Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Shelves > Psych > Flashcards

Psych Flashcards

1
Q

What do you need to check before starting an SSRI

A

Episodes of hypomania or manic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A pt being treated for bipolar develops a targetoid rash. What is his new med?

A

Lamotrigine
Can cause Stevens-Johnson syndrome is titrated up too quickly
Carbamazepine is similar AE’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are your options for a schizophrenic pt that is non compliant with QD po meds?

A

Long acting depot neuroleptic medications
IM Q2wks
Formulations of: haloperadol, fluphenazine, and risperidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A pt that delay’s getting to their point, includes way too many details while answering a question but does eventually answer the question

A

Circumstantial thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

2 years of depressed mood

A

Dysthymic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pt who has schizophreniza syx for < 6 mo

A

Schizophreniform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Syx of Schizophrenia

A

2 or more of:

delusions, hallucinations, disorganized speech, catatonic behavior, negative syx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Personality disorder with restricted emotions and social detachment

A

Schizoid PD

Distance from other individuals and happy being loners

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Manic episode with dilated pupils

A

Cocaine abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pt feels restless and psychomotor agitation while taking an antipsychotic med. Dx and management?

A

Akathisia
Decrease dosage, or add a benzo, or a BBlocker
Common w/ risperidone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Defense mechanism where an unacceptable impulse (ie sex drive) is transformed into the opposite (restriction)

A

Reaction formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tourette syndrome is associated with what two other psych conditions?

A

ADHD
OCD
Occurs in 1/3 tourette pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

1 or more depressive episodes + 1 or more hypomanic episodes

A

Bipolar I

Hypomanic = elevated mood, abn high self esteem x 1wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Recommended tx for anorexia?

A

Behaviorally-based tx (CBT) outpt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What should be given to a schizophrenic that has poor response to typical antipsychotics despite compliance?

A

Clozapine

30% effective in resistant schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx of panic disorder?

A

SSRI

CBT will augment benefits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pt has delirium in the setting of fever. Dx?

A

Febrile delirium

AKA acute confusional state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pt has suxual urges that he has difficulty containing. He has urges to touch strangers innappropriately, including brushing his genitals against people in crowded places

A

Frotteurism
Recurrent fantasies, sexual urges, behavior involving innapropriately touching a non-consenting person
Often causes distress or impairement of function because the pt conciously knows this is bad behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

After starting an antidepressant pt has syx of blurred vision, dry mouth, and orthostatic hypotension

A

Imipramine (TCA’s)
Inhibits NE, Serotonin
Antagonist at muscarininc, histaminic, and alpha-adrenergic receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

1st line tx for PTSD?

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

1st line for post partum blues

A

No tx necessary

Condition will resolve when hormones stabilize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Incontinence + gait ataxia + dementia. Dx and workup?

A

Normal pressure hydrocephalus (NPH)
CT + LP
Caused by failed resorption of CSF so LP helps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pt is incoherent and been taking a benzo daily. Now what?

A

Admit to the medical floor for delirium

She is in withdrawl which is an emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pt has at least 5 of
Odd beliefs, unusual perceptions, lack of close friends, suspiciousness, odd speech, inappropriate affect, and an odd appearance

A

Schizotypal PD

Odd and magical thinking. Functional, but difficult to make friends

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

syx of benzo w/d

A 
Anxiety
Diaphoresis
irritability
Insomnia/fatigue
HA/myalgia
Nausea
Perceptual disturbance
Tremors
Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What disorder predisposes people to Antisocial PD?

A

Conduct disorder

Considered necessary for the development of antisocial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Syx of lithium intoxication

A

Weakness, unsteady gait, diarrhea, tremor, confusion

If lithium>2 -> dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

PD that wants friends but too afraid of rejection to put themselves out there

A

Avoidant PD

Social inhibition, feelings of inadequicies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why is bupropion conta in anorexia pts?

A

It decreases the seizure threshold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do you medically manage benzo w/d?

A

IV Lorazepam

Short acting so helps w/d without allowing seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Immature defense mechanism where individual places negative feelings from on event onto another person that is safer

A

Displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What medication can be used to counter the excessive cholinergic effects of heroine w/d?

A

Diphenhydramine
Anticholinergice
Inhibits - muscle aches, abd cramps/loose stool, chills, clear nasal discharge, dilated pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you treat phobias?

A

CBT + exposures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Euphoric affect + fast/pressured speech + tangential associations

A

Mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pediatrician becomes withdrawn after treating a girl that was seriously injured ina car accident. Started dreaming about a MVA he had 3 years ago

A

PTSD with delayed expression

Can also have avoidance behaviors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How do you tx PTSD?

A

Prazosin + Trauma-Focused CBT

Add SSRI if also anxious or depressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

A male on hormone therapy as he is transitioning to become female presents with significant anxiety. How do you treat?

A

Start sertraline w/ recommendation for Acceptance and Commitment Therapy (ACT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

9 y/o Son refuses to go to school, has dreams that father will die, insists on sleeping with dad. Mother passed away suddenly 8 years ago

A

Serparation anxiety disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

14 y/o had a breakdown during an exam. Sweaty palms, rapid breathing, heart pounding, tremors. Has had similar syx x 1 year Dx?

A

Generalized anxiety disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

General anxiety after a major life change (ie, death, divorce)

A

Adjustment disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is a mental health hold?

A

M1; 72 hour hold for S/I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How long can short term certifications last in Colorado?

A

Up to 90 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How long should pts with MDD be treated before considering weaning?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Personality disorder defined by grandiose sense of self and sense of entitlement

A

Narcissistic PD

Countertransferrance of boredom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Lithium toxicity can mimic which other dz?

A

Hypothyroidism

Weight gain, fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Pt becomes aggressive and destroys property. Degree of aggressiveness is out of proportion of the precipitating event

A

Intermittent explosive disorder

Tx - anticonvulsants, mood stabilizers, psychotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Most common treatment for specific phobias?

A

Exposure therapy (flooding or desensitization)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Sexual arousal by exposing genitals to strangers

A

Exhibtionist disorder

Goal is to shock and frighten the victim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Pt has a long hx of aggressive impulses resulting in destruction of property or result of another person

A

Intermittent explosive disorder

Tx - SSRI’s, anticonvulsants, mood stabilizers, psychotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Why are most pts on classic antipsychotics also given an anticholinergic?

A

To avoid acute dystonia (extrapyramidal side effects)

Anticholinergics = benztropine, diphenhydramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What finding in an interview suggests pseudodementia secondary to depression rather than true dementia?

A

If the patient is concerned of the dementia - pseudo

If the pt tries toc cover up the memory loss - dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Weight neutral antipsychotics

A

ziprasidone

Increased risk of QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

A pt wants to reach smoking cessation w/ the help of bupropion. What are his instructions?

A

Decrease smoking gradully during the second week of treatment
Continue tx 7-12 weeks
If they have not reached cessation by week 7, unlikely that they will

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Behaviors/emotions that develop w/in 3 months of an identifiable stressor

A

Adjustment disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

When are kids prone to sleep terrors?

A

2-6 yrs
Abrupt wakening from slee, screaming, unresponsive to others
Tx - supportive, most outgrow this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

During an interview, a verbal or nonverbal cue to help the pt continue their train of though

A

Facilitate

Kindly asking the pt to continue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How long can normal grief last?

A

1 yr

if >1 yr think MDD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Pt in a psychotic state is in a catatonic state and resists against anyone that tries to move his arms/legs

A

Negativism
Resistance to movement and instruction
Catatonia is associated with schizophrenia, mood disorders, general medical conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Pt has manic episode w/ no hx of depressive episode

A

Bipolar I

Only a manic episode lasting at least 7 days is required for the dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Hypomania + major depression

A

Bipolar II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Hypomania + low grade depression x 2 years

A

Cyclothymic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Which antipsychotics are most likely to cause tardive dyskinesia

A

Risperidon - most

Clozapine - least likely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Tourette’s is associated with?

A

ADHD and OCD in 1/3 of pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Tx for people that have a fear of public speaking and social situations

A

Social anxiety disorder

Give propanolol or SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Child reaches milestones in first 5 months of life. During 6-30 months a decel in head growth, FTT, loss of eye contact, and hand wringing

A

Rett syndrome
X-linked
Almost exclusively occurs in females, males typically die in utero
Associated with seizures and irregular respiratory patterns
Receptive and expressive communication skills remain at developmentally less than a year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What do you do for a pt on life support w/o advanced directives and the family disagrees on what to do?

A

Arrange a family meeting to mediate a decision about w/ding life support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How do you work up a child with enuresis (nighttime bedwetting)

A

Urinalysis (UTI, DKA, DI)
When organic causes have been r/o can do behavioral mangement (fluid management, bladder retention training, enuresis alarms)
Can give desmopressin and imipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Pt is aware they are faking a disease, but poor insight as to why they are doing it

A

Factitious disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Pt loses sight after a traumatic event, but nothing is neurologically wrong

A

Somatic symptom disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Pt fakes an injury to get worksman’s comp

A

Malingering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What do you do for a trichotillomania pt?

A

Identify if there are other psych disorders present (OCD, Borderline, depressive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Tx for OCD?

A

SSRI (fluoxetine, sertaline, paroxetine, fluvoxamine)

OCD is caused by low levels of serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Which antidepressants are contra in pt with a hx of attempted suicide due to OD?

A

TCAs

QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Preggo has psychotic depression and high risk of suicide

A

ECT
Works faster than a SSRI and safe in pregnancy
NO Benzo or lithium during preggo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Tx for akathisia

A

Lorazepam

Look for recent use of haloperidol or prochhlorperazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Pt has nystagmus, belligerence, psychomotor agitation

A

PCP
Give benzo or antipsychotic
Benzo preferred
Acidfying the urine with cranberry juice helps to clear PCP faster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What criteria must be met to dx a pt with anorexia?

A

BMI <17

Immediately hospitalize

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What tests abstract thinking on MMS exam?

A

Interpreting proverbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Pt has at least 1 fixed false belief for at least 1 month. No other impairments

A

Delusional disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Many years of HIV infection puts a pt at risk of?

A

HIV dementia

Precipitous decline but other causes of encephalopathy are not present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Following a psych hospitalization pt is amenorrhic and decreased libido

A

She is on risperidone

Associated with elevated prolactin -> amenorrhea, sexual dysfunction, galactorrhea, weight gain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Research study in which medical records of individuals that are alike in many ways but differ on one characteristic (ie high vs low exposure) are reviewed to compare for a particular outcome

A

Retrospective cohort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Acute tx for panic disorder

A

Benzo w/ medium half life (clonazepam, lorazepam, alprazolam)
Long term tx - SSRI, TCA, MAOI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

After starting anew antihypertensive, pt has decreased appetite, insomnia, and other depressive syx

A

Propanolol

One of the most common pharmacologic agents to cause depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Pt with AMS, fever, rigidity, and elevated creatinine phosphokinase (CPK)

A

Neuroleptic malignant syndrome
Look for a hx of antipsychotic medications
Tx - cooling, hydration, dantroline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Prochlorperazine given for chemo related n/v is causing a pt to be stiff and bradykinetic

A

Counter this EPS rxn with benztropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

When is dialysis indicated when a pt has lithium toxicity?

A

When there is evidence of renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Appropriate tx for insomnia in a pt with a recent stroke

A

Trazodone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Pt has amnesia of a traumatic event

A

Dissociative amnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Tx for urinary retention secondary to an antipsychotic

A

Bethanecol

Cholinergic stimulant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

common side effect of lithium use

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Depression for at least 2 years + functioning at a suboptimal level (ie blah work performance)

A

Persistent depressive disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Which antidepressant has the fewest sexual side effects?

A

Bupropion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

CVA’s increase the risk for which psychiatric disorder?

A

MDD

Any event affecting the vasculature (MI, CVA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Manic syx + dry mouth + dilated pupils + tachycardia

A

Amphetamine use

Increased alertness, energy, mood x days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Pt with rape hx has pain w/ sex

A

Genito-pelvic pain or penetration disorder
Caused by involuntary muscle contraction in the outer thrid of the vagina
Tx - Kegels, vaginal dilators, relaxation techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Side effect of quetiapine?

A

Metabolic syndrome, significant weight gain

Generally prescribed for psychotic depressive disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Tx for Narcolepsy

A

Modafinil (stimulant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What should be used for tx resistant schizophrenia?

A

Clozapine

Need regular CBC’s for agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Which syx must be seen to dx a child with conduct disorder?

A 
Any of the following for at least 6 months:
Destruction of property
Aggression to animals and people
Deceitfulness or theft
Serious violations of rules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Why should you be cautious when switching a pt from an MAOI to a SSRI?

A

Serotonin syndrome can occur if two overlap. Need a minimum of 10 day washout after stopping the MAOI OR 5 week wash out from the SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Pt has a dysfunctional fear of losing control and/or being unable to escape from a situation

A

Agoraphobia

Tx - antidepressants and behavioral therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Extreme depressive syx (depressed affect, >5% weight loss, fatigue, poor concentration/sleep) x at least 2 weeks

A

MDD

Can also have anhedonia (decreased interest), psychomotor agitation, worthlessness, guilt, SI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Tx for Bipolar I with renal dz

A

Valproate
Lithium is contra in renal failure
Carbamazepine is 3rd line

105
Q

Which atypical antipsychotic has little sedative effects and is weight neutral

A

Ziprasidone

106
Q

Most common treatments of OCD?

A

Fluoxetine and fluvoxamine

107
Q

Psych pt has polyuria, vomiting, diarrhea, confusion and lethargy

A

Water intoxication (psychogenic polydipsia)

108
Q

Tx for Bulimia

A

Fluoxetine - the only SSRI that can be given

109
Q

Why do TCA’s cause orthostatic hypotension?

A

alpha1 adrenergic receptor blockade

Dry mouth is caused by anticholinergic effect

110
Q

`What should be done for a panic disorder pt that is having poor control with SSRI

A

Add CBT

111
Q

What is seen on CT for a schizophrenia pt?

A

Enlargment of the lateral cerebral ventricles

Also decreased hippocampus and amygdala volume

112
Q

CT reveals increased total brain volume

A

Autism

Can have rapid head growth in infancy

113
Q

CT reveals structural abnormalities of the orbitofrontal cortex and basal ganglia

A

OCD

114
Q

Two people with a close relationship (family, spouse) share a delusion

A

Shared psychotic disorder
Seperate the two to break the chain.
The dominant one will require treatment, the more passive one may not

115
Q

Pt’s identity fragments into two different personalities

A

Dissociative identity disorder

116
Q

What does CBT focus on?

A

Reducing automatic negative thoughts and avoidance behaviors

117
Q

Why are benzo’s preferred for treating PCP induced agitation

A

Antipsychotics can amplify hyperthermia, dystonia, anticholinergic effects

118
Q

Pt that parties reports acute depression, SI after a binger

A

Cocaine w/d

Also hypersomnia, increased dreaming, hyperphagia, impaired concentration, intense drug craving

119
Q

Panic episodes are not triggered or expected and pt changes behavior because they are worried about future attacks

A

Panic disorder

Unexpected panic attacks, fear of future attacks, avoidance behavior

120
Q

Compare/contrast anorexia and bulimia?

A

Both have distorded body image and can engage in purge behaviors
Difference - anorexia has a significantly low body weight

121
Q

Psychosis + tooth decay + skin picking

A

Meth abuse

122
Q

How do antipsychotics cause hyperprolactinemia

A

Decreased DA activity in the tuberinfundibular pathway (DA antagonists)

123
Q

Transforming an unacceptable feeling/impulse into the extreme opposite?

A

Reaction formation

124
Q

Decreased concentration of 5-hydroxyindoleacetic acid in CSF

A

Associated with depression, multiple suicide attempts

125
Q

How can you decrease the risk of TD with a pt on haldol?

A

Switch to ariprazole (atypical)

126
Q

Benzoylecgonine is a metabolite of?

A

Cocaine

Help them withdrawl with clonazepam

127
Q

What do you do with an alcohol withdrawl pt that continues to be agitated despite giving diazepam?

A

Keep giving diazepam

128
Q

Unspecific abdominal pain + anxiety, paranoia, delsions, depression

A

Acute intermittent porphyria
genetic defect in heme production (porphobilinogen deaminase)
AD

129
Q

Tx for adjustment disorder

A

Therapy

130
Q

At what point can the dose of an SSRI be increased if pt is having inadequate response

A

If taking therapy >6wks (take 4-6 wks to take full effect)

131
Q

SI pt has decreased respration and pinpoint pupils?

A

Opioid OD

132
Q

Pt has intense anxiety during public speaking

A

Social phobia (a type of specific phobia)

133
Q

Are compulsions required to dx OCD?

A

Nope, they can just fixate on a single distressing thought

134
Q

MOA of haloperidol?

A

D2 antagonist

Decreases DA binding

135
Q

Neuroleptic malignant syndrome looks a lot like?

A

Serotonin syndrome

Look at med hx to determine which

136
Q

5 y/o with epicanthal folds and delayed motor skills

A

Down Syndrome

137
Q

Pt has staring spells, lip smacking, picks at shirt collar, smells rubber, intense hissing sound

A

Complex partial seizure

EEG - focal spikes localized to the temporal lobe

138
Q

Second line Tx for OCD

A

Clomipramine (consider after SSRI failure)

139
Q

Parkinsonism + visual hallucinations

A

Lewy Body Dementia

140
Q

Pt’s with anorexia are most likely to also have?

A

amenorrhea

141
Q

Spiral Fx =

A

Child abuse

142
Q

What do you do for a family that has a kid that is only bratty at home?

A

Parent management training

143
Q

Pt has acute onset of lots of crazy visual hallucinations

A

LSD

144
Q

Primary metabolite of Dopamine?

A

Homovanillic acid

Found in CSF, Urine, blood

145
Q

Sudden loss of muscle tone in response to strong emotions?

A

Cataplexy

146
Q

What test is challenging for Alzheimers?

A 
Ask the pt to pick up a piece of paper, fold it, put it on the table
Ideational apraxia (abiity to put several skilled acts in a row, controlled by the parietal)
147
Q

Why does stress make it harder to remember stuff?

A

Increased gluccocorticoids in the HPA axis

Negative effect on hippocampus

148
Q

Hyposexuality, emotional intensity, perseverative (extreme detail orientation) when communicating

A

Temporal lobe epilepsy personality

149
Q

Benzo’s barbs and anticonvulsants act at which receptor?

A

GABA

150
Q

When does dreming occur?

A

REM sleep

Random, fast, saw toothed waves on EEG

151
Q

Tx for Neuroleptic malignant syndrome?

A

Dantrolene (muscle relaxant) and bromocriptine

Sometimes amantadine instead of bromocriptine

152
Q

What suggests poor prognosis in schizophrenia?

A 
Onset at early age w/o stressors
Poor pre morbid functioning
Neurologic syx
Social isolation/poor support system
FHx of schizophrenia
Presence of negative syx
153
Q

If pt has poor response to a first gen antipsychotic, what should be done?

A

Transition to a second gen

154
Q

when is psychoanalysis appropriate?

A

Pt that is highly motivated and can handle a great deal of frustration, good insight

155
Q

How do you manage a pt with factitious disorder?

A

Primary care should be the gatekeeper for all decisions

Try to limit the number of invasive tests offered

156
Q

Group sessions that help patients realize they are not alone in their ways is called?

A

Universalization

157
Q

What percentage of new moms have post partum blues

A

50%

158
Q

Which conditions are associated with increased incidence of anxiet?

A 
Endocrinopathies (pheo, hyperthyroid, hypercortisol, hyperparathyroid)
Metabolic problems (hypoxemia, hypercalcemia, hypoglycemia)
Neuro, vascular, trauma
159
Q

Hyperchondriac is now called

A

Illness anxiety disorder

160
Q

Pt has many different syx and see many different docs, several recent surgeries

A

Somatic syx disorder

161
Q

sybil had

A

Dissociative identity disorder

162
Q

Which med can you offer to a male pt with MDD that is concerned about sexual dysfunction

A

Mirtazapine

163
Q

What should be given for a pt on LSD?

A

Diazepam

164
Q

At what BAC do folks exhibit drunk syx?

A

20-30mg/dL

165
Q

Pt withdrawing for alcohol is hallucinating

A 
Alcohol withdrawl delirium (Delirium tremens)
po chlordiazepoxide (benzo)  or diazepam is a good initial treatment
166
Q

opiate antagonist used in OD?

A

Naloxone

167
Q

SSRI w/ longest half life?

A

Fluoxetine

168
Q

SSRI with greatest risk for GI syx?

A

Sertaline

169
Q

SSRI highly protein bound and short half life leads to w/d syx if dose is missed

A

Paroxetine

170
Q

SSRI w/ fewest drug interactions but increases risk of QT prolongation

A

Citalopram

171
Q

Enantimor of citalopram with less risk of QT prolongation

A

excitalopram

172
Q

Which SSRI is FDA approved for ICD

A

Fluvoxamine

173
Q

MOA of cocaine

A

Competitive blockade of DA reuptake by the DA transporter

174
Q

MOA of opiates?

A

Disinhibition of inhibitory GABA

175
Q

What is concerning when prescribing a SSRI to a pt on HAART?

A

Protease inhibitors affect cytochrome P450 and can elicit serotonin syndrome

176
Q

How do you manage if you clozapine pt WBC count falls below 5K

A

2xwk CBCs with diff, continue clozapine

177
Q

What do you recommend for a pt that has a hard time falling asleep

A

Ramelteon
Mimics melatonin, most common AE is HA
Make sure they don’t have a severe hepatic impairment, severe OSA, or severe COPD prior to starting it

178
Q

Tx for ADHD

A

Dextroamphetamine
methylphenidate
dexmethylphenidate

179
Q

What 4 elements must be present to file malpractice?

A

Negligence
Harm to the patient due to the physicians actions
Harm to the patient
Duty to treat

180
Q

Tarasoff I declared?

A

providers have a duty to warn the potential victim of a violent patient

181
Q

Most common cause of malpractice in psych?

A

Improper treatment

182
Q

Fluctuating disturbance in attention developed acutely secondary to an underlying condition

A

Delirium

183
Q

What should you do with a pt that failed SSRI after 8 wks of tx

A

Try another SSRI or switch to a SNRI
Add psychotherapy
Or augment with a second agent

184
Q

How do you manage a child with acute psychosis?

A 
Rule out cohronic medical conditions: 
SLE
Thyroiditis
Metabolic
CNS
185
Q

Elderly pt with paradoxical agitation (agitation at bedtime)

A

D/c any benzo use

186
Q

Alcoholic hallucinosis vs. Delirium tremens?

A

AH - < 24 hours, lots of visual hallucinations, stable vital signs
DT - >48 hours post cessation, disorientation, confusion, hallucinations, fever, tachy HTN, diaphoretic, can be life threatening

187
Q

syx of schizophrenia presenting as a manic or major depressive episode

A

Schizoaffective

Delusions, hallucinations >2wks in the absence of a mood episode

188
Q

Tx for catatonia

A

Benzo

189
Q

Management of a pt with acute stress disorder

A

Educate on the range of syx
Refer to trauma focused CBT
ASD is very similar to PTSD but more acute. PTSD requires >4 wks of symptoms

190
Q

What endocrine change is associated with MDD?

A

hyperactive HPA axis -> increased cortisol

Decreased REM sleep latency

191
Q

How do you handle a teen with SI?

A

Hospitalize and inform the parents, confidentiality must be broken
Need parental consent to start a psychotropic
Parental consent for hospitalization is not required if the teen is a danger to self or others

192
Q

MAOI + tyramine rich food causes

A 
Hypertensive crisis (HA -> stroke -> death)
MAOI = phenelzine
193
Q

How is pediatric depression different from adult depression?

A

Can present as irritability rather than depressed mood

194
Q

What is a normal pupillary size?

A

2mm

195
Q

What is indicative of poor prognosis on TCA OD?

A

QT prolongation

196
Q

Which antidepressant is helpful in a depressive pt with low energy, poor concentration, hypersomnia, weight gain

A

Bupropion

Mild stimulant properties

197
Q

1st line tx for major depression with psychotic features (ie auditory hallucination)

A

ECT

Good option for elderly pts that have stopped eating/drinking due to the rapid response vs pharma

198
Q

Tx for kleptomania?

A

Impulse control disorder

Tx - CBT, SSRI, lithium

199
Q

Anxiety/Insomnia pt has Macrocytosis and elevated LFT’s

A

Alcohol use disorder

200
Q

When a pt interprets a proverb literally

A

Concrete thinking

Associated with cognitive disorders (IDD, dementia) and schizophrenia

201
Q

An infant that does not get adequate nurturing is at risk for?

A

FTT and depression

202
Q

What is primary process thinking?

A

Nonlogical, denying the existence of negatives

Primitive

203
Q

According the freud, what is id?

A

Instinctual drives

204
Q

According to Freud, what is the ego?

A

To find equilibrium between gratification of the instinctual drives and the rules of society

205
Q

According the Freud, what is the supergo?

A

The agency that contains the internalized parental and societal rules and dictates to the ego what should not be done.
Source of guilt

206
Q

Which mood stabilizer causes Hepatotoxicity

A

Valproate

Can cause hepatic failure in first 6 months of use

207
Q

Kid comes to parents room in the middle of the night due to nightmares

A

Nightmare disorder

Recurrent awkenings from REM sleep w/ full alretness and dream recall

208
Q

Diaphoretic + dilated pupils

A

Amphetamine intoxication

209
Q

Pathophys of tardive dyskinesia?

A

DA receptor hypersensitivity

210
Q

Older pt with bradykinesia begins acting their dreams out at night

A

REM sleep behavior disorder

Early sign of neurodegeneration (PD or LBD)

211
Q

In social anxiety disorder, how do you decide between an SSRI or propanolol

A

Propanolol - only if the anxiety is related to performance, presenting
SSRI - anxiety about going to meetings, parties etc.

212
Q

Pt has akathisia following increase in antipsychotic dose. What do you do?

A

Decrease antipsychotic

Add propranolol, benztropine or a benzo

213
Q

What do you do with a schizophrenic that develops TD?

A

Switch to clozapine

Diphenhydramine, benztropine only help with dystonias

214
Q

Days aftter receiving a major diagnosis pt is tearful and can’t sleep

A

Benzo’s

Too short time period to dx with MDD, adjustment disorder, etc. Just need to help her sleep

215
Q

Does MDD have to have weight loss?

A

No, significant weight change is one criteria

216
Q

Oxalate crystals are found in

A

Ethylene glycol toxicity

217
Q

What is pervasive developmental disorder?

A

A psychiatry way of saying the child falls ina spectrum of disorders, but feels the child is too young to give an official diagnosis
PDD includes Autism, Aspergers, Rett syndrome, Childhood disintegrative disorder

218
Q

After NSAID use, bipolar pt has seizure, tremors, nystagmus, and ECG changes

A

Lithium toxicity

219
Q

What do you do with a clozapine pt with a WBC of 2.5 and signs of infection

A

D/c clozapine

Needs his white count to fight infection

220
Q

Elderly pt suddenly develops confussion and hallucinations. Which med can cause this?

A

TCA’s

D/c

221
Q

In a fit of anger, mom slaps 2 year old across the face. What is the most likely outcome?

A

No impact

222
Q

Kid doesn’t like making eye contact, good with numbers, draws the same picture over and over

A

Asperger’s

223
Q

Pt has not engaged in sex since their partner passed away despite dating

A

Hypoactive sexual desire disorder

224
Q

After trying synthetic heroine pt becomes stiff, unresponsive, and drools

A

Designer drugs contain MPTP which causes Parkinsonian symptoms due to damage to the substantia nigra

225
Q

Pt with performance anxiety and asthma

A

Benzo prn

226
Q

Pt has delusions, hallucinations but no mood disorders

A

Schizoaffective (not weird/isolated like schizophrenia. Not manic like bipolar. Not quite MDD)

227
Q

Pt is having sudden personality changes (high energy to irritable) + dilated pupils

A

Cocaine abuse (opposite pupils of opioids)

228
Q

Decreased REM latency

A

Narcolepsy (fall asleep quickly)

229
Q

What lab changes are seen in Bulemia?

A 
Elevated bicarb (compensating)
Hypernatremia
Increased BUN
Increased amylase
Altered thyroid hormone
230
Q

Buspirone is?

A

Anxiolytic, useful in GAD in conjunction with an SSRI

231
Q

Can Hypercalcemia cause hallucinations?

A

Yup, look for malignancy, hyperPTH

232
Q

Olanzapine should be avoided in pts with?

A

Diabetes

233
Q

When do you decide a pt has pastpartum depression vs. postpartum blues

A

If syx persist >2wks. At that point add a SSRI

234
Q

Tx for adjustment disorder

A

Psychotherpy

Good for pts that do not meet criteria of MDD

235
Q

GI syx + confusion + ataxia + tremor

A

Lithium toxicity
Can be seen in a bipolar pt that starts a new thiazide diuretic
Also ACEI, NSAIDs, tetracyclines, and metronidazole

236
Q

MDD pt is getting poor control with 2 trials of SSRI’s. Add what?

A

Bupropion - weight neutral, no sexual effects

Mirtazapine - sig weight gain

237
Q

Teen that is argumentative and defiant toward authority figures, but does not seriously violate the rights of others

A

Oppositional defiant disorder
Risk of developing conduct disorder
Increased adult risk of antisocial PD, substance abuse, anxiety, depression

238
Q

Tx for antipsychotic induced parkinsonism?

A

Benztroping or amantadine

239
Q

MOA of risperidone

A

Serotonin 2A and dopamine D2 receptor blockade

MOA of all second gen

240
Q

Sumitriptan acts on

A

Serotonin

5-HT 1D

241
Q

Child fails to develop stable relationship with guardin due to a severely dysfunctional relationship early on

A

Reactive attachment disorder

242
Q

Child voluntarily abstains from talking at school, but talks freely at home

A

Selective mutism

243
Q

Confused + can’t move eyes up or right + ataxia

A

Wernicke

244
Q

Most common AE after ECT?

A

HA

245
Q

How long would cyclothymic syx have to be present?

A

At least two years with no more than 2 consecutive months w/o an episode

246
Q

Medication induced psychosis in asthmatic

A

gluccocorticoids

247
Q

Benztropine is a

A

anticholinergic

Useful in dystonias

248
Q

To treat neuroleptic malignant syndrome you need?

A

DA agonists

Bromocriptine and Amantadine

249
Q

erythema of the nasal turbinates

A

Cocaine use

250
Q

Tx for hoarding disorder

A

CBT

251
Q

Survivors of sexual assault are at increased risk for?

A

PTSD
Depression
SI

252
Q

What should you do with a somatic syx pt?

A

Schedule regular follow up appointments. Try to avoid specialty referals and limit diagnositic testing

253
Q

Antipsychotics with greatest risk of metabolic side effects?

A

Olanzapine

Clozapine

254
Q

Significant mood episode (depressive or manic) with psychotic features > 2, psychotic features persist after resolution of mood episode

A

Schizoaffective

In MDD, psychotic features only seen during mood episode

255
Q

Muscle/joint ache + nausea/diarrhea + rhinorrhea + dilated pupils

A

Heroine w/d

256
Q

1st line therapy for people wanting to quit alcohol

A

Naltrexone

Decreases craving/heavy drinking. Appropriate in opioid free folks that are still drinking

257
Q

Tx for tyramine crisis while on MAOI?

A

Phentolamine

258
Q

Palpebral fissures, epicanthal folds, “fish mouth” appearance

A

Fetal alcohol syndrome

Shelves (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions