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Clerkship > PSYCH > Flashcards

PSYCH Flashcards

1
Q

TCA overdose symptoms

A

CV: palpitation, chest pain, hypotension
CNS: convulsion, decr mental status, resp depress, drowsiness, coma
Autonomic: dry mouth, dry skin, urinary retention, blurred vision

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2
Q

TCA overdose physical findings

A

tachycardia, hypotension/orthostasis, fever, altered mental state, ileus, absent bowel sounds, rigidity, mydriasis
(consistent with anticholinergic toxidrome)

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3
Q

Antidepressants with lowest rate of sexual side effects.

A

buproprion (Wellbutrin), mirtazapine (Remeron), vilazodone (Viibryd)

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4
Q

typical vs atypical antipsychotics

A

typical blocks dopamine, atypical (2nd gen) blocks dopamine and decreases serotonin levels

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5
Q

4 dopamine pathways

A

mesolimbic, mesocortical, nigrostriatal, tuberoinfindibular

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6
Q

Which symptoms of schizophrenia is the mesolimbic pathway responsible for?

A

Positive symptoms (e.g. hallucinations).

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7
Q

Which symptoms of schizophrenia is the mesocortical pathway responsible for?

A

Negative symptoms (e.g. avolition, lack of spontaneity)

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8
Q

What symptoms do you get when you block dopamine function in the nigrostriatal pathway?

A

Parkinsonism (e.g. tremors, rigidity, postural instability)

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9
Q

What symptoms do you get when you block dopamine function in the tubuloinfindibular pathway?

A

Prolactinemia

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10
Q

How do typical antipsychotics works?

A

Block D2 receptors to reduce positive symptoms of schizophrenia but subsequently incr negative symptoms.

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11
Q

Major signs/symptoms of NMS (neuroleptic malignant syndrome).

A

delirium, muscle rigidity, elevated CK, myoglobinuria, fever

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12
Q

NMS treatment

A

aggressive cooling, dantrolene +/- bromocriptine

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13
Q

What medication can be used to reverse extrapyramidal symptom side effects?

A

anticholinergics (blocking acetylcholine)

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14
Q

ODD diagnostic criteria

A

pattern of negativistic, hostile, defiant behavior lasting at least 6 months, during which >= 4 are present:

  • often loses temper
  • often argues with adults
  • actively defies or refuses to comply with adult instructions
  • deliberately annoys people
  • blames others for his or her mistakes/behaviour
  • touchy or easily annoyed
  • angry and resentful
  • spiteful or vindictive
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15
Q

CD diagnostic criteria

A

repetitive, persistent pattern of behavior in which basic rights of others or major age-appropriate rules are violated with >= 3 of the following in the past 12 months and at least 1 in the past 6:

  • aggression to people or animals
  • destruction of property
  • deceitfulness or theft
  • serious violations of rules
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16
Q

Similarities between autism and ADHD.

A

inattention, hyperactivity, impulsivity, sensory processing difficulty, behavior problems, impaired social skills

17
Q

Differences between autism and ADHD.

A
  • communication usually more impaired with autism
  • lack of “theory of mind” in autism (e.g. lack of empathy)
  • ADHD usually better able to engage and connect with others
  • ADHD would obviously respond better to stimulant medication
18
Q

1st line ADHD treatment (two classes)

A

methylphenidate and dextroamphetamine

19
Q

What is Zopiclone and what is it used for?

A

Zopiclone is a nonbenzo hypnotic agent used in the treatment of insomnia. It is a cyclopyrrolone, which increases the normal transmission of the neurotransmitter GABA in the CNS.

20
Q

SAD PERSONS scale is for suicide risk assessment. What does the mnemonic stand for?

A 
S: male sex
A: age
D: depression
P: previous attempt
E: excess EtOH/substance
R: rational thinking loss
S: social supports lacking
O: organized plan
N: no spouse
S: sickness
21
Q

alcohol abuse vs. dependence

A

Abuse is “harmful use” of alcohol whereas dependence is that plus a pattern of behaviors seeking alcohol (e.g. attending social functions only if alcohol is being served).

22
Q

Treatment of mild to moderate dementia (AD).

A

cholinesterase inhibition (ChEI) (prevent breakdown of acetylcholine) e.g. donepezil, rivastigmine, galantamine

23
Q

NPH vs. AD

A

NPH: magnetic gait (feet stuck to ground), dementia (more rapid onset), urinary incontinence
AD: don’t normally have balance problems, and incontinence

24
Q

What is pedophilia?

A

Adult or older adolescent experiences a primary or exclusive sexual attraction to prepubescent children, generally 11 or younger.

25
Q

GAD diagnostic criteria

A

A. excessive anxiety and worry occurring more days than not for at least 6 months about (e.g. school or work).
B. Individual finds it difficult to control worry.
C. With >=3 of: restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance.
D. Causes impairment in social, occupational, or other areas.
E. Not organic/physiological.
F. Not better explained by other mental disorder.

26
Q

What is malingering?

A

Fabricating or exaggerating symptoms of mental or physical disorders for “secondary gain”. Secondary gain is getting drugs, or avoiding work/school, etc.

27
Q

What is factitious disorder?

A

Falsification or exaggeration of symptoms. Purpose is NOT secondary gain but more a result of an innate obsession with being ill.

28
Q

What benzo do give to EtOH withdrawal patient with liver disease?

A

Lorazepam

29
Q

What three drug classes can cause increased Li retention?

A

NSAID, ACEi, HCTZ

30
Q

Difference between OCPD and OCD.

A

OCPD: Rigid adherence to rules and regulations and an overwhelming need for order and personal control are the primary characteristics of obsessive compulsive personality disorder. People living with OCPD are inflexible, perfectionists and unwilling to yield responsibilities to others. Don’t believe anything is wrong with their rigid tendencies.

OCD: People with obsessive compulsive disorder are often aware that their obsessions are abnormal, but are compelled to perform them anyway.

31
Q

What is an illusion?

A

Misinterpretation of stimuli.

32
Q

What is a delusion?

A

Belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument.

33
Q

Criteria to certify someone under MHA.

A
  • suffering from mental disorder
  • likely to cause harm to self or others
  • unsuitable for admission to facility other than as formal patient
34
Q

Mania criteria

A

DIG FAST (distractibility, irresponsibility, grandiose thinking, flight of ideas, incr activity, decr sleep, talkative)

35
Q

First line for acute mania?

A

Lithium

36
Q

Pharmacodynamics of cocaine (how does it cocaine)?

A

Blocks reuptake of dopamine (and so enhances its activity). May also block reuptake of noradrenaline and serotonin.

37
Q

What does the MoCA test?

A

memory recall, visuospatial, executive function, attention, concentration, working memory, language, orientation.

Clerkship (1 decks)

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