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PANCE study guide > Psych > Flashcards

Psych Flashcards

1
Q

Difference between adjustment d/o and Complex bereavement

A

Adjustment 1st line tx is psychotherapy

Persistent 1st line tx is Antidepressant and psychotehrapy to prevent MDD

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2
Q

What is the onset of Adjustment D/o

A

onset within 3 months of stressor, lasts 6months after end of stressor

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3
Q

Example of adjustment d/o

A

Loss of job –> tylenol od

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4
Q

What are characteristics of grief

A

Searching behaviors, shock/numbness, crying spells

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5
Q

What is the timeframe for grief

A

6-12 months duration depends on deceased

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6
Q

Define persistent complex bereavement

A

out of proportion bereavement from expected norms
Inability to deal w/ daily fxn (hygiene, housekeeping)
Desire to be w/ the deceased
Life is meaningless

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7
Q

SIGECAPS

A 
sleep
interest
Guilt
Energy
Concentration
Appetite
Psychomotor stimulation
SI
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8
Q

PHQ 9 scoring

A 
1-4 Min
5-9 Mild
10-14 Mod 
15-19 Mod/severe
>20 severe
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9
Q

Devfinition of MDD

A

At least 2 weeks of depressed mood or loss of interest + at least 4 additional symptoms

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10
Q

TX for MDD

A

SSRI first line

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11
Q

Define Dysthymia

A

2 years of depressed mood for more days than not
-Extreme version of MDD and less common
pt will say they have “felt depressed all their life”

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12
Q

What are the characteristics of BD1

A

Mania
Lack of sleep
Flight of ideas
Can exist w/o MDD

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13
Q

Characteristics of BD2

A

MDD w/ at least 1 hypomanic episode (doesn’t affect function)

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14
Q

Is rapid cycling MC w/ BP1 or BP2

A

BP1

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15
Q

Cyclothymia

A

at least 2 years of numerous periods of hypomanic sx that don’t meet criteria for mani cpisode
(milder form of BP2)

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16
Q

Gold standard tx for BP

A

Lithium

DONT give Antidepressants (can shift into hypomanic state)

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17
Q

What levels need to be monitored w/ Li use

A 
LI+ trough level
Renal fxn
Thyroid
ECG
CBC
Lytes
Pregnancy
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18
Q

Dx of GAD

A

> 3sx for >6mo present on more days than not

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19
Q

Sx of GAD

A 
A lot of non-sepcific MSK complaints
Restlessness
easy fatigue
sleep disturbance
dec conc
irritability
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20
Q

panic d/o

A

Recurrent unexpected attacks WITH the fear that those panic attacks will happen again

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21
Q

Tx of choice for panic d/o

A

psychotherapy

SSRI gold standard

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22
Q

Define Agoraphobia

A

Fear of places and situation where escape would be difficult

panic can occur concurrently

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23
Q

Stage fright is an example of what?

A

social phobia

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24
Q

TX for OCD

A

CBT

SSRI

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25
Q

When can we call sx of PTSD actual PTSD

A

not until after 30 days with significant occup disruption

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26
Q

If a pt who seems to be exibiting PTSD sx presents before they have been experiencing them for the full 30 day window what do we call this?

A

ASD

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27
Q

TX for PTSD

A

SSRI, BBlocker, Prazosin for nightmares

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28
Q

What drug causes worsening of sx in PTSD

A

BZD

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29
Q

Delusion

A

Strongly held belief that untrue is true, can be bizarre/not

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30
Q

Hallucination

A

experiencing something that is NOT PRESENT

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31
Q

Illusion

A

Distortion of something that IS THERE

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32
Q

Positive sx of schizophrenia

A 
Hallucination
Delusions
disorganized thought/speech/behavior
cognitive impairment 
These are all things that are not usually present but will present themselves with the psychotic break
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33
Q

Negative sx of schizophrenia

A 
Affective flattening
Alogia (poverty of speech)
Autism
Avolution (No goals or desires)
These are all sx that are taking away from the person what they would usually have.
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34
Q

How long must sg last for in order to dx as schizophrenia

A

> 6mo

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35
Q

What would we define apparent schizophrenia as if it has not yet been 6mo?

A

Schizophreniform disorder

36
Q

Schizoaffective disorder define

A

MDD and mania overlaping with sx of schizophrenia

So-looks like BPD1 (mania and mdd) but add in delusions

37
Q

1st line Tx for ACUTE schizophrenia presentation

A

Reduce harmful symptoms
Admit
1st line SGA’s

38
Q

What are the three clusters of personality d/o

A

A - Mad
B- Bad
C- Sad

39
Q

List cluster A disorders

A

(Mad-a little cooky)
Paranoid
Schizoid
Schizotypal

40
Q

List cluster B disorders

A 
(Bad-socially unacceptable and dangerous)
Antisocial
Borderline 
Histrionic
Narcissistic
41
Q

List cluster C disorders

A

(Sad-withdrawn)
Avoidant
Dependent
Obsessive Compulsive PD

42
Q

Define Paranoid personality d/o

A

preoccupied thoughts of disloyalty

43
Q

Schizoid personality d/o

A

Pervasive detachment and restriction of range of expression
“social loners”
lack intimacy
show little emotion

44
Q

Schizotypal personality d/o

A

Acute discomfort w/ reduced capacity for close relationships and distortions (MAGICAL THINKING).

45
Q

Antisocial personality d/o

A

Disregard for others boundaries
MUST BE AT LEAST 18 FOR Dx
Aggression w/ people and animals
Sociopaths

46
Q

Borderline personality d/o

A

Instability/interpersonal relationships
real/imagined abandonment
Impulsivity
“80% chance I might kill myself”

47
Q

Histrionic personality d/o

A

Provocative
dramatic
need to be the life of the party

48
Q

Narcissistic PD

A

Pattern of grandiosity

Dr. F

49
Q

Avoidant PD

A

Avoid places where they might be judged
Often decline job promotions out of fear
low self esteem
shyness

50
Q

Dependent PD

A

Pervasive excessive need to be taken care of

51
Q

Obsessive compulsive personality d/o

A

different than OCD because they are preoccupied with orderliness, perfection and mental interpersonal control.
Reject help, don’t break rules
Plan ahead in meticulous detail
ME

52
Q

Difference between conduct d/o and ODD

A

ODD is negativistic behavior lasting at least 6mo

conduct d/o includes legal issues

53
Q

Heroin overdose looks like

A

Pinpoint pupils

Acute CNS and resp depression

54
Q

Tx for heroin OD

A

Acute OD- Narcan

55
Q

Withdrawal meds for heroin

A 
Clonidine
dicyclomide
loperamide
Hydroxyzine
ibuprofen
56
Q

Cocaine OD looks like

A 
dilated (midriasis) pupils
CNS stimulation
TAchy everything
Euphoria
paranoia
sexual stim
57
Q

What medication do you need to avoid in cocaine OD

A

Bblockers!!!

58
Q

Tx for cocaine OD

A

Lorazepam IV PRN
IVF
BP management: ntiropursside, or phentolamine (NO BB)

59
Q

Tx for spice OD

A

Ativan - Wait it out

60
Q

Tx for acetaminophen od

A

Activated charcoal w/in 4h

NAC IV if >8hr, preg, present w/ hepatic failure

61
Q

ASA od tx

A

Active charcoal

dialysis if severe

62
Q

When should ASA levels be checked after OD

A

6 hours is peak but should check at 4hrs and q3 after until level declines

63
Q

At 6hrs post ingestion and OD of ASA what level indicate prognosis?

A

<35 no sx
35-70 mild-mod
70-100 severe
>120 potetially fatal

64
Q

What medications make up the FGAs

A

Chrlorpromazine
Fluphenazine
Perphenazine
Haloperidol

65
Q

acute dystonia

A

contraction, arching of back, one or both eyes turned upwards, tongue protrusion, jaw clenching

66
Q

When would you expect to see acute dystonia after initiating FGA

A

min to hours after FGA is started

67
Q

Tx for acute dystonia

A

Anticholinergics (benztropine, diphenhydramine)
BZD
relief should occur w/in 5min
Prevent by co-dosing FGA’s with antichol automatically

68
Q

Akathesia

A

Motor restlessness, inner disquiet

69
Q

Tx of akathesia

A

BBlockers. Anticholinergics are not helpful! BZD’s are contraindicated

70
Q

Pseudoparkinsonism

A 
Resembles idiopathic parkinson's 
Rigidity
Tremor
Bradykenisia
postural instability
71
Q

Tx for pseudoparkinsonism

A

Anticholinergic

sx should resolve in 3-4 days

72
Q

tardive dyskenisia

A

Abnormal movements, lip smacking, trunk extremities, unusual posture

73
Q

When does Tardive dyskenisia usually present after taking FGA’s

A

a year after

74
Q

Tx for Tardive

A

Often irreversible
Reassess need for continuation
D/C start atypical if needed
Prevent by checking AIMS q6mo

75
Q

Describe Neuroleptic Malignant Syndrome

A 
Rare
Onset varies
Fever (>100.4)
AMS
Leukocytosis
Inc CK and LFT
Myoglobinuria
76
Q

Which SGA is first line d/t ADE profile

A

Aripiprazole

77
Q

Which SGA has the worse ADE profle

A

Chlorpromazine

78
Q

Why is clozapine not first line?

A

Agranulocytosis

79
Q

Which SGA is best for pt’s with QTC prolongation

A

Aripiprazole

Olanzapine

80
Q

which SGA is assoc. most with weight gain

A

Olanzapine

81
Q

How many days must go by for a washout period when switching from MAOi to any other antidepressant or from another antidepressant to MAOi

A

14 days

82
Q

What is the exception to the rule for 14d washout w/ MAOi

A

Fluoxetine - must have 5 week washout

83
Q

Why is there a washout period for MAOi’s

A

Hypertensive crisis may occur

84
Q

Drug of choice for Classic Mania

A

Lithium

85
Q

How does VA compare to LI+

A

better for mixed states and rapid cycling than LI+

86
Q

Who do we not give Lamotrigine to

A

kids under 16 - SJS

87
Q

Tx for BZD od

A

flumazenil

PANCE study guide (14 decks)

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