Psych 2

Question 1

serious complications vs crash sxs from stimulants vs tx stimulant use d/o

Answer 1

MI, sz, meth mouth (brux, teeth fall out, dec parotid), paranoid psychosis (DA hypothesis) vs (severe) dep, nightmares, profuse sweat, mm cramps, hunger vs mirtazapine, maybe bupro + naltrexone

Question 2

MDMA OD sxs. risks vs w/drawal sxs cannabis

Answer 2

rhabdo -> AKI, sz, sero syndrome, hyperthermia. inc HR, breathing problems, suicidal, psychosis, hyperemesis, amotivational vs insomnia, restless, can’t eat or conc

Question 3

nml milestone: 2mo vs 4-6mo vs 6mo vs 9mo vs 12mo

Answer 3

lift head while prone vs roll over vs sit w/o support vs pull to stand/cruise vs walk

Question 4

Alz vs vasc dementia

Answer 4

hippo to parahippo, def dx w/ brain tissue only, early or sporadic, insidious & progressive vs subcortical & prefrontal -> no exec fxn or recall, indep neurocog process

Question 5

diffuse lewy body vs EtOH dementia vs Korsakoff

Answer 5

cortical > subcortical, 3ad: visual halluc, varying alert/conscious, Parkinson sxs vs deteriorating mammillary bodies, nml social & speech, spotty cog loss, episodic mem loss vs rambling, confab

Question 6

how to tx neurocog d/o

Answer 6

prevention, support, cholinesterase inhib (donazepil, rivast, galant) or NMDA blockers (memantine) to block gluE uptake; antiamyloid mabs

Question 7

delirium. tx?

Answer 7

subcortical from post op or chronic ill -> CONFUSION, varying alert & mental status, attn deficit, disturbed lang/mem/visuospatial. low dose a/typical antineuroleptics like haloperidol

Question 8

phencyclidine sxs. name 4 stress hormones

Answer 8

bizarre, jerks, nystagmus; coma, sz, death, NO mydriasis. GH, thyroid, sex hormones, insulin

Question 9

w/u for alc w/drawal. tx?

Answer 9

CMP, Mg, NH3, AST/GGT sensitive to heavy alc, CBC shows megaloblast anemia, CDT inc w/ heavy alc. chlordiazepoxide, diazepam, lorazepam

Question 10

describe 3 alc sobriety tx

Answer 10

disulfram to inhib alc dehydrogenase -> no acetaldehyde but hep injury; naltrexone to dec cravings & pleasurable alc effects; acamprosate = gluE receptor modulator to dec urge, thru renal -> good for cirr but suicide

Question 11

late complications of alc cirr include:

Answer 11

portal HTN, hepatoencephalopathy, coag d/o, splenomeg, hepatorenal fail

Question 12

delirium tenens from alc w/drawal

Answer 12

confusion, perception disturbance, autonomics hyperarousal. ex: pt thinks tubes are snakes in hospital

Question 13

opiates sxs vs w/drawal sxs

Answer 13

euphoria, resp/CNS dep, miosis, HOTN/thermia, brady, constip vs lac, rhinorrhea, sweats, yawn, piloerection, HTN, tachy; N/V/D, abd cramps, hot/cold, mm/joint pain