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Shelf Prep > Psych > Flashcards

Psych Flashcards

1
Q

Personality Disorder Characteristics: Avoidant

A

Avoidance due to fears of criticism and rejection

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2
Q

MOA of second generation antipsychotics (ex - risperidone); benefit over first gen?

A
  • Serotonin 2A and dopamine D2 receptor blockade (serotonin and dopamine antagonist)
  • the addition of serotonin blockade to the dopamine (1st gen only have dopa block) helps avoid extrapyramidal side effects
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3
Q

Clinical features of Anorexia nervosa (4)

A
  • significantly low weight
  • intense fear of weight gain
  • distorted views of body shape and weight
  • subtypes = binge/purge, restricting
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4
Q

treatment for bipolar type 1 options?
What to avoid?
options if pt does not respond to monotherapy?

A
  • Lithium, Valproate, quetiapine, lurasisone and lamotrigine
  • Antidepressants
  • Lithium or valproate combined with quetiapine (second gen antipsychotics)
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5
Q

Personality Disorder Characteristics: Obsessive-Compulsive

A

Rigid, controlling, perfectionistic

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6
Q

Personality Disorder Characteristics: Schizoid

A

Prefers to be a loner, detached, unemotional

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7
Q

Personality Disorder Characteristics: Narcissistic

A

Grandiosity, lack of empathy

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8
Q

Personality Disorder Characteristics: Borderline

A

Chaotic relationships, sensitivity to abandonment, labile mood, impulsivity, inner emptiness, self-harm

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9
Q

ADR of ingesting Tyramine while taking MAOI such as phenelzine?
source of tyramine?

A
  • Hypertensive crisis - can start with HA but will ultimately lead to intracranial bleeding, stroke and death
  • aged cheese, aged meats, aged or fermented soy products, overripe fruits, some ETOH drinks.
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10
Q

Diagnosis criteria for Major depressive disorder?

A

5 of 9 SIGECAPS symptoms for 2 or more weeks

  • sleep disturbances
  • loss of interest
  • excessive guilt
  • low energy
  • impaired concentration
  • loss of appetite
  • psychomotor agitation or retardation
  • SI
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11
Q

Personality Disorder Characteristics: Paranoid

A

suspicious, distrustful, hypervigilant

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12
Q

Common ADR of risperidone

A

increased prolactin excretion

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13
Q

Contraindications of Bupropion? (4)

A
  • SEIZURE DISORDERS, bulimia nervosa, anorexia nervosa, and use of MAOI within the past two weeks
  • eating disorders –> electrolyte imbalances –> lowers seizure threshold
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14
Q

Personality Disorder Characteristics: Dependent

A

submissive, clingy, needs to be taken care of

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15
Q

Clinical features for binge-eating disorders (2)

A
  • recurrent binge eating with lack of control

- no compensatory behaviors

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16
Q

Personality Disorder Characteristics: Histrionic

A

Dramatic, superficial, attention-seeking

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17
Q

Personality Disorder Characteristics: Schizotypal

A

eccentric; odd thoughts, perceptions and behaviors

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18
Q

Patients with chronic alcohol use may be seen in the general medical setting for? Lab findings that support this?

A
  • insomnia and/or anxiety

- increased liver enzymes AST:ALT 2:1 and macrocytosis

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19
Q

Personality Disorder Characteristics: Antisocial

A

Disregard and violation of the rights of others

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20
Q

Nightmare disorder vs sleep terror disorder?

A

Nightmare disorder - recurrent awakenings from REM sleep associated with full alertness, consolability and dream recall

sleep terror disorder - non REM arousal disorder with incomplete awakening, unresponsiveness to comfort, and no recall of dream content; amnesias of event in the morning are common

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21
Q

Clinical features of Bulimia nervosa (4)

A
  • Recurrent episodes of binge eating
  • compensatory behavior to prevent weight gain (vomiting or exercise)
  • Excessive worry about body shape and weight
  • maintains normal body weight
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22
Q

Characteristics of Narcolepsy? (4) Diagnosis?

A
  • Excessive daytime sleepiness
  • hallucinations while falling asleep (hypnagogic) or upon waking (hypnopompic)
  • Cataplexy (loss of mm tone in response to intense emotion)
  • sleep paralysis
  • dx - recurrent lapses into sleep/naps at least 3/wk for 3 months
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23
Q

Brief physchotic disorder dx?

A
  • positive psychotic symptoms last >1 day <1 month.

- it is characterized by a sudden onset and full return to premorbid level of functioning

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24
Q

Delusional disorder is characterized by….?functioning?

A
  • one or more delusions in the absence of other psychotic symptoms.
  • functioning may be normal apart from the direct impact of the delusions
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25
Q

Diagnosis of schizophrenia requires….?

A

the presence of symptoms for at least 6 months; this period must include at least one month of active phase symptoms and may include periods of prodromal or residual symptoms.

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26
Q

CI of lithium use and base line studies

A
  • renal and CV disease

- UA, BUN, Creatinine, Thyroid function tests, ECG

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27
Q

Normal Pressure Hydrocephalus Triad?

A

Dementia, gait disturbances, urinary incontinence

28
Q

Key to differentiating normal aging from pathological dementia?

A

occasional forgetfulness and word-finding difficulty do not impact activities of daily living

29
Q

what is schizoaffective disorder?

A
  • Major depressive or manic episode concurrent with symptoms of schizophrenia
  • live time history of delusions or halluciations for 2 or more weeks in the absence of major depressive disorder or manic episodes.
30
Q

Schizoaffective disorder is distinguished from schizophrenia by….?

A

the presence of mood symptoms for a significant portion of the illness.

31
Q

Bipolar I is distinguished from Schizoaffective disorder by….

A

psychotic symptoms occur exclusively during manic or depressive episodes.

32
Q

Psych ADRs of high dose glucocorticoids?

A
  • drug induced psychosis

- depressive or manic symptoms

33
Q

Treatment for panic disorder?

A
  • Immediate/short term = benzodiazepines (use while waiting for SSIs to begin working too)
  • long term = SSRs and CBT
34
Q

Treatment of Choice for Adjustment disorder? and time line?

A
  • symptoms with in 3 months of stressor

- Tx = psychotherapy

35
Q

most common ADR for olanzapine?

A

Sedation and weight gain

36
Q

Which 2nd gen antipsychotics cause the most weight gain?

A

olanzapine and clozapine

37
Q

nephrogenic diabetes insipidus is seen with?

A

lithium therapy

38
Q

Leukopenia and agranulocytosis are significant risks with?

A

clozapine

39
Q

amenorrhea seen from prolactin increase is most commonly seen with

A

risperidone and paliperidone

40
Q

Serotonin syndrome vs neuroleptic malignant syndrome (NMS)

A

SS - tremor, hyperreflexivity, myoclonus

NMS - mm rigidity and higher fever

41
Q

elevated labs in neuroleptic malignant syndrome

A

elevated CK and leukocytosis

42
Q

Benzos should be used sparingly in which population? Because they cause?

A
  • elderly

- confusion, paradoxical agitation and increased risk of falls

43
Q

Drug OD?

  • Hyponatremia
  • Serotonin syndrome
  • Hypertension
  • Tachycardia
  • Hyperthermia
  • seizures or coma
A
  • Ecstasy (3 4 methylenedioxy-methamphetamine)

- not detected by routine tox screens

44
Q

MRI

  • loss of cortical tissue with enlargement of the ventricles
  • lateral ventricular enlargement
  • decreased volume of the hippocampus and amygdala
A
  • brain changes seen with schizophrenia
45
Q

Accelerated head growth during infancy and increased total brain volume have been seen in

A

autism

46
Q

structural abnormalities in the orbitofrontal cortex and BG are associated with

A

obsessive compulsive disorder

47
Q

Atrophy of the caudate is associated with

A

Huntington’s disease

48
Q

Treatment for PTSD?

A
  • Trauma focused CBT

- SSRIs

49
Q

First line pharmacotherapy for narcolepsy?

A

modafill

50
Q

Parkinsonism secondary to risperidone treatment can be treated with ____ when decreasing the dose it not an option

A

Benztropine or amantadine

51
Q

Akathisia (restlessness or inability to sit still) secondary to risperidone treatment can be treated with ____

A
  • propranolol or benzo (lorazepam)
52
Q

Due to the risk of agranulocytosis, _____ is reserved for psychotic patients who ______

A
  • clozapine

- do not respond to 2 or more antipsychotics

53
Q

treatment for catatonia?

A
  • benzo (lorazepam) or ECT
54
Q

treatment of muscular rigidity in NMS?

A

dantrolene or bromocriptine or amantadine

55
Q

treatment of severe cases of serotonin syndrome

A

Cyproheptadine

56
Q

Tx of OCD

A
  • SSRI

- CBT - exposure and response preventions

57
Q

Risk Factors in completing homicide

A
  • access to guns (greatest risk factor)
  • history of violence
  • substance abuse
  • high levels of impulsivity
58
Q

Common side effects of methylphenidate

A
  • decreased appetite
  • weight loss
  • insomnia
59
Q

Drug intoxication?

  • NYSTAGMUS
  • violent behavior, dissociation, hallucinations, amnesia, ataxia
A

PCP (phencyclidine)

60
Q

Drug Intoxication?

  • VISUAL HALLUCINATIONS
  • euphoria, dysphoric/panic, tachy/HTN
A

LSD

61
Q

Drug intoxication?

  • CHEST PAIN, SEIZURES
  • euphoria, agitation, tach/htn, mydriasis (dilated)
A

cocaine

62
Q

Drug intoxication?

  • INCREASED APPETITE, IMPAIRED TIME PERCEPTION, CONJUNCTIVAL INJECTION
  • euphoria, dysphoria/panic, dry mouth
A

THC

63
Q

Drug intoxication?

  • DEPRESSED MENTAL STATUS, MIOSIS, RESP DEPRESSION
  • euphoria, constipation
A

heroin

64
Q

tx for sudden, sustained contraction of the neck, mouth, tongue, mouth, or eye muscles after beginning antipsychotics

A

benztropine or diphenhydramine

65
Q

abrupt cessation of _____ which is a ____ is associated with significant withdrawal symptoms including generalized seizures and confusion

A

alprazolam (short acting benzo)

Shelf Prep (5 decks)

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