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MTB STEP 3 (J) > MTB 3 - Psychiatry (jenna created) > Flashcards

MTB 3 - Psychiatry (jenna created) Flashcards

1
Q

Which receptor is associated with negative symptoms of schizophrenia

A

Muscarinic

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2
Q

Dx requirement for schizophrenia

A

2/5.
1 must be hallucination, delusions, or disorganized SPEECH

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3
Q

Reasons to hospitalize schiphrenia patients

A

Bizzare, paranoid, suicidal

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4
Q

Rx duration after 1st episode of schizophrenia

A

6 months

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5
Q

Other uses of antipsychotics

A

Sedation (with or instead of benzos if there is c/i)
Movement disorders (huntingtons, tourettes ticks)

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6
Q

AE of thioidazine (melleril)

A

Prolonged QT and arrythmias
Abnormal retinal pigmentation

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7
Q

Fluphenazine (Prolixin) (what category drug)

A

High dose typical antipsychotic

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8
Q

Haldol (what category drug)

A

High dose typical antipsychotic

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9
Q

Perphenazine (Trilafon) (what category drug)

A

High dose typical antipsychotic

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10
Q

Thioidazine (Melleril) (what category drug)

A

Low dose typical antipsychotic

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11
Q

Class of antipsychotic with worst anti-cholinergic, andti-alpha and anti-histamine effects

A

Low dose typical antipsychotic

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12
Q

AE clozapine (clozaril)

A

Agranulocytosis
Seizures
Myocarditis

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13
Q

atypical worst for weight gain

A

olanzapine (zyprexa)

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14
Q

Atypical worst for galactorrhea

A

risperidone

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15
Q

Atypical worst for EPS

A

risperidone

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16
Q

Atypical worst for sedation

A

Quietapine (seroquel)

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17
Q

Atypical with no hyperprolactinemia

A

aripiprazole (abilify)

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18
Q

Atypical worst for QT prolongation

A

Ziprasidone (Geodon)

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19
Q

Anticholinergics to treat EPS

A

Benztropine (Cogentin)
Diphenhydramine (Benadryl)
Trihexyphenidyl (Artane)

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20
Q

Rx Acute dystonia

A

Anticholinergics

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21
Q

Rx bradykinesia (parkinsonism)

A

Anticholinergics

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22
Q

Rx akathesia

A

Benzos or propanolol

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23
Q

NMS symptoms (6)

A

Fever/sweating
Unstable vitals
Altered LOC
Rigidity
Increased CK (rhabdo, ARF)
Increased WBCs

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24
Q

Rx NMS

A

Dantroline
Amantadine
Bromocriptine

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25
Q

Rx adjustment disorder

A

COuNSELING (it is normal)

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26
Q

Which has a precipitating event, panic disorders or phobic disorders?

A

Panic

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27
Q

Rx GAD

A

Citalopram (Celexa, SSRI)
Venlafaxine (Effexor - SNRI)
Buspirone (Buspar)
Benzos

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28
Q

AE stopping benzos quickly

A

seizures

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29
Q

Rx OCD

A

SSRI
Clomipramine (Anafranil - TCA)

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30
Q

Xanax

A

Alprazolam

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31
Q

Ativan

A

Lorazepam

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32
Q

Valium

A

Diazepam

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33
Q

Buspirone Benefits (3)

A

No sedation
No cognitive impairment
Non-addicting

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34
Q

Buspirone mechanism

A

Partial agonist @ 5HT1A

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35
Q

Acute stress disorder dx

A

Traumatic event
symptoms start within 1 month of event
Symptoms gone within 1 month of onset

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36
Q

Timeline of MDE

A

2 weeks

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37
Q

Iatrogenic causes of depression (4)

A

Beta blockers
Antipsychotics
Corticosteroids
Reserpine (anti-HTN, anti-aggitation)

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38
Q

Hospitalizatoin criteria for MDD

A

SI/HI
Paranoia

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39
Q

When to use ECT

A

Acute suicidality
Pregnancy (don’t want AE of meds)
Medications not working
ECT useful in past

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40
Q

1st and 2nd line for dysthymic disorder

A

1) psychotherapy (insight-oriented)
2) SSRIs

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41
Q

Rx for narcolepsy

A

Modafenil (provigil)
Amphetamines
Armodafenil (NuVigil)
Sodium oxybate (for cataplexy)

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42
Q

Neuroimaging changes in autism

A

Increased total brain volume

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43
Q

Neuroimaging changes in OCD

A

abnormal orbitofrontal cortex and striatum

44
Q

Neuroimaging changes in PTSD

A

Decreased hippocampal volume

45
Q

Neuroimaging changes in panic disorder

A

Decreased amygdala volume

46
Q

Neuroimaging changes in schizophrenia

A

Increased cerebral ventricles

47
Q

Rapid cycling bipolar

A

> 4 episodes mania/year

48
Q

DOC for acute mania

A

Risperidone

49
Q

DOC for mania maintenance

A

Lithium

50
Q

DOC for non-compliant severly manic patients

A

!M depot phenothiazine

51
Q

DOC for preventing suicidal ideation in bipolar

A

lithium

52
Q

Mgmt bipolar in pregnancy

A

1st trimester: ECT
2/3rd: Lamotrigine

Lithium, valproate, and cabamazepine are teratogenic

53
Q

1st line for bipolar (3)

A

Lithium
Lamotrigine
Riperidone

54
Q

2nd line bipolar

A

Divalproex (Depakote)
Olanzapine
Aripiprazole
Quietapine

55
Q

DOC in cyclothymia

A

Divalproex (depakote)

56
Q

After which birth # do you get these usually:
Blues
Depression
Psychosis

A

Blues = any
Depression = 2nd
Psychosis = 1st

57
Q

Zoloft

A

Sertraline

58
Q

Prozac

A

Fluoxetine

59
Q

Paxel

A

Paroxetine

60
Q

Celexa

A

Citalopram

61
Q

DOC for atypical depression

A

MAOIs

62
Q

Nordil

A

Phenylzine (MAOI)

63
Q

When to use Buproprion

A

Want to quit smoking
Had sexual AE or weight gain with SSRIs

64
Q

AE buproprion and c/i

A

Seizures
c/I benzos, alcohol, eating disorders

65
Q

Beneifts of mirtazapine (Remeron; atypical antidepressant)

A

weight gain

66
Q

Antidepressant for enuresis

A

Imipramine (TCA)

67
Q

Antidepressant for insomnia

A

Trazodone

68
Q

Antidepressent that also treats chronic pain

A

Amitriptyline (TCA)

69
Q

Welbutrin

A

Buproprion

70
Q

Desyrel

A

Trazodone

71
Q

SNRIs

A

Cymbalta - Duloxetine
Effexor - venlafaxine

72
Q

AE TCAs

A

seizures
anticholinergic
sedating
arrythmias (long QT, QRS, PR)
akpha-blocker

73
Q

RX TCA EKG abnormalities

A

sodium bicarb

74
Q

Drugs that alter lithium levels

A

NSAIDS
ACE-I
ARBs
Antiepileptics
diuretics
SSRIs

75
Q

Lithium toxicity s/s (6)

A

GI (N/V/D)
Headaches
Acute disorientation
tremors
seizures
increased DTRs

76
Q

AE lithium (5)

A

Hypothyroid
Ebstein fetus
DI
acne
Weight gain

77
Q

AE depakote (2)

A

Blood dyscrasias
liver toxicity

78
Q

AE cabamazepine (5)

A

Agranulocytosis
sedation
aplastic anemia
SIADH
CYP 450 inducer

79
Q

How doe slithium cause SIADH

A

Stored in CD, increases prostaglandin E2, causes lysosomal degradation of aquaporin channels

80
Q

Rx lithium toxicity

A

dialysis

81
Q

Serotonin syndrome s/s

A

Aggitatoin
Hyperreflexia
Volume contraction
Hyperthermia
Rigidity

82
Q

Serotonin syndrome rx

A

IVF
Cyproheptadine (5HT and histamine antagonist)
Benzos

83
Q

Pt hx in Serotonin syndrome vs. MAOI hypertensive crisis

A

Serotonin syndrome = on MAOI, add SSRI or tryptan (migrains)

MAOI HTN = on MAOI, take antihistamine, nasal degongestant, tyramine foods (cheese, pickled food)

84
Q

Medical rx anorexia

A

olanzapine (zyprexa)

85
Q

Medical rx bulemia

A

SSRIs, especially fluoxetine (prozac)

86
Q

BMI of anorexia

A
87
Q

Rx BDD

A

High dose SSRIs

88
Q

Dx intermitten exploside disorder

A

Age >6
2x/week for 3 months PR 3+ distructive episodes (assault) in 1 year
aggression out of proportion to stressor

89
Q

Rx intermittent exploside d/o

A

SSRI and mood stabilizer

90
Q

Conduct disorder dx

A

3+ behaviours in 12 months (with 1 in past 6 months)
childhood-adolescence

91
Q

oppositional-defiant dx

A

problems with authority

92
Q

Hightst risk of spousal abuse

A

3rd trimester pergnancy

93
Q

Medications for PDs

A

Cluster B can use SSRIs and mood stabilizers

94
Q

How many CAGE needed for alcohol abuse?

A

2+

95
Q

Acute inaptient alcohol mgmt

A

Thiamine
B12
folate
Magnesium
Glucose

96
Q

Rx alcoholic seizures

A

DOC = Librium (chlordiazepoxide) or valium (diazepam)
DOC if severe liver disease = ativan (lorazepam) or Serax (oxazepam)

97
Q

Drugs to decrease alcoholic relapse rate

A

Acamprosate
Naloxone

98
Q

s/s DTs (7)

A

HTN
Low-grade fever
tachycardia
Hallucinations
Disorientation
agitation
Diaphoresis

99
Q

seizure prophylaxis for alcohol withdrawal

A

NO!

100
Q

Rx heroin withdrawal (2)

A

Clonidine
Methadone

101
Q

Benzo/barb intoxication s/s

A

Inapropriate sexual or aggressive behaviour
Impairment memomry/concentration

102
Q

Rx benzo/barb intoxication

A

Flumazenil

103
Q

Rx benzo/barb withdrawal

A

long-acting benzo/barb (chlordiazepoxide or phenobarbital)

104
Q

Ss benzo/barb withdrawal

A

autonomic hyperactivity
tremors
insomnia
anxiety
seizures

105
Q

Frotteurism

A

rubbing against/touching non-consenting partner

106
Q

rx paraphilic d/o

A

individual psychotherapy + aversive conditioning
SSRI or anti-androgens to decrease sex drive if severe

MTB STEP 3 (J) (3 decks)

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