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Psych Flashcards

1
Q

clozaril SE’s

A
  • weight gain/metabolic syndrome

- moderate risk of prolonged QTc

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2
Q

second generation antipsychotic least associated with weight gain

A
  • Abilify
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3
Q

Second generation antipsychotics vs first generation antipsychotics

A

Less risk of EPS

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4
Q

EPS is

A

dystonia, akathisia, parkinsonism (dopamine deficiency)

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5
Q

Management of social anxiety disorder (social phobia)

A
  • SSRI

- CBT

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6
Q

What is an adequate trial of an SSRI

A

6 weeks

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7
Q

Management of SSRI non responder

A

Stop SSRI, switch to another antidepressant

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8
Q

Management of patient who partially responds to an SSRI

A

Continue SSRI + Augment with a second agent

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9
Q

first line for borderline personality disorder

A
  • psychotherapy (dialectical behavioral therapy)
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10
Q

Borderline personality disorder features

A
  • unstable relationships
  • mood instability (mood swings and mood reactivity)
  • recurrent suicidal behaviors
  • self mutilation and threats of self mutilation
  • chronic feelings of emptiness
  • transient paranoia
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11
Q

First line treatments for bipolar 1 disorder

A
  • quetiapine
  • lurasidone
  • olanzapine + fluoxetine
  • lithium
  • lamictal
  • valproate
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12
Q

Management of tardive dyskinesia

A
  • discontinue causative medication if feasible
  • *IF continued antipsychotic is required –> switch to second-generation antipsychotic
  • treatment = valebnazine or deutetrabenazine
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13
Q

sporotrichosis clinical features + biopsy features

A
  • nodule forms, which typically ulcerates or can remain nodular, then more proximal lesions develop in a lymphatic chain
  • clear fluid drained
  • no adenopathy or other signs of infection
  • granulomatous inflammation
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14
Q

tularemia clinical features

A
  • single erythematous ulcerative lesion with a central eschar + tender regional LAD
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15
Q

PFTs in primary pulmonary hypertension

A
  • typically normal but decreased diffusion capacity
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16
Q

physical exam + clinical features of pulmonary HTN

A
  • left parasternal lift, right ventricular heave
  • loud P2, right-sided S3
  • pan systolic murmur of TR
  • **JVD, ascites, peripheral edema, hepatomegaly
17
Q

Presentation + labs for APAP toxicity

A
  • markedly elevated liver enzymes or acute liver failure
  • may say concurrent intake of CYP450 meds (phenytoin or bactrim) or chronic alcoholic (additional RF)
  • subtle at first (asymptomatic or mildly altered with nausea and vomiting, then become progressively lethargic)
18
Q

Presentation + labs for liver abscess

A
  • fever + RUQ pain

- elevated liver enzymes but not in thousands

19
Q

acute hep c presentation

A
  • often asymptomatic

- rarely causes liver failure

20
Q

Management of SSRI withdrawal syndrome

A
  • restart SSRI and then gradually taper
    OR
    substitute an equivalent dose of long-acting fluoxetine
21
Q

Diagnosis of depression in cancer patients

A
  • non somatic symptoms (loss of interest, worthlessness, suicidality)
  • guilt over being a burden to family, thinking about death are not reliable because they are common among cancer patients
  • Depression in cancer patients is under-recognized and underrated
22
Q

Acute stress disorder presentation + feature differentiating it from PTSD

A
  • within 4 weeks of a traumatic event (PTSD is over 1 month)

- similar to PTSD: re-experiencing of event + hyperarousal + avoidance behaviors + nightmares

23
Q

Management of elderly male with depression

A

IF RF’s for suicide (widowed, living alone, hopelessness, access to firearms) –> psych hospitalization

24
Q

Suicide risk from beta blockers

A
  • association with depression hasn’t been supported by research
25
Q

First and second line treatment of anorexia

A

First line: CBT + nutritional rehabilitation

Second line: olanzapine

26
Q

Bulimia vs binge-eating disorder

A
  • bulimia = inappropriate compensatory behavior
27
Q

When pharmacotherapy is indicated for anorexia

A
  • only when people don’t respond to nutritional rehab and psychotherapy
28
Q

Postpartum depression vs blues

A

postpartum depression = 2 or more weeks + meeting SIGECAPS criteria

29
Q

MMSE scoring + caveat

A

less than 24 = dementia

*highly educated patients can have normal scores

30
Q

First line treatment of PTSD

A
  • trauma focused CBT
  • SSRIs or SNRIs
  • not atypical antidepressants or wellbutrin
31
Q

Treatment of akathisia

A
  • Dose reduce antipsychotic if possible

- beta blockers or benzos

32
Q

Indications for hospitalization with diverticulitis

A
  • high fever or high white count
  • poor oral intake
  • significant comoborbidities
  • immunosuppressed
33
Q

Options for inpatient diverticulitis antibiotic treatmnet

A

zosyn
CTX + flagyl
quinolone + flagyl

34
Q

Other features of PTSD

A
  • dissociative symptoms (don’t confuse with depersonalization-derealization disorder)
35
Q

antidepressants that don’t effect sexual function

A
  • bupropion

- mirtazapine

36
Q

Features of transient global amnesia vs. dissociative amnesia

A
  • transient global amnesia = transient impaired anterograde memory (can’t form any new memories)
  • dissociative amnesia = loss of autobiographical memory (no ability to remember details about self or family)
37
Q

treatment of pelvic organ prolapse

A
  • vaginal pessary

- pelvic floor muscle exercises

38
Q

Panic disorder management

A
  • acute: benzos

- maintenance: SSRI + CBT

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