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MTB Flashcards

1
Q

Rett disorder Presentation

A 
Progressive encephalopathy
Microcephalopathy
Hand wringing
Loss of speech
Ataxia
Psychomotor retardation
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2
Q

Child Disintegrative disorder Presentation

A

Normal development first 2 yrs
Regression after 2
Repetitive/stereotyped movements

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3
Q

Oppositional defiant disorder Presentation and management

A

Usually by 8 yoa
Argumentative, loss of temper, blame others
Authority figure issues
Teach parents coping skills

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4
Q

Diff bt Antisocial v Conduct Disorder

A

Antisocial > 18 yoa

Conduct < 18 yoa

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5
Q

Assn’s w Conduct Disorder

A

Parents w Antisocial

Parents w Alcohol dependence

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6
Q

Diff bt oppositional defiant disorder v Conduct Disorder

A

ODD - do not break rules, commit crimes

Conduct disorder - do break rules/commit crimes

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7
Q

How do tics present

A

Preceded by irresistible urges, followed by relief

Exacerbated by stress and fatigue

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8
Q

Comorbidities w Tourette

A

OCD

ADHD

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9
Q

Tourette presentation

A

Multiple tics
Last > 1 year
Before Age 18

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10
Q

TX for Tourette

A 
Dopamine Antagonists
APs = Risperidone (2nd G AP) 
FDA approved are 1st G AP, used less b/c of AEs
- Haloperidol
- Pimozide
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11
Q

How long must major depression be present for Dx

A

2 weeks

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12
Q

What is MDD

A

Anhedonia
+
4 others = SIGECAPS
weight, sleep, psychomotor, fatigue, concentration, worthlessness, death thoughts

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13
Q

MC medical cause of depression

A

Hypothyroidism

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14
Q

MC Neuro Assn w depression

A

PD

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15
Q

Management of Pt on SSRI w improvement but not full response

A

Increase dose

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16
Q

Management of Pt on SSRI w single episode of depresssion

A

Continue SSRI for 6 months and follow pt

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17
Q

Management of pt w depression + neuropathic pain

A

Desvenlafaxine

SNRI

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18
Q

Management of pt w depression + fearful of weight gain or sexual AEs

A

Bupropion

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19
Q

Bipolar Disorder Presentation

A

Mood disorder - typically starts w depression

Pt has manic sx’s that last at least ONE WEEK + cause significant distress in level of functioning

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20
Q

Manic sx’s in Bipolar

A

DIG FAST

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21
Q

DX for Bipolar

A

R/O drugs - cocaine, amphetamine

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22
Q

Difference bt mania and hypomania

A 
Mania 
- last more than 1 week
-affect functioning
- severe enough for hospitalization 
- psychotic features
Hypomania
- less than 1 week
- do not severely affect functioning
23
Q

Is depression required for Bipolar I DX?

A

No. Mania alone is enough for Dx.

24
Q

What is required for Bipolar II DX?

A

Hypomania

Depression - at least 1 MDD Sx required

25
Q

TX for Bipolar - Acute mania

A 
Lithium
Valproic acid
Atypical APs = OAR 
- Olanzapine
- Aripripazole
- Risperidone
26
Q

TX for Bipolar Depression

A

Lithium

Lamotrigine

27
Q

Steps in management of Acute Mania

A
  1. Hospitalize
  2. Mood stabilizers
  3. APs. DOC = Risperidone
  4. IM depot phenothiazine - noncompliant, severely manic
  5. Antidepressants IF hx of recurrent episodes depression
28
Q

Presentation of Pseudodemntia

A

Elderly
Severe depression + memory impairment
Aware/concerned of cognitive decline

29
Q

TX for Pseudodemntia

A

SSRI

- reversible with AD

30
Q

Dysthymia Presentation

A

Depressed mood most of the day, continuous

Sx’s for more than 2 YEARS

31
Q

TX for Dysthymia

A

ADs + Psychotherapy

32
Q

Cyclothymia Presentation

A

Hypomanic episodes + Mild depression

Sx’s for more than 2 YEARS

33
Q

TX for Cyclothymia

A

Pscyhotherapy +

  • Lithium
  • Valproic Acid
  • Carbamezapine
34
Q

Atypical Depression Presentation

A

Reverse vegetative sx’s
- increased sleep, weight, appetite
Mood worse in evening
Pts feel “heavy”

35
Q

TX for Atypical Depression

A

SSRIs or MAOIs

36
Q

Seasonal Affective Disorder

A

Wt gain, increased sleep, lethargy in winter

TX: Phototherapy

37
Q

How long do grief sx’s last?

A

Up to 1 year, typically less 6 months

38
Q

TX for grief

A

Supportive therapy

Medical tx = wrong

39
Q

ADs safe in pregnancy

A

SSRIs - except Paroxetine (Paxil)

TCAs

40
Q

SSRIs first line TX for

A 
MDD
Bipolar
Anxiety disorders
Panic disorder, OCD, Social phobia, GAD
Bulimia nervosa
41
Q

AD for enuresis

A

Imipramine

42
Q

AD for severe insomnia

43
Q 
Postpartum blues Presentation
Onset
Sx's
Mother's feelings
TX
A

Immediately after birth -> 2 weeks
Sadness, mood, lability, tearfulness
No negative feelings twd baby
Supportive

44
Q 
Postpartum Depression Presentation
Onset
Sx's
Mother's feelings
TX
A

W/in 1-3 months after birth
Depressed mood, Wt/sleep changes, excess anxiety
May have negative feelings twd baby
ADs

45
Q 
Postpartum Psychosis Presentation
Onset
Sx's
Mother's feelings
TX
A 
W/in 2-3 weeks after birth
Depression, delusions, thoughts of harm
May have thoughts of harming baby
APs, Lithium, maybe ADs
Step 3 says avoid meds if breastfeeding, choose ECT
46
Q

AE of ECT

A

Transient memory loss

Induced transient intracracranial pressures

47
Q

AE’s of TCAs

A 
HypoTN
Dry mouth
Constipation 
Arrhythmias - QT prolongation
Sexual AE's
Weight GAIN
GI disturbances
Insomnia
48
Q

AE’s of MAOI’s

A

HTN w tyramine

49
Q

AE’s of SSRI’s

A

HA
Wt changes
Sexual AE’s
GI disturbances

50
Q

AE’s of Lithium

A 
Acne
Weight gain
Tremors
GI disturbances
Nephrotoxic
Teratogenic
Leukocytosis
DI - polyuria, Hypothyroidism
SEVERE = confusion, ataxia, lethargy, abnormal reflexes
51
Q

AE’s of Valproic Acid

A 
Weight gain
Tremors
GI disturbances
Alopecia
Teratogenic
Hepatotoxic
Toxicity - Hyponatremia, coma, death
52
Q

Presentation of Serotonin Syndrome

A

Cognitive: confusion, agitation, hallucinations, hypomania
Autonomic: sweating, tachycardia, hyperthermia, N/D, shivering
Somatic: tremors, myoclonus

53
Q

Management of Serotonin Syndrome

A
  1. Stop SSRI
  2. Tx fever, diarrhea, HTN
  3. Cyproheptadine = serotonin antagonist

Psych (3 decks)

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