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MS3 > Psych 4 > Flashcards

Psych 4 Flashcards

1
Q

What classifies as mixed features of bipolar disorder

A

Depressive sx present during the majority of days during mania/hypomania: dysphoria, depressed modd, anhedonia, psychomotor retardation, fatigue, worthlessness, guilt, SI

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2
Q

What classifies as rapid cycling of bipolar

A

At least 4 mood episodes (manic, hypomanic, depressed) within 12 months

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3
Q

Diagnostic criteria of Persistent depressive disorder (dysthumia)

A
  • Depressed mood for the majority of time most days for at least 2 years (vs. MDD which is episodic)
  • At least 2 of the following: poor concentration, hopelessness, poor appetite or overeating, insomnia or hypersomnia, low energy or fatigure, low self-esteem)
  • During the 2 year period, pt has not been without the above sx for > 2 months at a time
  • May also have MDD
  • Must never have had a manic or hypomanic episode (this would make diagnosis bipolar or cyclothymic disorder)

THINK: Persistent Depressive Disorder (DD) = 2 Ds

  • 2 yrs depression
  • 2 listed criteria
  • Never asymptomatic for > 2 months
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4
Q

Tx of dysthymia

A

Combo with psychotherapy and pharmacotherapy (SSRI, TCA, MAOI) is preferred

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5
Q

Diagnostic criteria for cyclothymic disorder

A
  • Numerous periods with hypomanic sx (but not a full hypomanic episode) and periods with depressive sx (but not full MDE) for at least 2 years
  • Pt must have never been sx free for > 2 months during those 2 years
  • No history of MDE, hypomania, or manic episode
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6
Q

Tx of cyclothymic disorder

A

Anti-manic agents (mood stabilizers and SGA) as used to treat bipolar

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7
Q

Progression of cyclothymic disorder

A

Approx 1/3 of patients eventually develop bipolar I/II

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8
Q

Describe in basic language Disruptive Mood Dysregulation Disorder (DMDD)

A

Chronic, severe, persistent irritability occurring in childhood and adolescence

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9
Q

Diagnostic criteria of Disruptive Mood Dysregulation Disorder (DMDD)

A
  • Severe recurrent verbal and/or physical outbursts out of proportion to the situation
  • Outbursts >3 per week ad inconsistent with developmental level
  • Mood between outbursts is persistently angry/irritable most of the day nearly every day
  • Sx last for at least 1 year and no more than 3 months without sx
  • Symptoms in at least 2 settigs
  • Sx must have started before age 10
  • No episodes meeting full criteria for manic/hypomanic episode lasting longer than 1 day
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10
Q

Tx of Disruptive Mood Dysregulation disorder (DMDD)

A
  • Unsure because new diagnosis
  • Psychotherapy (parent management training = first line)
  • Stimulants, SSRIs, mood stabilizers, and SGA can treat sx
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11
Q

Time frame of adjustment disorder

A
  • Sx develop within 3 months in response to stressor
  • Distress in excess of what would be expected
  • Sx resolve within 6 months after stressor is terminated
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12
Q

Time frame required for diagnosis of major depressive episode

A

2 weeks with 5+ depressive sx

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13
Q

What type of drug is Abilify

A

Aripiprazole

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14
Q

Time frame for mania

A

7 days minimum

Or manic sx + psychosis
Or manic sx + hospitalization

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15
Q

Time frame for hypomania

A

4 days minimum (can last more than 7 days)

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16
Q

Time frame for dysthymia

A

2 years for adults

1 year in kids

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17
Q

How many SIG E CAPS are needed for dysthymia vs. MDD

A 
MDD = 5 or more
Dysthymia = 3 or more
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18
Q

Time frame and definition of cyclothymia

A

2 years

Hypomania + dysthymia

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19
Q

What is delusional disorder

A

1-2 fixed delusions, but functioning well in rest of life

20
Q

How do you distinguish between delusional disorder and paranoid personality disorder

A

Paranoid personality applies to more than just a few things - have delusions about everything in their life, not just one or two things

21
Q

What must MDD be if there are psychotic features

A

MUST be severe (psychosis bumps mild or moderate up to severe)

22
Q

Can Bipolar II disorder have psychotic features

A

Yes, only if psychotic features ONLY present during depressed state of Bipolar II

If psychotic features present during hypomanic state, that hypomania is bumped up to mania, which means BPII becomes BPI

23
Q

How do you define schizoaffectve disorders in the context of mood vs. psychotic disorders

A

When people have both psychosis and mood sx but the sx occur independent of each other

24
Q

What type of drug is Zyprexa

A

Olanzapine (SGA)

25
Q

What is dystonia (side effect of FGA)

A

Involuntary muscle spasm, contraction

26
Q

Tx of dystonia

A

Botox

Can also give Benztropine or Benadryl

27
Q

What are Parkinsonian sx

A

Slowed movements, resting tremor (symmetric, high frequency, low amplitude), shuffling gait, cogwheel rigidity (when extremities “catch” during movement)

28
Q

What is akathisia

A

Subjective feeling of need to move

Urge does not improve with movement (vs. restless leg syndrome where urge does improve with movement)

29
Q

What lab finding is often seen in suspected MDD and restless leg syndrome

A

Iron deficiency

30
Q

Common side effect of Risperidone

A

Breast formation (increases prolactin via blocking dopamine)

31
Q

Common side effect of Ziprasidone

A

QTc prolongation

32
Q

Common side effect of Olanzapine

A

Highest weight gain; sedating

33
Q

Common side effect of Quetiapine

A

Highest weight gain (along with Olanzapine); sedating

34
Q

How does Aripiprazole affect weight

A

Averages of weight change are “weight neutral” (individuals can gain or lose weight)

35
Q

What is Thorazine

A

Chlorpromazine (FGA)

36
Q

What is Invega

A

Paliperidone (SGA)

37
Q

What is Prolixin

A

Fluphenazine (FGA)

38
Q

What is Clozaril

A

Clozapine (SGA)

39
Q

What is Zyprexa

A

Olanzapine (SGA)

40
Q

What is Seroquel

A

Quetiapine (SGA)

41
Q

What is Trilafon

A

Perphenazine (FGA)

42
Q

What is Geodon

A

Ziprasidone (SGA)

43
Q

What SGA causes the least weight gain

A

Ziprasidone

44
Q

What are the 3 main side effects to know for Clozapine

A

(1) Agranulocytosis (suppression of WBC in >1% of population)
(2) Myocarditis (>1% of population)
(3) Metabolic effects (weight gain, risk of DM, increased appetite)

45
Q

What antipsychotic is the most associated with decreased risk of suicide in Bipolar disorder

A

Clozapine (decreases by 70%)

But is so infrequently prescribed because of ridiculous amount of monitoring necessary

MS3 (88 decks)

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