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USMLE > Psych > Flashcards

Psych Flashcards

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USMLE® Step 1 flashcards
1
Q

Treatment for ADHD

A

Methylphenidate

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2
Q

Treatment for bulimia nervosa

A

SSRI (fluoxetine)

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3
Q

Ataxia + internuclear opthalmoplegia + confabulation

A

Wernicke Korsakoff

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4
Q

Seizure + bugs crawling on skin + confusion

A

Delerium tremens

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5
Q

Intoxication eye clues:
Mydriasis
Miosis
Horizontal/vertical nystagmus

A 
Mydriasis = LSD, amphetamine, cocaine
Miosis = opioids
Nystagmus = PCP
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6
Q

Heavy feeling in arms and legs + increased sleep + weight gain

A

Atypical depression

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7
Q

What are the 2 low potency typical antipsychotics?
“CHeating THeives are LOW”
What is their major side effect?

A

Chlorpromazine and thioridazine

Anticholinergic and sedation

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8
Q

What are the side effects of the high potency typical antipsychotics?

A

Extrapyramidal (acute dystonia, parkinsonism, akathasia, and tradeoff dyskinesia) and neuroleptic malignant syndrome

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9
Q

What is the major side effect of atypical antipsychotics?

A

Weight gain

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10
Q

Indications for typical antipsychotics

A

Psychosis, acute mania, tourette syndrome (fluphenazine, high potency typical)

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11
Q

What are the 4 extrapyramidal side effects and when do they occur?

A
  1. Acute dystonia (days) - spasms
  2. Parkinsonism (1 mo) - bradykinesia
  3. Akathasia (2 mo) - compulsion to move
  4. Tardive dyskinesia (mo-yrs) - lip smacking
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12
Q

Delerium + rigidity/myoglobinuria/fever + autonomic instability

A

Neuroleptic malignant syndrome

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13
Q

What are 2 treatments for neuroleptic malignant syndrome?

A

Dantrolene and bromocriptine (DA agonist)

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14
Q

Indications for atypical antipsychotics

A

Psychosis, bipolar/depression, OCD/anxiety/tourette syndrome

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15
Q

What antipsychotic has the strongest association with wright gain?

A

Olanzapine

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16
Q

Which antipsychotic can cause agranulocytosis? How frequently must CBCs be monitored?

A

Clozapine

Once per week

17
Q

What 3 drug categories are used as mood stabilizers in bipolar disorder?

A

Li, atypical antipsychotics, and anti-seizures

18
Q

What are 5 side effects for Li?

“LMNOP”

A 
L - Li
M - movement (postural tremor)
N - nephrogenic DI
O - hypOthyroidism, nO heart beat (heart block)
P - pregnancy (ebstein anomaly)
19
Q

Myoclonus/hyperthermia + autonomic instability + flushing/diarrhea + acute mental status changes

A

Serotonin syndrome

20
Q

Treatment for serotonin syndrome

A

Cyproheptadine (5HT2 antagonist)

21
Q

What 4 non-antidepressant drugs can contribute to Serotonin syndrome?

A

Amphetamines, sumatriptan, linezolid, and tryptophan

22
Q 
What is the mechanism of:
Citalopram
Duloxetine
Venlafaxine
Doxepin
Amoxapine
Tranylcypromine
Isocarboxazid
Trazodone, nefazodone
A 
Citalopram - SSRI
Duloxetine, venlafaxine - SNRI
Doxepin, amoxapine - TCAs
Tranylcypromine, Isocarboxazid - MAOIs
Trazodone, nefazodone - 5HT modulators (insomnia)
23
Q

What are the 2 indications for SSRIs?

A

Depression and anxiety disorders

24
Q

What are the 2 indications for SNRIs?

A

Depression and chronic neuropathic pain (fibromyalgia)

25
Q

What are the 3 effects of TCA OD?

A

“Tri-Cs” - Cadiotoxicity (arrhythmias), CNS toxicity (coma, seizures), and antiCholinergics
Most common cause of death = arrhythmias

26
Q

When is Bupropion contraindicated?

A

Bulemics - can cause seizures

27
Q

What is the best drug therapy for depression in a little old lady that isn’t eating well?

A

Mirtazapine - can cause weight gain

28
Q

What is the other side effect of Mirtazapine that may actually help depression symptoms?

A

Sedation - may improve sleep

29
Q

What is the most common use for Trazodone?

What is the most serious side effect?

A

Insomnia (5HT modulator)

Priapism

30
Q

What antidepressant is used to treat:
Fibromyalgia
OCD
Nocturnal enuresis

A

Fibromyalgia - amitryptiline
OCD - clomipramine
Nocturnal enuresis - imipramine

31
Q

Indication for buspirone (5HT agonist)

Indication for bupropion (NDRI)

A

Generalized anxiety disorder

Smoking cessation

32
Q

What’s the difference between GAD and adjustment disorder?

A

GAD is > 6 mo

Adjustment disorder is

33
Q

What causes narcolepsy?

A

Decreased orexin (hypocretin) production in the lateral hypothalamus - normally suppresses REM

34
Q

What 2 drugs can be used to treat narcolepsy?

A

Amphetamines or modafinil (non-amphetamine stimulant)

35
Q

What personality disorder is associated with:
Projection
Increased suicide rate/self mutilation
Splitting

A

Projection - paranoid

Increased suicide rate, splitting - borderline

36
Q

How can you distinguish Neuroleptic Malignant Syndrome and Serotonin Syndrome?

A 
NMS = rigidity
SS = myoclonus

USMLE (12 decks)

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