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9 Psychiatry > NBME - Psych > Flashcards

NBME - Psych Flashcards

1
Q

Lewy body demential vs Frontotemporal dementia

A

Lewy body dementia is associated with visual hallucinations.

Frontotemporal dementia is associated with behavior change (eg hypersexuality)

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2
Q

Intoxication with which drug causes hyperreflexia?

A

Amphetamines

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3
Q

Some association between this cardiac drug and depression.

A

Beta blockers

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4
Q

Intoxication with what drug causes papillary dilation?

A

Cocaine

Amphetamines

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5
Q

1st line treatments for Obsessive Compulsive Disorder

A

CBT
SSRI
Venlafaxine
Clomipramine (Serotonin Selective TCA)

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6
Q

3 Hz spike on EEG. What type of seizure is this?

A

Absence seizure

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7
Q

EEG: Focal spikes localized to the temporal lobe. What type of seizure is this? Symptoms?

A

Complex partial seizure

  • impaired consciousness
  • automatisms
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8
Q

Benzoylecgonine on urinanalysis - tests for?

A

Cocaine

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9
Q

Treatment of cocaine toxicity.

A

Alpha blocker

Benzodiazepines

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10
Q

At what age does separation anxiety become abnormal?

A

4 years old

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11
Q

Hypocretin deficiency in CSF. Dx?

A

Narcolepsy

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12
Q

Low levels of 5-hydroxyindolacetic acid (5-HIAA) in CSF. Dx?

A

Major Depressive Disorder

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13
Q

Meperidine. Drug class? Side effect

A

Opioid
Side effect: Seratonin Syndrome
and mydriasis (unlike other opioids which cause miosis)

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14
Q

Aripiprazole - drug class.

A

Atypical (2nd gen) antipsychotic

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15
Q

Hallucinogen affect on pupil size.

A

Dilate pupils.

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16
Q

Ziprasidone - drug class.

A

Atypical (2nd gen) anti-psychotic

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17
Q

Hydroxyzine - mechanism? use?

A

Hydroxyzine is an antihistamine.

It is used as a quick acting anxiolytic when benzodiazepines cannot be used.

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18
Q

Somatic Symptoms Disorder
vs
Conversion Disorder

A

Both have unconscious symptoms and unconscious motivation. Somatic symptoms disorder is a variety of bodily complaints. Conversion disorder is loss of sensory or motor function with “la belle indifference”.

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19
Q

Define: athetosis

A

Abnormal muscle contractions

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20
Q

Acute stress disorder can develop into _______ after __(period of time)__

A

Post-traumatic stress disorder

- after 1 month

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21
Q

Adjustment disorder can develop into _______ after __(period of time)__

A

Generalized Anxiety Disorder

- after 6 months

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22
Q

Brief psychotic disorder can develop into _______ after __(period of time)__

A

Schizophreniform disorder
- after 1 month
Schizophrenia
- after 6 months

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23
Q

Major Depressive Disorder can develop into _______ after __(period of time)__

A 
Dysthymic disorder (Persistent Depressive Disorder)
- after 2 years
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24
Q

Cyclothymic disorder is defined as numerous periods of hypomanic symptoms (But not full hypomanic episode) and periods of depressive symptoms (But not full Major depressive episode) lasting at least (period of time)

A

2 years

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25
Q

Treatment for oppositional defiant disorder.

A

Parent Management Training

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26
Q

Prominant Epicanthal folds. Dx?

A

Down’s Syndrome

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27
Q

Almond-shaped eyes. Dx?

A

Prader-Willi Syndrome

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28
Q

Timetable of adjustment disorder.

A

Anxiety within 3 months of stressor.
Resolves withing 6 months of stressor.
If it does not resolve after 6 months then = GAD

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29
Q

What test is used to confirm diagnosis of narcolepsy?

A

Polysomnography

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30
Q

Acute temporary management of anxiety until a patient can be bridged to long-term medications.

A

Benzodiazepine

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31
Q

Methimazole mechanism? use?

A

Methimazole inhibits thyroid peroxidase, inhibiting thyroid hormone synthesis.
Used to treat hyperthyroidism.

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32
Q

Rapidly progressive cognitive decline with myoclonus. Dx?

A

Creutzfeldt-Jakob disease

33
Q

Agitation, hyperthermia, nystagmus. Dx?

A

PCP intoxication

34
Q

Agitation, hyperthermia, no nystagmus. Dx?

A

Amphetamine intoxication

35
Q

Despiramine. Drug class?

A

TCA

36
Q

Rotatory nystagmus. Dx?

A

PCP intoxication

37
Q

Region of brain affected in Alzheimer’s disease?

A

Basal nucleus of Meynert, decreased ACh

38
Q

Pupils when pt has LSD intoxication.

A

Dilated pupils

39
Q

Pupils when pt has alcohol intoxication.

A

Normal pupils

40
Q

Pupils when pt has amphetamine intoxication.

A

Dilated pupils

41
Q

Pupils when pt has cocaine intoxication.

A

Dilated pupils

42
Q

Pupils when pt has heroin intoxication.

A

Constricted pupils

43
Q

Drowsiness and nystagmus. Intoxication with?

A

Benzodiazepines or Barbituates.

44
Q

Intellectual disability and hand wringing in female toddler. Dx?

A

Rett syndrome

45
Q

Smooth philtrum. Dx?

A

Fetal alcohol syndrome

46
Q

Inappropriate laughter, seizures, ataxia and severe intellectual disability. Dx?

A

Angelman Syndrome

47
Q

Large jaw, big ears, intellectual disability. Dx?

A

Fragile X

48
Q

Lysch-Nyhan Syndrome. Mechanism? Findings?

A 
Absent HGPRT (hypoxanthine phosphoribosyltransferase)
Findings = Mn* HGPRT
Hyperuricemia
Gout
Pissed off (aggression, self mutilation)
Retardation (intellectual disability)
dysTonia
49
Q

Hypogonadism and intellectual disability Dx?

A

Klinfelter syndrome (XXY)

50
Q

Macroorchidism and intellectual disability. Dx?

A

Fragile X

51
Q

Hydroxyzine. Mechanism? Use?

A

Hydrozxyzine is an antihistamine.

Quick-acting, short-term anxiolytic (PRN use) for patients who do not want to take benzodiazepines.

52
Q

Tourette’s Disorder. Tx?

A

1st line = alpha-2 agonists: guanafacine (1st choice), clonidine (more sedating)
For severe cases use: atypical (risperidone) or typical (pimozide) antipsychotic.

53
Q

Perphenazine. Drug class?

A

1st gen antipsychotic (like Fluphenazine)

54
Q

What is the heart rate like in marijuana intoxication?

A

Mild tachycardia

55
Q

What is the effect of major depressive disorder on serum cortisol? Mechanism? Test?

A 
MDD = High serum cortisol
Mechanism = hyperactivity of hypothalamic-pituitary-adrenal axis
Test = failure to suppress cortisol levels in the dexamethasone suppression test
56
Q

Eye finding in Down’s syndrome

A

Prominent Epicanthal Folds

57
Q

Eye finding in Fetal Alcohol syndrome

A

Small Palpebral Fissure

58
Q

Treatment of MAOI toxicity due to ingestion of tyramine.

A

Phentolamine (nonselective alpha blocker)
OR
Nitroprusside (NO release –> Increase cGMP)

59
Q

What psychiatric emergency is Bromocriptine used for? What is the mechanism?

A

Psych Emergency Tx for Neuroleptic Malignant Syndrome.

Mechanism = Dopamine Agonist

60
Q

What psychiatric emergency is Dantrolene used for? Mechanism?

A

Psych Emergency = Neuroleptic Malignant Syndrome

Dantrolene = Binds to ryanodine receptor, preventing Calcium release from sarcoplasmic reticulum of skeletal muscle

61
Q

What Psych Emergency is Diazepam used for?

A

Psych emergency = Delerium Tremens

62
Q

What Psych Emergency is Diphenhydramine used for? Mechanism

A

Psych emergency = Acute Dystonia

Diphenhydramine = H1 blocker

63
Q

What is Fluvoxamine?

A

SSRI

64
Q

What medication is used for opioid intoxication?

A

Naloxone

65
Q

When is physostigmine used? Mechanism?

A 
Use = anticholinergic toxicity
Mechanism = Indirect Acetylcholine Agonist
66
Q

What Psych Emergency is Phentolamine used for? Mechanism?

A

Psych Emergency = MAO inhibitor hypertensive crisis

Mechanism = Nonselective alpha blocker

67
Q

Lab findings for Bulemia Nervosa.

A 
Hypochloremia
Hypokalemia
High Bicarbonate (compensation)
High BUN
High Amylase
68
Q

Medication used for Bulemia Nervosa

A

SSRI

69
Q

Thin upper lip. Dx?

A

Fetal alcohol syndrome

70
Q

What cause of intellectual disability is also associated with growth retardation?

A

Fetal alcohol syndrome

71
Q

Symptoms of Vit B1 deficiency.

A

Vit B1 = Thiamine
Deficiency = Wernicke-Korsakoff syndrome
Triad of:
- Ataxia
- Confusion
- Ophthalmoplegia (paralysis of eye muscles)
Eventually = memory loss –> confabulation

72
Q

Symptoms of Vit B3 deficiency.

A

Vit B3 = Niacin

Deficiency = Diarrhea, Dermatitis, Dementia (+ hallucinations)

73
Q

Symptoms of Vit B6 deficiency.

A

Vit B6 = Pyridoxine

Deficiency = Convulsions, Hyperirritability, Peripheral Neuropathy

74
Q

Symptoms of Vit B12 deficiency

A

Vit B12 = Cobalamin
Deficiency = Ataxic gait, paresthesia, impaired position/vibration sense
+ pernicious anemia

75
Q

Agitation, confusion and oxalate crystals in urine. Dx? Tx?

A 
Dx = Ethylene glycol toxicity
Tx = Fomepizole (alcohol dehydrogenase inhibitor)
76
Q

What medication is used to discourage alcohol drinking? Mechanism?

A

Disulfiram

inhibits Acetaldehyde Dehydrogenase

77
Q

In what condition are mammillary bodies affected?

A

Wernicke-Korsakoff syndrome

78
Q

Hydralazine vs Hydroxyzine

A

Hydralazine increases cGMP, causing smooth muscle relaxation, thus dilating arterioles. Hydralazine is used in severe Hypertension, safe in pregnancy.
Hydroxyzine is an antihistamine used to treat anxiety.

9 Psychiatry (6 decks)

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