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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
When can we call sx of PTSD actual PTSD
not until after 30 days with significant occup disruption
26
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?
ASD
27
TX for PTSD
SSRI, BBlocker, Prazosin for nightmares
28
What drug causes worsening of sx in PTSD
BZD
29
Delusion
Strongly held belief that untrue is true, can be bizarre/not
30
Hallucination
experiencing something that is NOT PRESENT
31
Illusion
Distortion of something that IS THERE
32
Positive sx of schizophrenia
``` 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 ```
33
Negative sx of schizophrenia
``` 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. ```
34
How long must sg last for in order to dx as schizophrenia
>6mo
35
What would we define apparent schizophrenia as if it has not yet been 6mo?
Schizophreniform disorder
36
Schizoaffective disorder define
MDD and mania overlaping with sx of schizophrenia | So-looks like BPD1 (mania and mdd) but add in delusions
37
1st line Tx for ACUTE schizophrenia presentation
Reduce harmful symptoms Admit 1st line SGA's
38
What are the three clusters of personality d/o
A - Mad B- Bad C- Sad
39
List cluster A disorders
(Mad-a little cooky) Paranoid Schizoid Schizotypal
40
List cluster B disorders
``` (Bad-socially unacceptable and dangerous) Antisocial Borderline Histrionic Narcissistic ```
41
List cluster C disorders
(Sad-withdrawn) Avoidant Dependent Obsessive Compulsive PD
42
Define Paranoid personality d/o
preoccupied thoughts of disloyalty
43
Schizoid personality d/o
Pervasive detachment and restriction of range of expression "social loners" lack intimacy show little emotion
44
Schizotypal personality d/o
Acute discomfort w/ reduced capacity for close relationships and distortions (MAGICAL THINKING).
45
Antisocial personality d/o
Disregard for others boundaries MUST BE AT LEAST 18 FOR Dx Aggression w/ people and animals Sociopaths
46
Borderline personality d/o
Instability/interpersonal relationships real/imagined abandonment Impulsivity "80% chance I might kill myself"
47
Histrionic personality d/o
Provocative dramatic need to be the life of the party
48
Narcissistic PD
Pattern of grandiosity | Dr. F
49
Avoidant PD
Avoid places where they might be judged Often decline job promotions out of fear low self esteem shyness
50
Dependent PD
Pervasive excessive need to be taken care of
51
Obsessive compulsive personality d/o
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
Difference between conduct d/o and ODD
ODD is negativistic behavior lasting at least 6mo | conduct d/o includes legal issues
53
Heroin overdose looks like
Pinpoint pupils | Acute CNS and resp depression
54
Tx for heroin OD
Acute OD- Narcan
55
Withdrawal meds for heroin
``` Clonidine dicyclomide loperamide Hydroxyzine ibuprofen ```
56
Cocaine OD looks like
``` dilated (midriasis) pupils CNS stimulation TAchy everything Euphoria paranoia sexual stim ```
57
What medication do you need to avoid in cocaine OD
Bblockers!!!
58
Tx for cocaine OD
Lorazepam IV PRN IVF BP management: ntiropursside, or phentolamine (NO BB)
59
Tx for spice OD
Ativan - Wait it out
60
Tx for acetaminophen od
Activated charcoal w/in 4h | NAC IV if >8hr, preg, present w/ hepatic failure
61
ASA od tx
Active charcoal | dialysis if severe
62
When should ASA levels be checked after OD
6 hours is peak but should check at 4hrs and q3 after until level declines
63
At 6hrs post ingestion and OD of ASA what level indicate prognosis?
<35 no sx 35-70 mild-mod 70-100 severe >120 potetially fatal
64
What medications make up the FGAs
Chrlorpromazine Fluphenazine Perphenazine Haloperidol
65
acute dystonia
contraction, arching of back, one or both eyes turned upwards, tongue protrusion, jaw clenching
66
When would you expect to see acute dystonia after initiating FGA
min to hours after FGA is started
67
Tx for acute dystonia
Anticholinergics (benztropine, diphenhydramine) BZD relief should occur w/in 5min Prevent by co-dosing FGA's with antichol automatically
68
Akathesia
Motor restlessness, inner disquiet
69
Tx of akathesia
BBlockers. Anticholinergics are not helpful! BZD's are contraindicated
70
Pseudoparkinsonism
``` Resembles idiopathic parkinson's Rigidity Tremor Bradykenisia postural instability ```
71
Tx for pseudoparkinsonism
Anticholinergic | sx should resolve in 3-4 days
72
tardive dyskenisia
Abnormal movements, lip smacking, trunk extremities, unusual posture
73
When does Tardive dyskenisia usually present after taking FGA's
a year after
74
Tx for Tardive
Often irreversible Reassess need for continuation D/C start atypical if needed Prevent by checking AIMS q6mo
75
Describe Neuroleptic Malignant Syndrome
``` Rare Onset varies Fever (>100.4) AMS Leukocytosis Inc CK and LFT Myoglobinuria ```
76
Which SGA is first line d/t ADE profile
Aripiprazole
77
Which SGA has the worse ADE profle
Chlorpromazine
78
Why is clozapine not first line?
Agranulocytosis
79
Which SGA is best for pt's with QTC prolongation
Aripiprazole | Olanzapine
80
which SGA is assoc. most with weight gain
Olanzapine
81
How many days must go by for a washout period when switching from MAOi to any other antidepressant or from another antidepressant to MAOi
14 days
82
What is the exception to the rule for 14d washout w/ MAOi
Fluoxetine - must have 5 week washout
83
Why is there a washout period for MAOi's
Hypertensive crisis may occur
84
Drug of choice for Classic Mania
Lithium
85
How does VA compare to LI+
better for mixed states and rapid cycling than LI+
86
Who do we not give Lamotrigine to
kids under 16 - SJS
87
Tx for BZD od
flumazenil

PANCE study guide (14 decks)

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