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MS3 > Psych 14 > Flashcards

Psych 14 Flashcards

1
Q

Age cutoff between conduct disorder and antisocial personality disorder

A

18 y/o

Before = conduct
After = antisocial
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2
Q

At what blood alcohol level do signs of intoxication begin

A

o 20-30 mg/dl
♣ First signs of intoxication
♣ Decrease in fine motor control

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3
Q

At what point of alcohol withdrawal do seizures occur

A

12-48 hours

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4
Q

At what point of alcohol withdrawal does delirium tremens occur?

A

48-96 hours

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5
Q

First line tx for alcohol use disorder

A

Naltrexone (opioid receptor blocker, decreases desire/craving and “high” from alcohol)

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6
Q

Describe presentation of Wernicke’s encephalopathy

A

Ataxia, confusion, ocular abnormalities

Can be reversed with Thiamine therapy

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7
Q

Describe presentation of Korsakoff syndrome

A

Impaired recent memory, anterograde amnesia, compensatory confabulation

Reversible in only about 20% of pts

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8
Q

MOA of Methadone

A

Long acting opioid agonist

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9
Q

Presentation of PCP intoxication

A

Agitation, depersonalization, hallucinations, synesthesia (one sensory stimuli evokes another), impaired judgement, memory impairment, assaultiveness, nystagmus, ataxia, HTN, tachycardia,high tolerance to pain

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10
Q

Describe withdrawal of PCP

A

No withdrawal syndrome, but “flashbacks: can occur (recurrence of intoxication due to release of drug from lipid stores)

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11
Q

Tx of barbiturate overdose

A

ABCs, activated charcoal to prevent further absorption

Alkalanize urine with NaHCO3 to promote renal excretion

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12
Q

Tx of Nicotine dependence

A

Varenicline/Chantix (1-800-Very-Clean) = nicotinic cholinergic receptor partial agonist

Bupropion = antidepressant that is an inhibitor of dopamine and NE reuptake

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13
Q

Dangers of PCP overdose

A

Seizures, delirium, coma, death

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14
Q

When you think of psych liver enzymes think…

A

2D6

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15
Q

Smoking is an inducer of what liver enzyme

A

1A2

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16
Q

What is significant about Vyvanse (stimulant)

A

Is a prodrug - so needs to be metabolized by the liver before it becomes active

Which is why it is long acting / extended release

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17
Q

How does Ritalin long-acting (LA) work?

A

30% of pill is regular release
70% of pill is enterically coated, so will take longer to dissolve and begin working later in the day

So it is basically taking two doses of Methylphenidate in one pill

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18
Q

How does Concerta work

A

There is an osmotic pump in a non-dissolvable pill. As pill goes through GI tract and water enter the pill via osmotic pump, the pill fills with water and begins to push out the Ritalin that is also within the pill

So it disperses slowly and doesn’t have two spikes like in Ritalin LA

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19
Q

How long can Amphetamines show up in U-tox (urine screen)

A

2-3 days

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20
Q

What type of stimulants will show up on U-tox and what types wont

A

U-tox looks for amphetamines, so Adderall and amphetamine derivates will show up by Ritalin and methylphenidate derivatives will not show up

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21
Q

What meds are biggest risk factors for delirium

A

Benzodiazepines, Anticholinergics, Opiates, Psychotropics

22
Q

Meds that can be used to treat delirium

A

Avoid unnecessary meds

Low dose Haldol (0.25-0.5) if agitated - scheduled BID IV for as short amount of time

Make sure to have plan to discontinue

23
Q

1 risk factor of delirium

A

Personal history of delirium

24
Q

What is so crucial about diagnosing delirium

A

Delirium is a medical emergency

All cause mortality within a year of patient having delirium increased by 50%

25
Q

Why do you NEVER give Haldol IV

A

Significant risk of death via arrhythmia QTc prolongation

26
Q

Percentage of schizophrenia

A

1%

27
Q

Sexual arousal from touching or rubbing against a nonconsenting person

A

Frotteurism

28
Q

What dementia is characterized by personality changes

A

Frontotemporal lobe dementia

29
Q

Average age of onset of FTD

A

40s

30
Q

Brain imaging seen in Huntington’s

A

Caudate atrophy

31
Q

What is characteristic of prion disease

A

Rapid deterioration

32
Q

Difference between tremor in Parkinson’s vs. tremor as antipsychotic side effect

A

Parkinson’s = asymmetric at first

EPS = symmetric

33
Q

Cut-off for BMI to distinguish between anorexia and bulimia

A

18.5%

34
Q

Tx of bulimia

A

Fluoxetine high dose

35
Q

Time frame for delusional disorder

A

1 month

36
Q

Substance associated with nystagmus

A

PCP intoxication or alcohol withdrawal

37
Q

What are the 3 learning disorder

A

Specific learning disorder with impairment in:

  • Reading
  • Writing
  • Math
38
Q

What percentage of new mothers is believed to experience postpartum blues?

A

30-75% in the 3 to 5 days after delivery

39
Q

How long after a stroke is a patient most likely to develop a post-stroke depression

A

6 months

40
Q

Time frame of persistent depressive disorder

A

2 years in adults

1 year in kids!

41
Q

Contraindication to ECT

A

MI within the past 4 weeks, increased ICP, aneurysms, bleeding disorders, conditions that disrupt BBB

42
Q

What does brain imaging often display in depressed patients

A

Reduced metabolic activity and blood flow in both frontal loves on PET scan

43
Q

Tx of MDD with melancholic features

A

TCAs

44
Q

Describe sx of MDD with melancholic features

A
  • Loss of pleasure in all activities
  • Lack of reactivity (nothing can make patient feel better)
  • Intense guilt
  • Significant weight loss
  • Early morning awakening
  • Psychomotor retardation
45
Q

Features of Lewy Body dementia

A

THINK: Creepy Lewy. Is not right in the head (early dementia). Staring at everyone (visual hallucinations). With darty eyes (rapid eye movement disorders - REM)

Core Features:
• Waxing and waning of cognition, especially in the areas of attention and alertness
o Early onset dementia (vs. Parkinson’s which has later onset)
• Visual hallucinations (syntonic – the hallucinations are not disturbing to the patient)
• Development of extrapyramidal signs (Parkinsonism) at least one year after cognitive decline becomes evident

Suggestive Features:
• Rapid eye movement (REM) sleep behavior disorder – violent movements during sleep in response to dreams, often of fighting
• Pronounced antipsychotic sensitivity

46
Q

Presentation of prion disease

A
  • Insidious onset with rapidly progressive cognitive decline
  • Difficulties with concentration, memory, and judgment occur early
  • More than 90% of patients experience myoclonus
  • Depression, apathy and hypersomnia are also common
  • Basal ganglia and cerebellar dysfunction, manifesting as ataxia, nystagmus, and hypokinesia, are present in a majority of individuals
47
Q

Tx of prion disease

A
  • No effective treatment exists

* Most individuals die within 1 year of diagnosis

48
Q

Tx of akathisia

A

Lorazepam, Propanolol or Diphenhydramine

49
Q

Tx of pseudoparkinsonism

A

Lower antipsychotic dose

Benztropine

50
Q

Tx of tardive dyskinesia

A

No good treatment; discontinue drug or reduce dose

51
Q

Presentation of Frontotemporal lobe dementia

A

♣ Age of onset = 40s (earlier than other dementias)
• Early Behavior/personality changes (frontal lobe) and/or aphasia (temporal lobe)
o Behavior = disinhibited, overeating, lack of emotional warmth/sympathy, apathy, perseveration, decline in social cognition and/or executive abilities
o Language = difficulties with speech and comprehension
• Late Dementia

MS3 (88 decks)

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