprazidone, Haloperiodol = AE’s
  4. Non-compliant => Long acting IM Risperidone. First assess tolerability w oral if 1st time
  5. Last line - Clozapine if unresponsive to others, Tx-resistant
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7
Q

What is TX-resistant Schizophrenia

A

Failed response to 2+ trials of AP’s

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8
Q

Pt w command hallucinations, denies SI/HI - next step?

A

Hospitalize

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9
Q

AE’s of olanzapine

A

Weight gain
DM
Sedation
Increase LFT’s

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10
Q

AE’s of Risperidone

A

Movement disorders

Ammennorhea = Palliperidone

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11
Q

AE’s of Quetiapine

A

Less likely for Movement disorders

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12
Q

AE’s of Ziprasidone

A

QT Prolongation

Avoid in pts w conduction defects

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13
Q

AE’s of Clozapine

A

Agranulocytosis

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14
Q

Which Atypical AP’s are least likely to cause weight gain/metabolic syndrome/DM?

A

AZ
Arirpripazole
Ziprasidone

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15
Q

Which Typical AP’s have a greater assn w/ Extrapyramidal Sx’s

A

Hi Potency
Fluphenazine
Haloperidol

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16
Q

Which Typical AP’s have a greater assn w/anticholinergic effects

A

Low Potency
Thioridazine
Chlorpromazine

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17
Q

AE’s of Thioridazine

A

QT Prolongation
Arrhythmias
Retinal pigmentation

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18
Q

AP TX for Insomnia

A

Aripripazole
Olanzapine
Quetiapine
Ziprasidone

19
Q

Presentation of Acute Dystonia
Time
Sxs
TX

A

Hours to days, during 1st week
Muscle spasm, torticollis, oculogyric crisis
Younger men at higher risk
Reduce dose
Benztropine, trihexyphenidyl, diphenhydramine

20
Q

Presentation of Akithesia
Time
Sxs
TX

A

Within weeks
Restlessness, Pacing, rocking, inability to sit still
Reduce dose, beta blockers or benzos, Switch to newer Atypical AP

21
Q

Presentation of Bradykinesia/Parkinsonism
Time
Sxs
TX

A

Within weeks
Bradykinesia, tremors, rigidity - elderly at risk
Reduce dose
Benztropine, trihexyphenidyl, diphenhydramine

22
Q

Presentation of Tardive Dyskinesia
Time
Sxs
TX

A

Months to Years
Abnormal involuntary movements of head, limbs, trunk, Perioral movements, often irreversible
Switch to Atypical AP, Clozapine - least risk

23
Q

Presentation of NMS
Time
Sxs
TX

A

Anytime
Muscle rigidity, hyperthermia, volatile vital signs, altered LOC, increased WBC and CK
Dantrolene or bromocriptine

24
Q

Presentation of Schizoaffective

A

Uninterrupted period of Sx’s for MDD, manic or mixed
Sx’s or schizophrenia, delusions, hallucinations for at least 2 wks WITHOUT mood sx’s
TX: assess for hospitalization, AD’s, AP’s, anticonvulsants

25
Q

Presentation of Delusional Disorder

A

Non-bizarre delusions
More than 1 month
No impairment in level of functioning

26
Q

TX of Delusional Disorder

A

Atypical APs

Psychotherapy

27
Q

TX for panic disorder

A
  1. SSRIs
  2. Benzos - alprazolam
  3. CBT
28
Q

TX for panic Attack

A

Alprazolam

29
Q

OCD

A

Obsessions and compulsions that affect level of functioning

Distressed about their Sx’s

30
Q

OCD v OC Personality

A 
OCD = distressed about sx's
Personality = unaware of problem
31
Q

What are PANDAS

A

Pediatric AI Neuropsych Disorders Ass’d with Strep Infxn

- Ass’d with GAS

32
Q

PTSD Presentation

A 
Sx's affect functioning
Increase startle response
Hypervigilance
Sleep disturbances
Anger Outbursts 
Concentration difficulties
33
Q

What are Sexual Assault victims at increased risk of

A 
PTSD
MDD
SI 
STDS
Pelvic Pain
Fibromyalgia
Functional GI disorders
34
Q

Diff bt PTSD and Acute stress disorder

A

PTSD = More than 1 month

Acute stress disorder = 2 days -> 1 month

35
Q

TX for PTSD

A

Paroxetine
Sertraline
Relaxation techniques

36
Q

Time Requirement for GAD

A

6 months

37
Q

Sx’s for GAD

A 
Fatigue
concentration 
Sleep
muscle tension 
restlessness
38
Q

TX for GAD

A

SSRIs
Venlafaxine
Buspirone = benzo abuse risk

39
Q

Lorazepam Indications

A

Emergency b/c IM

40
Q

Clonazepam Indication

A

Longer half life = addiction concerns

41
Q

Chlordiazepoxide, oxazepam indications

A

Alcohol Withdrawl

42
Q

Flumazenil IS a benzo antagonist when

A

Overdose is Acute
AND
NO chronic dependence

43
Q

Alcohol Abuse v Dependence

A

Abuse - continued use despite adverse consequences

Dependence - withdrawl when trying to cut down

44
Q

TX for Alcohol Intoxication?

Withdrawl?

A

Mechanical Vent

Benzos, Thiamine, Multivitamins, Folic Acid

Psych (3 decks)

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