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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
Diagnosis of schizophrenia requires....?
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.
26
CI of lithium use and base line studies
- renal and CV disease | - UA, BUN, Creatinine, Thyroid function tests, ECG
27
Normal Pressure Hydrocephalus Triad?
Dementia, gait disturbances, urinary incontinence
28
Key to differentiating normal aging from pathological dementia?
occasional forgetfulness and word-finding difficulty do not impact activities of daily living
29
what is schizoaffective disorder?
- 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
Schizoaffective disorder is distinguished from schizophrenia by....?
the presence of mood symptoms for a significant portion of the illness.
31
Bipolar I is distinguished from Schizoaffective disorder by....
psychotic symptoms occur exclusively during manic or depressive episodes.
32
Psych ADRs of high dose glucocorticoids?
- drug induced psychosis | - depressive or manic symptoms
33
Treatment for panic disorder?
- Immediate/short term = benzodiazepines (use while waiting for SSIs to begin working too) - long term = SSRs and CBT
34
Treatment of Choice for Adjustment disorder? and time line?
- symptoms with in 3 months of stressor | - Tx = psychotherapy
35
most common ADR for olanzapine?
Sedation and weight gain
36
Which 2nd gen antipsychotics cause the most weight gain?
olanzapine and clozapine
37
nephrogenic diabetes insipidus is seen with?
lithium therapy
38
Leukopenia and agranulocytosis are significant risks with?
clozapine
39
amenorrhea seen from prolactin increase is most commonly seen with
risperidone and paliperidone
40
Serotonin syndrome vs neuroleptic malignant syndrome (NMS)
SS - tremor, hyperreflexivity, myoclonus NMS - mm rigidity and higher fever
41
elevated labs in neuroleptic malignant syndrome
elevated CK and leukocytosis
42
Benzos should be used sparingly in which population? Because they cause?
- elderly | - confusion, paradoxical agitation and increased risk of falls
43
Drug OD? - Hyponatremia - Serotonin syndrome - Hypertension - Tachycardia - Hyperthermia - seizures or coma
- Ecstasy (3 4 methylenedioxy-methamphetamine) | - not detected by routine tox screens
44
MRI - loss of cortical tissue with enlargement of the ventricles - lateral ventricular enlargement - decreased volume of the hippocampus and amygdala
- brain changes seen with schizophrenia
45
Accelerated head growth during infancy and increased total brain volume have been seen in
autism
46
structural abnormalities in the orbitofrontal cortex and BG are associated with
obsessive compulsive disorder
47
Atrophy of the caudate is associated with
Huntington's disease
48
Treatment for PTSD?
- Trauma focused CBT | - SSRIs
49
First line pharmacotherapy for narcolepsy?
modafill
50
Parkinsonism secondary to risperidone treatment can be treated with ____ when decreasing the dose it not an option
Benztropine or amantadine
51
Akathisia (restlessness or inability to sit still) secondary to risperidone treatment can be treated with ____
- propranolol or benzo (lorazepam)
52
Due to the risk of agranulocytosis, _____ is reserved for psychotic patients who ______
- clozapine | - do not respond to 2 or more antipsychotics
53
treatment for catatonia?
- benzo (lorazepam) or ECT
54
treatment of muscular rigidity in NMS?
dantrolene or bromocriptine or amantadine
55
treatment of severe cases of serotonin syndrome
Cyproheptadine
56
Tx of OCD
- SSRI | - CBT - exposure and response preventions
57
Risk Factors in completing homicide
- access to guns (greatest risk factor) - history of violence - substance abuse - high levels of impulsivity
58
Common side effects of methylphenidate
- decreased appetite - weight loss - insomnia
59
Drug intoxication? - NYSTAGMUS - violent behavior, dissociation, hallucinations, amnesia, ataxia
PCP (phencyclidine)
60
Drug Intoxication? - VISUAL HALLUCINATIONS - euphoria, dysphoric/panic, tachy/HTN
LSD
61
Drug intoxication? - CHEST PAIN, SEIZURES - euphoria, agitation, tach/htn, mydriasis (dilated)
cocaine
62
Drug intoxication? - INCREASED APPETITE, IMPAIRED TIME PERCEPTION, CONJUNCTIVAL INJECTION - euphoria, dysphoria/panic, dry mouth
THC
63
Drug intoxication? - DEPRESSED MENTAL STATUS, MIOSIS, RESP DEPRESSION - euphoria, constipation
heroin
64
tx for sudden, sustained contraction of the neck, mouth, tongue, mouth, or eye muscles after beginning antipsychotics
benztropine or diphenhydramine
65
abrupt cessation of _____ which is a ____ is associated with significant withdrawal symptoms including generalized seizures and confusion
alprazolam (short acting benzo)

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