Psych Flashcards
What will an isolated benzodiazepine overdose present with?
A patient who has normal vital signs and is arousable. Bradycardia, respiratory depression, ect suggests involvement of another CNS depressant.
What are PTSD symptoms less than 1 month but greater than 3 days referred to as?
Acute stress disorder.
What triad defines serotonin syndrome?
Mental status changes, autonomic dysregulation, and neuromuscular hyperactivity. A tyramine induced HTN crisis would have just hypertension, not hyperreflexia or mydriasis, ect.
What agent other than dantrolene can be used in the treatment of neuroleptic malignant syndrome?
Bromocriptine (after stopping the antipsychotics of course).
What would SIG E CAPS symptoms in someone who’s wife died 7 months ago be classified as?
Major depressive disorder. MDD is diagnosed regardless of an existing precipitant. Thus the most appropriate next step would be anti-depressant therapy.
Can anorexia present initially as edema?
Yes, it can cause edema due to nutritional deficiencies. Initially put hypothyroidism but I should have noticed that her BMI was 17; hypothyroidism would have caused weight gain.
What is the first line medication for OCD?
SSRIs. Can also use the TCA clomipramine.
What is premenstrual syndrome/PMS?
Bloating, fatigue, headaches, mood swings, anxiety, ect that begin 1 week before menses and resolve a few days into menses.
What is the most appropriate next step for suspected premenstrual syndrome/PMS?
A menstrual diary to rule out a primary mood disorder (if symptoms not consistently tied to menstrual cycle it may not be PMS).
What is the difference between separation anxiety disorder and normal development in a pre-schooler?
It is normal for a child to initially protest and cling to their parent on the first day of school if they then settle down, play with other children, engage in school activities, ect.
What is the greatest risk factor for committing homicide?
Access to firearms.
What agents are used in the management of PCP intoxication?
Benzodiazepines.
What is the best initial approach to a patient with acute stress disorder?
Educate them on the range of reactions to trauma to normalize their experience.
What do individuals with alcohol use disorder commonly present to the PCP with?
Sleep disturbance and/or mild anxiety symptoms due to mild withdrawal.
How is a grief reaction differentiated from MDD?
Grief involves sadness that is specific to the person with “waves” of grief at reminders. Feelings of worthlessness and guilt are less likely than MDD.
What is the best next step for a single episode of major depressive disorder that has gone into remission following anti-depressant therapy?
Continue the anti-depressant(s) for 6 additional months to reduce risk of relapse.
What is the first line non-stimulant option for management of adult ADHD?
Atomoxetine (a NE re-uptake inhibitor).
What mood stabilizer is associated with hepatotoxicity?
Valproate. Those on it should receive regular LFTs.
What is the best management for tardive dyskinesia if anti-psychotic dose reduction isn’t possible?
Switch to clozapine as it is the least likely anti-psychotic to produce extrapyramidal symptoms.
What is valbenzine?
A VMAT2 inhibitor that is FDA approved for tardive dyskinesia.
How do you tell adjustment disorder from a normal stress reaction?
In adjustment disorder there is a functional impairment, while with a normal stress reaction there is no functional impairment (ex stressed out due to changes at work but is still getting work done, ect.).
Can a 15 year old have oppositional defiant disorder?
Yes. A teenager who is defiant in multiple situations resulting in impairment (school suspension, ect) and who blames failings on others has ODD.
What is REM sleep behavior disorder?
Motor movement/dream enactment that occurs during REM sleep if muscle atonia is absent. Patients can be awakened and become fully alert and remember the dream (contrast to non-REM disorders like sleepwalking or night terrors).
What is nightmare disorder?
Recurrent awakenings from REM sleep associated with full alertness and dream recall. Contrasted from REM sleep behavior disorder in that there is no sleep motor movement, and from non -REM disorders like sleep terror and sleep walking where patients lack dream content and are slow to awaken.
