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1
Q

1st line treatment for anorexia?

A

CBT + Antipsychotic

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2
Q

What is the best treatment for OCD?

What else?

A

CBT

SSRI or clomipramine (TCA)

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3
Q

Patient that has insomnia, what is the next step to assess the reason?
What does that mean?

A

of hours sleep greater or less than 6 hours

< 6 hours = fix sleep hygiene, treat underlying disease, try BENZOs

> 6 hours means adjust sleep schedule

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4
Q

What defines Bipolar II?

A

Hypomania AND major depression

Less than 4 days of duration

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5
Q

How do BENZOs affect sleep?

A

Shorten REM -> less restful sleep

Eliminate dreams

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6
Q

What is Gender Dysphoria definition?

A

> 6 months AND distress d/t 1 of 4 things:

Incongruence
Desire to be other gender
Wanting to rid of self sex char
Believe they are opp sex

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8
Q

Treatment for GAD?

A

1st line: Psychotherapy is best

2nd line: SSRI, buspirone

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10
Q

Psychiatric illness w/a patient on no medications that has rigidity, increase temp, and ANS instability what do they have?

A

Malignant catatonia

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11
Q

Pt that has a SBO and is missing hair most likely has what?

Need to r/o what?

A

Trichobezoar

Fungus

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12
Q

Night terrors occur in what stage?

Memory?

Tone?

Treatment?

A

Stage 3

No

Yes

Reassurance

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13
Q

What are the cluster C personality disorders?

A

ADO —> fear, shy
Avoidant
Dependent
Obsessive-Compulsive

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14
Q

What is Wernicke’s encephalopathy?

Symptoms?

A

Reversible lesion of cerebellum bc No B1

causes confusion, ATAXIA, ophthalmoplegia

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15
Q

What defines Autism spectrum disorder?

What else do they have?

A

Dec social communication
Restricted repetitive behaviors

Dec language
IQ impaired

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16
Q

ADHD defined by what timeline?

A

Before age 12, last > 6 months

Must occur in 2 settings or more

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17
Q

What is the loss of muscle tone while conscious called?

A

Cataplexy

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18
Q

What defines GAD?

A

Constant anxiety about almost everything

Most days >/= 6 months and have >/= 3 somatic sx

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19
Q

What are the nt’s of sleep and what stages do they occur?

A 
SAND
Serotonin - inc sleep
ACh - Dream
NorEpi - Dream
Dopamine - inc awake
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21
Q

What are the 5 categories of PTSD?

A 
Intrusion - nightmares, flashbacks
Mood changes - Negative
Dissociation 
Avoidance
Arousal - hypervigilance
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23
Q

Treatment for Bulimia Nervosa?

Never use what?

A

Fluoxetine + CBT

Bupropion

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24
Q

What involves regurgitation of food for at least a month?

MC in whom?

A

Rumination disorder

Infants, retards

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25
Q

What are the MC sx of GAD?

A 
Irritability
Somatic pain
Weight change
Sleep change
Concentration
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27
Q

What is intermittent explosive disorder?

Treat how?

A

Stressor that induces anxiety which causes person to violently act out at people or property

No benefit to SSRI or therapy therefore:

JAIL if severe

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29
Q

What defines insomnia?

A

Difficult falling asleep or waking up too early w/out falling back asleep 3 nights/wk for 3 months

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30
Q

Baby blues occurs with which baby?

Timing?

Depression?

Psychosis?

Treatment?

A

1, cares about baby

Onset and duration w/in 2 weeks

Dysthymic

None

None

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31
Q

What med is long acting and used for long term maintenance of opioid dependence?

A

Naltrexone

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32
Q

A girl that regresses after a period of normal development until about 6 months most likely has what?

A

Rett syndrome

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33
Q

How is Tourette’s treated?

Like what?

A

Antipsychotics

Risperidone (dopamine antagonist)

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34
Q

What defines schizophrenia?

A

Greater than 6 months AND 2 of 5, ONE must be 1-3

1) bizarre delusions
2) hallucinations
3) Disorganized speech
4) disorganized behavior
5) flat affect, cognitive defects, poverty of speech, anhedonia

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35
Q

What does SIGECAPS stand for?

A 
Sleep - dec
Interest - dec
Guilt - inc
Energy - dec
Concentration - dec
Appetite - dec
Psychomotor - dec
Suicide - inc
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36
Q

The object stolen in kleptomania is described how?

A

Little to no value
Pt CAN afford
Unplanned, w/OUT help

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37
Q

What is Tourette’s associated w/?

A

OCD

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39
Q

Paradoxical behavior, appearance changes, memory gaps (blackouts) is what?

Treat how?

A

DID

Psychotherapy

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40
Q

PCBD timeline?

A

Started after 6 months, lasts greater than 12 months

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41
Q

What defines Panic Disorder?

A

SOB, trembling, unsteadiness, depersonalization, excessive HR, numbness, tingling, sweating, palpitations, ABD distress, N, intense fear of losing control/dying, chest pain

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41
Q

What are the 2 treatment techniques to overcome specific phobias?

Describe

A

Systemic desensitization - start w/small amount and build up —> works best but takes longer

Flooding - anxiety response burns out —> best for time-sensitive need

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42
Q

What defines narcolepsy?

Dx how?

Treat how?

A

Rapidly plunged to REM sleep at least 3x / wk for 3 months

Low CSF hypocretin-1, polysomnography

Schedule naps, stimulants

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44
Q

What meds can treat enuresis?

Without meds?

A

Desmopressin
Oxybutynin
Imipramine

Positive reinforcement

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46
Q

Adjustment disorder timeline?

D/t what?

Treat how?

A

> 3 months, less than 6 months

Less severe stressor

No treatment needed

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47
Q

What are the 2 types of IED?

MC in whom?

A

Mild: 2x / week in 3 months w/out harm

Severe: 3x / year WITH harm

MEN

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48
Q

What is the key feature of schizotypal personality disorder?

A

Magical thinking

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49
Q

What are the 5 Kubler-Ross states of death and dying?

A

DABAD

Denial
Anger
Bargaining
Acceptance
Depression
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51
Q

What does DIGFASTER stand for?

A 
Distractibility
Insomnia
Grandiosity
Flight of Ideas
Agitation, Activities 
Sexual Exploits 
Talkative
Elevated Mood
Racing thoughts
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52
Q

Moderate autism occurs when?

Presents how?

A

2-4

Plateau

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53
Q

Side effects of TCAs?

A 
TCCAS
tachycardia, HoTN
cardiac conduction delay (QRS)
Change in mental status
AntiAch
Seizures
54
Q

What are the cluster A personality disorders?

A

PSS
Paranoid
Schizoid
Shizotypal

55
Q

Definition of enuresis?

Wetting the bed is normal up until when?

A

2 or more times / wk for 3 months in 5 yrs or older

7

56
Q

Acute stress disorder defined how?

PTSD?

A

Less than 4 weeks from the event

Older than 4 weeks

56
Q

Pt that has Disinhibited Social Engagement Disorder has what sx?

Must r/o what?

A

PAIRS too much

Autism

58
Q

DBT is used for treating what?

A

Borderline personality disorder

59
Q

What are the 5 stages of substance abuse?

A 
Pre-contemplative
Contemplative
Preparation
Action 
Maintenance
60
Q

What defines encopresis?

What is it?

A

1x or more / Month for 3 months

Shitting in public

61
Q

What defines MDD?

A

5 SIGECAPS w/depressed mood/anhedonia for at least 2 weeks

61
Q

Haldol is the BEST medicine for a pt w/acute severe mania w/psychosis except when it is contraindicated in what pts?

A

Prolonged QT

62
Q

What are atypical features of MDD?

A

Increased sleep

Increased appetite/weight

65
Q

Nightmares occur in what stage?

Memory?

Tone?

Treatment?

A

REM

YES, awake easily

No

Address stressor

66
Q

When starting an SSRI, how long is an adequate trial?

A

1-2 months of MAX dosing

67
Q

Pt that was once dry but now has bed wetting with negative UA and negative US what is the cause?

D/t what?

A

Regression

New sibling, sexual abuse

68
Q

What defines Bipolar I?

A

Elevated mood + 3 sx of DIGFASTR for at least 1 week

69
Q

What is anxiety in response to a mild stressor that leads to anxiety about 1 specific thing which leads to a loss of function w/out psychosis?

A

Adjustment disorder

70
Q

Respiratory depression + mitosis in a pt indicates what?

A

Opiate OD

71
Q

Bupropion is used for what?

A

Smoking

Has NO weight gain

72
Q

What defines pyromania?

What is their motivation?

A

Fire setting 2x or more + fascination/gratification

To decrease anxiety or Increase sexual arousal —> THEY LIKE IT

73
Q

ADHD characterized how?

A

Impulsivity
Inattention

Ex. Poor grades and bad behavior

74
Q

Amnesic-Confabulatory syndrome is known as what?

What symptoms?

Pathology?

A

Korsakoff’s syndrome

Retrograde and anterograde amnesia, confabulation
IRREVERSIBLE

B1 Deficiency for too long

75
Q

Pt that is presenting with panic disorder, what must be ruled out first?

MC pt?

A

ACS - troponin, EKG
Hyperthyroid = TSH
Asthma = wheezing

Female in their 20s w/no PMHx

75
Q

Schizophreniform timeline?

Treat how long?

A

> 1 month, less than 6 month

3-6 months

75
Q

Anorexia Nervosa severe signs?

A

Bradycardia
Leukopenia
HoTN

76
Q

IDD pt w/6th grade level is what severity?

6 y/o (3rd grade)?

Age 3?

Age 1?

A

Mild

Mod

Severe

Profound

78
Q

How long should you treat with a SSRI?

Treat for how long before changing meds?

How long for washout?

A

6 weeks at MAX Dose

6 months

3 weeks or more

79
Q

FRAMES is used for what?

Means what?

A

Motivational interviewing

F - offer Feedback
R - emphasize personal Responsibility 
A - give Advice
M - Menu of option
E - use Empathy
S - support Self-efficacy
80
Q

Describe the classic Kleptomaniac

A

WOMAN, object causes increased anxiety, only stealing it reduces anxiety

Feels remorse, therefore gifts, hoards, or returns item

81
Q

What are the cluster B personality disorders?

A 
BANH
Borderline
Antisocial
Narcissistic
Histrionic
82
Q

What drug can be used to help opiate withdrawal?

Helps what symptoms?

A

Clonidine

Lacrimation, diarrhea, sweating, nausea

83
Q

What is cataplexy assoc w/?

A

Narcolepsy

84
Q

What personality disorder is characterized by being a loner, happy in isolation?

A

Schizoid

85
Q

What is agoraphobia?

A

Fear and avoidance of public areas, crowds, public transportation, going outside alone

86
Q

Mild autism occurs when?

Presents how?

A

Age 4-6

Regression

87
Q

What psychotherapy treatment for panic disorder?

A

CBT

88
Q

Grief timeline?

Features?

A

Less than 12 months

Waxes and wanes
Can be happy
IS insight to psychosis

89
Q

People w/IED described how after the act?

A

Calm, relaxed, without Remorse

89
Q

What is the timing for acute stress disorder?

PTSD?

A

> 3 days but less than 1 month

> /= 1 month

89
Q

Treatment for RAD/DSED?

A

Find a caregiver —> parent better

89
Q

What is the treatment ladder for Bipolar I?

A

1 - Lithium
2 - Valproic Acid
3 - Carbamazepine/lamatrogine
4 - Quietapine

89
Q

Post-Partum psychosis occurs with which baby?

Timing?

Depression?

Psychosis?

Treatment?

A

After 1st, fears baby and will kill it

Onset w/in 1 month

None

Yes

Mood stabilizer, antipsychotic

89
Q

Travel + amnesia = what?

A

Fugue

89
Q

What defines intellectual disability disorder?

A

Dec cognitive skill

Dec adoptive function

90
Q

What is depersonalization disorder?

Derealization?

A

Dissociation from your BODY

From the environment

91
Q

What is the stressor for reactive attachment disorder?

Evident when?

What is impaired?

A

Neglect or abuse

Less than 5 y/o

Ability to PAIR/bond

91
Q

Depression (MDD) in the setting of death of a loved one has what timeline?

What features

A

Duration greater than 12 months

Hallucinations
Hopeless, NEG self

91
Q

Anorexia nervosa is categorized by what?

What are they?

A

Weight

Mild - BMI > 17
Mod - 16 - 16.9
Severe/Extreme —> < 16

91
Q

Catatonia is treated how?

Refractory cases treated how?

Pts at risk for what?

A

Lorazepam

ECT

DVT, Rhabdo (Inc CK)

93
Q

Dysthymia defined how?

Treat how?

Rule out what?

A

Depressed mood for > 2 years but w/out symptoms > 2 months at a time

SSRI

Thyroid - get TSH

94
Q

MC social phobia?

Treat how?

A

Public urination, public speaking

Beta blockers, CBT

94
Q

Brief psychotic disorder timeline?

A

> 1 day, less than 1 month

95
Q

What is Cataplesy associated w/?

A

Catatonia

95
Q

What are the stages of sleep with wave forms?

A

BATS Drink Blood

Beta - awake
Alpha - drowsy
Theta - Stage 1
Spindles and K complexes - Stage 2
Delta - Stage 3
Beta - REM
96
Q

Treatment for PTSD or ASD?

A

Group therapy is the BEST

Then use SSRI/SNRI

96
Q

What defines cyclothymia?

A

At least 2 years of hypomania and a MDE

97
Q

Acute opioid overdose use what medicine?

A

Naloxone

99
Q

What medication is useful in treating nightmares and sleep disruption in PTSD?

MOA?

A

Prazosin

Alpha-1 blocker that blocks adrenaline receptors

100
Q

What is Flumazenil used for?

A

Benzo OD

101
Q

At what stage is it hardest to arouse?

A

3

104
Q

What does GABA do to sleep?

A

Decrease Stage 3

Decrease Sleep latency

105
Q

OSA can lead to what health complications?

Treatment?

A

Pulm HTN —> RHF

CPAP, lose weight

106
Q

For pts w/IDD what IQ score is no disability? What adaptive fxns?

Mild?

Mod?

Severe?

Profound?

A

> 70 no restriction

50-70 no advanced life skills

35-49 no advanced life skills, cannot work

20-34 no ADLs

< 20 total care

107
Q

Binge-Eating Disorder patients are described how?

A

Overweight, NO purge

108
Q

Post-Partum depression occurs with which baby?

Timing?

Depression?

Psychosis?

Treatment?

A

After 1st, doesn’t care about baby, may hurt

Onset w/in 1 month

MDE

None

SSRI

110
Q

What causes central sleep apnea?

Look for what?

Treat how?

A

Opiates, COPD, idiopathic, CVA

Cheyenne-Stokes breathing

BiPAP

Psych (8 decks)

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