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step 2 ck > PSYCH > Flashcards

PSYCH Flashcards

1
Q

alcohol drugs

naltrexone 
vs
acamprosate
vs
disulfiram
A

naltrexone is first line to decrease craving and increase abstinence; can be started while still drinking; mu opioid receptor antagonist and decreases alcohol effect

acamprosate is a glutamate modulator; used for maintenence AFTER abstinence is achieved

disulfiram inhibits alcohol dehydrogenase to discourage drinking; must be used in motivated and abstinent people

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2
Q

neuroleptic malignant syndrome
sx?
tx?

A

fever >104, mental change, muscle rigidity and autonomic instability

stop neuroleptics and give dantrolene or bromocriptine + hydration/cooling

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3
Q

which bug is associated with uti and struvite stones?

A

proteus

urease producing –> makes ammonium

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4
Q

anorexia vs bulimia

A

anorexia has significantly low BMI (can have compensatory behavior)

bulimia always has compensatory behavior but maintains normal body weight

both are distorted view of body

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5
Q

how long is adequate trial length before switching to a second SSRI?

A

6 weeks

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6
Q

contraindication for bupropion use in depression?

A

history of seizures or bulimia

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7
Q

If autistic patient is aggressive… Treatment with what?

A

Antipsychotic medication such as risperidone

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8
Q

Tx for Tourette’s

A

Antipsychotics such as haloperidol or rosperidone

Or clonidine

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9
Q

Treatment for major depression

A

First line is SSRI like fluoxetine paroxetine sertraline citalopram or escitalopram

After 4 weeks can switch to another ssri

After that, can increase dose or switch to tac

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10
Q

Best medication for patient with depression and neuropathic pain

A

Duloxetine

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11
Q

Best treatment for depression who is scared of weight gain or sexual side effects OR smoker trying to quit

A

Bupropion

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12
Q

Bipolar 1 versus 2

A

1 is mania and depression

2 is hypomanic and depression

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13
Q

Patient in lithium who comes in aggressive and punched nurse…first step

A

Give antipsychotic

Don’t need to verify lithium level given that his symptoms are so acute

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14
Q

Cyclothymic

A

Depression and hypomanic episodes on and off for 2 years

Tx w lithium, valproate, or antipsychotic and psychotherapy

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15
Q

Atypical depression sxs

Tx?

A

Weight gain
Increased sleep
Increased appetite

Tx w MAOIs

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16
Q

Seasonal pattern depression

A

Fall and winter mood changes

Tx w phototherapy and bupropion or SSRI

17
Q

MAOIs

A

PhenelZine
Isocarboxazid
Tranylcypromine

18
Q

Mirtazipine has risk of

A

Weight gain and sedation

19
Q

Lamotrigine has risk of

A

Steven Johnson syndrome

20
Q

What is the single most effective treatment for depression?

A

Electroconvulsive therapy is usually used for suicidal patients unresponsive to regular meds

21
Q

Brief psychotic disorder versus schizophreniform disorder’s versus schizophrenia

A

Brief psychotic disorder or is one month or less

Schizophreniform is six months or less

Schizophrenia is more than 6 mo

22
Q

Side affects of the following:
– Olanzapine – risperidone – quetiapine
-ziprasidone
-clozapine

A

Olanzapine - diabetes and weight gain

Risperidone - movement disorders and breasts/gynecomastia

Quetiapine - lowers movement disorders (goodfor movement disorders)

Ziprasidone - qt prolongation

Clozapine - agranulocytosis (monitor CBC)

23
Q

Antipsychotics least likely to cause weight gain or diabetes

A

Aripiprazole or ziprasidone

24
Q 
Tx for 
Acute dystonia
Akathisia
Tardive dyskinesia
NMS
A

Benztropine or diphenhydramine

Beta blocker and switch to an atypical

Switch to an atypical

Dantrolene or bromocriptine

25
Q

Tx for panic disorder

A

Ssri

26
Q

Tx for panic attack

A

Benzo (alprazolam)

27
Q

Treatment for performance anxiety

A

Beta blocker like propanolol or atenolol

28
Q

Treatment for OCD

A

SSRi Plus exposure and response therapy

29
Q

Treatment for opiate intoxication and withdrawal

A

Intoxication - naloxone

Withdrawal - methadone or buprenorphine

30
Q

Treatment for somatic symptom disorder

A

Psychotherapy

31
Q

Anorexia versus bulimia

A

Answers always anorexia if they cannot maintain normal body weight

32
Q

What medication has been effective for Binge eating disorders

A

Topiramate

33
Q

Treatment for narcolepsy

A

Forced daytime naps and modafinil

34
Q

Treatment for insomnia

A

First try sleep hygiene and then can add Z drug

35
Q

Gastric lavage to be used for pill ingestion…

A

One patient arrives under two hours from ingestion

36
Q

common brain frinding in schizophrenia?

A

enlarged cerebral ventricles

37
Q

tx for catatonia

A

benzo (lorazepam) or ECT

step 2 ck (16 decks)

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