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PSICHIATRY Flashcards

0
Q

What’s transference and countertansference?

A

Transference. Psychiatrist is seen as parent

Countertransference patient reminds physician of young sibling

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1
Q

The most easiest ego defenses

A 
Dissociation  multiple personality
Fixation adult fixating on video games
Displacement mother yells at her child
Projection a DOG man thinks his wife is cheating on him
Rationalization al cabo que ni quería
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2
Q

Whats the peak of incidence of child abuse?

A

9-12 yrs

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3
Q

Treatment for attention-deficit hyperactivity disorder (2)

A

Stimulants methylphenidate

Atomoxetine

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4
Q

Age to separation anxiety disorder

A

7-9 yrs

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5
Q

Time to diagnosis Tourette disorder

A

> 1 year of…

Sudden, rapid, recurrent,nonrhythmic,stereotyped motor and vocal tics can have COMPROLALIA Hpss!!!!!!

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6
Q

What are neurotransmitters changes in Alzheimer disease?

A

⬇️ACh

⬆️glutamate

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7
Q

Principal motor characteristic of rest syndrome?

A

Hand-wringing

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8
Q

What’s dissociative amnesia?

A

Inability to recall important personal information

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9
Q

What’s dementia?

A

⬇️ in intellectual function without affecting level of consciousness.

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10
Q

Principal characteristics of psychosis (3)

A

delusions
hallucinations
disorganized thinking

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11
Q

Principal characteristic of delirium

A

⬆️⬇️level of consciousness whit acute onset

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12
Q

Difference between hypnagogic and hypnopompic hallucinations

A

hypnagogic GOING TO SLEEP

hypnopompic. WEAKUP

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13
Q

Different schizophrenic disorders (4)

A

🔺Schizophrenia
Diagnosis requires >2
ƒ Delusions
ƒ Hallucinations—often auditory
ƒ Disorganized speech (loose associations)
ƒ Disorganized or catatonic behavior
ƒ “Negative symptoms”—flat affect, socialwithdrawal, lack of motivation, lack of speech or thought

🔺Brief psychotic disorder—lasting 2 weeks; psychotic symptoms superimposed major depression or mania .

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14
Q

Whats delusional disorder?

A

lasting > 1 month

woman who genuinely believes she is married to a celebrity

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15
Q

How many time is dingos is for maniac episode and hypo maniac episode?

A

maniac episode 1 week

hypomanic episode 4 consecutive days

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16
Q

Definitions of bipolar type 1 or and type 2

A

Bipolar I
at least 1 manic episode with or without a hypomanic or depressive episode.

Bipolar II defined
a hypomanic and a depressive episode.

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17
Q

What’s the first line drug for bipolar disorder?

A

LITHIUM!!!!!!!!!

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18
Q

Diagnosis of cyclothymic disorder(2)

A

dysthymia and hypomania

least 2 years.

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19
Q

Diagnosis of Major Depressive Dissorder

A

lasting 6–12 months
ALMOST EVERY DAY FOR >2 WEEKS!!!!!!

Sleep disturbance
ƒ Loss of Interest (anhedonia)
ƒ Guilt or feelings of worthlessness
ƒ Energy loss and fatigue
ƒ Concentration problems
ƒ Appetite/weight changes
ƒ Psychomotor retardation or agitation ƒ Suicidal ideations
ƒ Depressed mood

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20
Q

What’s dysthymia ?

A

depression, often milder, lasting at least
2 years.

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21
Q

Sleep disorders in major depressive disorder

A

ƒ ⬇️ slow-wave sleep
ƒ  ⬇️REM latency
ƒ ⬆️ REM early in sleep cycle
ƒ  ⬆️total REM sleep
ƒ Repeated nighttime awakenings
ƒ Early-morning wakening (terminal
insomnia)

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22
Q

What’s Atypical depression

A

Be able to experience improve the whit positive thinks events

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23
Q

Differential between maternal blues, postpartum depression, postpartum psychosis

A

maternal blues 2-3 days after delivery resolves 10 days

postpartum depression 1month after delivery tto SSRIs

postpartum psychosis mood-congruent delusions, hallucinations, and thoughts of harming the baby or self.
Risk factors include history of bipolar or psychotic disorder, first pregnancy, family history, recent discontinuation of psychotropic medication.

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24
Q

Difference between anxiety disorder and panic disorder

A

anxiety disorder Fear or worry incongruent tto SSRI. SNRI

panic disorder physical signs intense fear discomfort Dx >1 month

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25
Q

Difference between generalized anxiety disorder and adjustment disorder

A

generalized anxiety disorder > 6 months

adjustment disorder

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26
Q

Difference between pos-traumatic stress and acute distress disorder ?

A

pos-traumatic stress > 1 month

acute distress disorder

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27
Q

Say principal feature of A personality disorders(3)

A 
Paranoid = Distrust 
Schizoid = distant.
Schizotypal = magical thinking.
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28
Q

Say principal feature of B personality disorders(4)

A

Antisocial= Sociopath
Borderline= unstable selfmutilation
Histrionic= attention seeking
Narcissistic= Grandiosity

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29
Q

Say principal feature of C personality disorders(3)

A

Avoidant Timid
Obsessive-compulsive. Perfectionism

Dependent low self-confidence

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30
Q

Severity of schizoids

A

Schizoid

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31
Q

Clinical signs of Bulimia nervosa(6)

A 
NORMAL BMI
parotitis
enamel erosion
electrolyte disturbances
alkalosis
dorsal hand calluses from induced vomiting
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32
Q

Difereence between Transsexualism and Transvestism

A

Transsexualism want to live as opposite sex SURGERY

Transvestism PARAPHILIA cross-dressing

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33
Q

Difference between sleep terror and nightmare

A

sleep terror non-REM phase

nightmare REM phase

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34
Q

What are cause, signs, treatment for Narcolepsy?

A

⬇️Hypocretin (orexin)

Hypnagogic , hypnopompic Hallucinations
Cataplexy

Tto day time stimulants , night time sodium oxidate

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35
Q

What are ten stages of change overcoming substance addiction (6)

A
  1. Pre-contemplation
  2. Contemplation
  3. Preparation/determination
  4. Action/willpower
  5. Maintenance
  6. Relapse
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36
Q

Say intoxications sings and withdrawal signs of Alcohol,Opioids ,Barbiturates,Benzodiazepines DEPRESSANTS

A

Alcohol assistency.// hyperactivity insomnia BZDs
Opioids pinpoint seizures tto Naloxone // midriasis, piloerection rinho- diarrhea - Methadone , buprenorphine
Barbiturates assist respiratory // delirium
Benzodiazepines tto flumazenil // sleep disorder

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37
Q

Say intoxications sings and withdrawal signs of amphetamines, cocaine, caffeine, nicotine STIMULANTS

A

amphetamines grandiosity midriasis
cocaine midriasis tactile hallucinations α-blockers, benzodiazepines. β-blockers counter-indicated

caffeine restlessness
nicotine restlessness withdrawal tto nicotine patch, gum, or lozenges; bupropion/ varenicline

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38
Q

Say intoxications sings and withdrawal signs of PCP,LSD, marijuana HALLUCINOGENS

A

PCP belligerency tto BZDs , rapid acting antipsychotic
LSD perceptual distortion visual auditory depersonalization
MARIJUANA slow time , paranoid, ⬆️apetite , dry mouth

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39
Q

Treatment for alcoholism

A

disulfiram
naltrexone

Alcoholics Anonymous

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40
Q

Say signs of wernicke-korsakoff (3-3)

A

Wernicke confusion, ophthalmoplegia, ataxia

Korsakoff memory loss, confabulation, personality change

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41
Q

Medication for ADHD ?

A

Stimulants methylphenidate amphetamines!!!!

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42
Q

Medication for alcohol withdrawal.

A

Long acting BZDs lorazepam diazepam

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43
Q

Medication for bipolar disorder

A

Lithium
Valproic acid
Atypical antipsychotic

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44
Q

Medication for bulimia

A

SSRIs

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45
Q

Medication for Depression

A

SSRIs

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46
Q

Medication for generalize anxiety disorder

A

SSRIs
SNRIs
BUSPIRONE

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47
Q

Medication for obsessive-compulsive disorder

A

SSRIs

CLOMIPRAMINE

48
Q

Medication for panic disorder

A

SSRIs
VELAFAXINE
BZDs

49
Q

Medication for Schizophrenia

A

Atypical antipsychotics

50
Q

Medication for Social phobias

A

SSRIs

Beta-Blockers

51
Q

Medication for Tourette syndrome

A

Antipsychotics ( fluphenazine, pimozide)
TETRABENZINE
CLONIDINE

52
Q

What’s the mechanism of action of antipsychotics?

And possible side effects

A

All typical antipsychotics block dopamine D2 receptors ( [cAMP]).

blocking muscarinic (dry mouth, constipation)
α1 (hypotension)
histamine (sedation) receptors.
Can cause QT prolongation.

53
Q

Ophthalmic side effects for chlorpromazine and thioridazine

A

Chlorpromazine—Corneal deposits

Thioridazine—reTinal deposits

54
Q

Evolution of extra pyramidal symptoms in antipsychotic use (4)

A

ƒ 4 hr acute dystonia (muscle spasm, stiffness, oculogyric crisis)
ƒ 4 day akathisia (restlessness)
ƒ 4 wk bradykinesia (parkinsonism)
ƒ 4 mo tardive dyskinesia

55
Q

Difference between typical an atypical antipsychotics

A

typical HALOPERIDOL+AZINE

atypical APINE+IDONE

56
Q

Side effects of olanzapine, clozapine, risperidone .

A

olanzapine/clozapine. WEIGHT GAIN dyslipidemia, hyperglycemia
clozapine AGRANULOCYTOSIS
risperidone ⬆️ prolactine

57
Q

What are lithium side effects? LMNOP

A

Lithium side effects:
Movement (tremor)
Nephrogenic diabetes insipidus
HypOthyroidism
Pregnancy problems

58
Q

What are SSRIs

A

Fluoxetine
paroxetine
sertraline
citalopram.

59
Q

What drugs are SNRIs

A

VELAFAXINE

Duloxetine

60
Q

Side effects of tricyclic antidepressants tri-Cs

A

Convulsions
Coma
Cardiotoxicity

61
Q

What are atypical antidepressants (3)

A

Bupropion smoking cessation
Mirtazapine for anorexia nervosa ⬆️ weight gain
Trazadone priapismo postural hypotension

62
Q

What are the typical scene of separation anxiety disorder?

A

Little girl in ability to sleep away from home “sleepovers” abdominal pain ,memories about losing her parents , nightmares “

63
Q

What’s the most important side effect of bupropion?

A

SEIZURES!!!!!!
Dopamine IR and SNIR

Not in bulimia or anorexia

64
Q

Side effect of Venlafaxine ?

A

High blood pressure

65
Q

Side effect of lamotrigene ?

A

Rash

Steven Jhonson

66
Q

Common substance hyperthyroidism like symptoms drugs are (4)

A

Symphaticomimetic drugs
Caffeine
Stimulant intoxication
Sedative hypnotic withdrawal

67
Q

Drugs which cause anthicholinergic toxicity

A 
Antihistamines
TCA
1st generation LOW POTENCY antipsychotics 
2nd generation antipsychotic 
Antiparkinsonian drugs
Atropine
68
Q

What are the Malingering disorders?

A

Somatic Symptom Disorder do not do anything
Factitious Disorder do but don’t know why SICK ROLE
Malingering Do cause want a thing

69
Q

What is the action of of monoamino-oxidase inhibitors?

A

INHIBITION OF MONOAMINE OXIDASE ENZYME!!!!!!

Which metabolize serotonin ,Dopamine and NE to unusefull products!!!!!!!!

70
Q

Mechanism of action of LITHIUM

A

Inositol monophosphate inhibition !!!!!

71
Q

Side effects of valproate, carbamazepine, Lamotrigene,clozapine

A

valproate Hepatotoxicity , neural tube defects
carbamazepine. Agranulocytosis ,SIADH, neural tube defects
Lamotrigene rash , Steven Jhonson
Clozapine AGRANULOCYTOSIS!!!!!

72
Q

significant signs of BZDs (alcohol) and HEROIN withdrawal

A

BZDs and alcohol Seizures tachycardia

Heroine (opiaced) midriasis, yawning , piloerection, lacrimation, hyperactive bowel sounds

73
Q

What arête the Symptoms of withdrawal of cannabis (5)

A 
Anxiety
Insomnia
Irritability 
Depressed mood
Decreased appetite
74
Q

What’s the mechanism of action of methadone and why is so good for the opioids dependency treatment ?

A

Methadone is a mu- receptor full agonist
Suppress cravings and withdrawal symptoms
Block euphoric effects

It has a LONG t1/2!!!!!!!

Side effect prolongs QT interval

75
Q

What’s reaction formation defense mechanism?

A

Responding in a manner opposite to one’s actual feelings

76
Q

What happen if look like a adjustment disorder but has criteria for major depressive disorder ?

A

MAJOR DEPRESSIVE DISORDER WINS!!!!!!!!

77
Q

What drug has MAOI activity and therefore is counter indicated in the patient who use SSRIs?

A

LINEZOLID!!!!

78
Q

What is the substance which cause more overdose deaths in United States of America ?

A

OPIODS!!!!!

79
Q

What are the the drugs which interacts whit LITHIUM?

A

Thiazides
NSAIDS (not aspirin)
ACE inhibitors

80
Q

What are the lithium toxicity signs?

A 
Nausea vomit diarrhea
Confusion
Agitation
Ataxia
Tremors fasciculations
81
Q

What is the best drug for delirium in elderly patient?

A

HALOPERIDOL!!!!!

82
Q

What are the features of neuroleptic malignant syndrome?(4)

A

Hyperthermia
Severe generalized “lead pipe” rigidity
Autonomic instability
Altered mental status

83
Q

Explain behavioral changes linked white differences cerebral lobe injuries (6)

A

Right frontal disinhibited sex behavioral
Left frontal apathy depression unmotivation for work
Right parietal hemineglect constructional apraxia denial problem
Left parietal Gerstmann syndrome
Right temporal impaired musical ability kluver-bucci
Left temporal verbal memory word recognition kluver-bucci
Corpus callosum split brain

84
Q

What are the signs of delirium tremens? (6) 2-4 days after drink

A 
Confusion
Agitation
Fever
Tachycardia
Hypertension 
Diaphoresis
85
Q

What’s the principal feature of panic disorder?

A

Recurrent UNEXPECTED panic Attacks

86
Q

Whic antipsychotic drug is linked whit QT prolongation

A

Ziprasidone

87
Q

What antipsychotic is most related whit hyper Prolactinemia?

A

risperidone

88
Q

What is the difference between schizoaffective disorder and major affective disorder whit psychotic features?

A

schizoaffective disorder hallucinations > 2 weeks whiteout depression
major affective disorder whit psychotic features //psychosis DURING depressive episode

89
Q

Time to diagnostic adjustment disorder ?

A

Onset of stressor whiting 3 months

90
Q

What are the first (typical) generation antipsychotics?

A 
HIGH POTENCY ( neurological , extrapiramidal symptoms)
Haloperidol 
Fluphenazine

LOW POTENCY (🚫histaminergic,🚫Cholinergic,🚫noradrenergic)
Chlorpromazine
Thioridazine

91
Q

Principal side effect of second- generation antipsychotics?

A

HIPERGLICEMIA!!!!

92
Q

In the alcohol withdrawal is prefer benzodiazepines, name them.(2)

A

Diazepam

Chlordaizepine

93
Q

What kind of BZD are prefer to use in the patient which liver disease?

A

Lorazepam
Oxazepam
Triazolam

Do not undergo oxidative metabolism in the liver

94
Q

What is the first line treatment for major depressive disorder?

A

BUPROPION!!!

Does not cause sexual Disfunction

95
Q

Medications for alcohol dependence ?(3)

A

Naltrexone ( blocks Mu receptors)
Disulfiram
Acamprostane

96
Q

Drugs to Nicotin abusers - smokers?

A

Varenicline Partial receptor agonist

97
Q

Treatment for narcolepsy ?

A

MODAFINIL!!!

98
Q

Use of melatonin?

A

Jet-lag

Age-related insomnia

99
Q

What is the age for diagnostic attention-deficit hyperactivity disorder?

100
Q

What’s learning disorder ?

A

Difficulties whit learning key academic skills
READING,WRITING, MATHEMATICS
In school

101
Q

Characteristics of maniac episodes?(6)

A 
Alevated/irritable mood
Hyperactivity
⬇️Need for sleep
Grandiosity
May occurs with psychotic features
102
Q

What’s bipolar I

A

> 1 manía episode

103
Q

What is deespesonalozation/derealization disorder?

A

Felling detachment from self

Sense of detachment or unreality

104
Q

Main characteristic of binge-eating disorder?

A

Recurrent episodes of binge with NO COMPENSATORY BEHAVIORS

105
Q

What’s transference?

A

Shifting feelings from a parent (person from the past) to another person in the present

106
Q

Are hallucinations normal in the grief process after die a parent ?

107
Q

Indications of use of clozapine ? (2)

A

Treatment resistant schizophrenia

Schizophrenia +suicidality

108
Q

Main characteristic of schizotypal behavior?

A

ECCENTRIC IDEAS!!!

109
Q

Which brain parts are Atrophied in schizophrenia?

A

Frontal lobes
Temporal lobes
Amygdala
Hypocampus

110
Q

Characteristics of orbitomedial frontal lobe lesion ?

A

Fearful

Violet explosive moods

111
Q

Sexual Side effect of SSRIs?

A

Delayed orgasm

112
Q

Symptoms of neonatal opioid abstinence syndrome?

A

Irritability,hypertonic, seizures (rare)

Diarrhea, vomiting,

Sweating, sneezing,pupillary dilation

113
Q

difference between somatic symptom disorder and conversion disorder?

A

SOMATIC excesive anxiety preocupation more than 1 unexplained symptoms

CONVERSION NEUROLOGIC symptom incompatible with any neurologic disease associated with stress.

114
Q

Drug which reduce Nicotin cravings while decrease pleasurable effects of cigarettes?

A

VERENICICLINE!!!

Partial stimulator of Nicotin receptor

115
Q

What’s topiramate ?

A

Anticonvulsant use in epilepsy

Migraine prophylaxis

116
Q

Which anticonvulsants inhibit Na channels? (3)

A

Phenytoin
Valproic acid
Carbamazepine

117
Q

What’s DONEPEZIL?

A

Acetylcholinesterase inhibitor

Use in ALZHEIMER

118
Q

What are the clinical features of tricyclic antidepressant overdose?
What’s the management?

A 
Seizures respiratory depression
Sinus tachycardia 
Prolonged QRS , QT
Dry mouth dilated pupils
Urinary retention 
Flushing 
Hypertemia

NaHCO3

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