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1
Q

Grief vs MDD (timeframe)

A

If > 2 mo then MDD

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2
Q

Abnormal grief (6 items)

A 
GUILT NOT directly related to E.O.L
SI NOT "better off dead"
Preoccupation with WORTHLESSNESS
PMR
Prolonged functional IMPAIRMENT
HALLUCINATIONS (beyond voice image of deceased)
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3
Q

Hypomania becomes mania when …

A

last MORE than 7 days OR
patient hospitalized OR
accompanied by psychosis

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4
Q

Erickson (7 stages)

A

0-18 mo: trust vs mistrust
3-5: initiative vs guilt (autonomy to explore)
5-13: industry vs inferiority (sense of self through creation)
13-18: identity vs role confusion
Young Adult: intimacy vs isolation
40-60: generativity vs stagnation (view of role in society)
Late life: ego integrity vs despair (place in life cycle vs unfulfilled desire

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5
Q

SSRI longest half life, how long, out of system in?

A

fluoxetine, 54 hours, 9 days

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6
Q

SSRI highest rate of QTc prolongation, at dose?

A

citalopram, at >40mg

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7
Q

Most associated with discontinuation syndrome and ADR?

A

paroxetine

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8
Q

SSRI with starting dose 20 mg (3)?

A

fluoxetine, citalopram, paroxetine

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9
Q

SSRI with starting dose 50 mg (2)?

A

sertraline, fluvoxamine

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10
Q

SSRI with starting dose 10 mg (1)?

A

escitalopram

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11
Q

SSRI shortest half life?

A

fluvoxamine 18 hours

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12
Q

SSRI not on $4 list?

A

escitalopram

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13
Q

Adequate SSRI trial?

A

6-8 weeks at treatment dose

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14
Q

OCD dosing for SSRIs? (3)

A

fluoxetine 60-80 mg
sertraline 250-300 mg
If refractory then high dose fluvoxamine

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15
Q

First gen anti psychotics (4)

A

haloperidol, chlopromazine, perphenazine, fluphenazine

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16
Q

FGA side effects (3)

A

tremors, tardive dyskinesia, dystonia

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17
Q

SGA side effects (4)

A

weight gain, increased lipids, DM risk, increased appetite

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18
Q

Antipsychotic with breast formation

A

risperidone (due to incr. PRL)

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19
Q

Antipsychotic with QTc prolongation but less weight gan

A

ziprasidone

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20
Q

Antipsychotics with highest weight gain, DM risk, and sedation

A

Olanzapine (more weight gain) and quetiapine (more sedating)

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21
Q

Weight neutral antipsychotic

A

Aripiprazole (can gain or lose weight)

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22
Q

Effect of clozpaine of Schizo suicide rate

A

10% –> 2-3%

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23
Q

Cigarettes affect metabolism via?

A

CYP1A2 (40% drop in clozapine and others metbaolized by 1A2)

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24
Q

Clozapine side effects (3)

A

Agranulocytosis (0.8%, 0.4% on other anti-psychotics)
Myocarditis (rate as above)
Metabolic effects

25
Q

GAD drugs

A

SSRI, TCA, Buspar, benzos

26
Q

Panic drugs

A

SSRI, TCA, benzos, MAOi

27
Q

Hyperarousal drugs

A

a1-antag, b-blocker, a2-agonist

28
Q

Hyperarousal center in brain?

A

Locus ceruleus

29
Q

Hypothalmic stimulates appetite

A

lateral

30
Q

Hypothalmic suppresses appetite

A

ventromedial

31
Q

Hypothalmic controls arousal

A

posterior

32
Q

Hypothalmic sexual behavior

A

anterior

33
Q

Hypothalmic makes ADH

A

supraoptic

34
Q

Schizophrenia prevalence in kids, siblings, parents

A

Kids 12.8%
Siblings 10%
Parents 5.9%
RISK FOR FIRST DEGREE RELATIVES IS ELEVATED BY 0.9%

35
Q

ADHD with bedwetting drug?

A

imipramine

36
Q

ADHD with tics drug?

A

clonidine

37
Q

LItihum onset of action?

A

7-14 days

38
Q

Hyperarousal center?

A

Locus ceruleus

39
Q

kid refusing to eat 7,8,9 not to do with fat

A

ARFID

40
Q

Confusion with neck rash

A

Niacin or thiamine

41
Q

somatization complaints

A

4 pain, 2 GI, 1 sexual and 1 pseudo neuro

42
Q

4 (hypo)manic in 12 mo =

A

rapid cycling

43
Q

4 Ds of malpractice

A

DUTY to patient
DEVIATION from standard of care
DIRECT CAUSAL relationship to bad outcome
DAMAGES occurred

44
Q

DSM AXES

A 
1 - psych disorders
2 - personality disorders
3 - medical probs
4 -  preceding events
5 - fucntioning
45
Q

How to tell epileptic seizures from non

A

incr PRL in epi, and EEG activity

46
Q

How long do you have after seizure to check PRL?

A

20 min

47
Q

RLS three comorbidities?

A

Pregancy, renal failure, metabolic disorders

48
Q

2 high/med/low potency antispcyhotics

A

High: haldol, fluphenazine
Med: Perphenezine, molidone
Low: Chlorpromazine, thioridazine

49
Q

ADRS with low potency

A

Anti-cholinergic

50
Q

Carbamazepine ADRs

A

aplastic anemia, steven johnson

51
Q

Tourettes drugs

A

Haldol (& anti-psyhcotics), a2-agonists, CCBs

52
Q

5 classes of drugs that cause depression

A 
corticosteroids
OCPs
Thyroid meds
HTN meds
Parkinson meds
53
Q

Med for opiate withdrawal

A

clonidine

54
Q

Shortest acting benzo & 2 long acting

A

fluorazepam vs lorazepam and oxazepam

55
Q

Dysphoric mania means …

A

mixed state

56
Q

Stable self theorist?

A

Kohut

57
Q

Bupropion has higher or lower risk than SSRI to induce mania?

A

Lower!

58
Q

Cyclothymia and dysthymia timeframe?

A

2 years

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