Psych Flashcards
neuroimaging obsessive compulsive disorder
structural abnormality in the occipital cortex and striatum
what is the dopamine receptor subtype responsible for extrapyramidal side effects and what are the antipsychotics that act most strongly on these?
D2
risperidone and haloperidol
what is the time cut-off for postpartum blues?
within 2-3 days and resolves in 2 weeks
what is the treatment of tardive dyskinesia?
valbenazine
what is first-line for alcohol abuse and what is the pharmacology?
naltrexone - mu opioid blocker
acamprosate - glutamate modulator
what is the treatment for OCD?
SSRI and CBT (exposure-response prevention)
expressing unacceptable feelings through actions
acting out
persistent depressive disorder
low mood (dysthmia) for more than 2 years
experiencing a person or situation as either all positive or all negative
splitting
what is the difference between bullimia and binge eating disorder?
binge eating disorder has no compensatory behaviour - just periods of binge
bullimia compensation = vomiting, fasting, running
child that is normally talkative at home but refuses to speak at school … what is the condition?
management?
selective mutism - considered an anxiety disorder
should be treated early: CBT and SSRIs
try to prevent educational and developmental delay by aggresively correcting it
which are the antipsychotic drugs least likely to cause hyperprolactinaemia?
aripiprazole and quetiapine
neuroimaging Huntington’s
atrophy of the caudate
justifying behaviour to avoid dealing with difficult truths
rationalization
what medication can be added to depression when the patient has had an initial partial response to a first line SSRI but has been gaining weight?
buspirone
neuroimaging schizophrenia
enlargement of the lateral ventricles
decreased volume in the hippocampus and amygdala
intentional falsification of a disorder for clear personal benefit
malingering
intentional falsification of an illness with no obvious reward
factitious disorder
neuroimaging Autism
increased brain volume
how can you accurately tell the difference between premenstrual dysthymic disorder and PMS?
prospective diary for >2 cycles with demonstration of resolution of low mood in the follicular phase
transferring feelings to a more acceptable object/person
displacement
what is the treatment of acute dystonia?
diphenhydramine or benztropine
what is the treatment of antipyschotic parkinsonianism?
benztropine or amantadine
what is the treatment of akathesia?
benztropine
beta blocker
benzodiazepine
in a severe presentation of bipolar I what is the pharmacotherapy?
mood stabiliser + 2nd gen antipsychotic
what medication can give a false positive PCP result on UDS?
dextromethorphan/tramadol, ketamine, diphenhydramine, venlafaxine
what are the BZDs used in alcohol withdrawal for patients at risk of liver disease
lorazepam, oxazepam or temazepam
how do you assess the severity of TCA overdose and what is the threshold for treatment?
What is the treatment?
QRS duration
>100 ms - increased risk of arrhythmia and seizures
sodium bicarbonate
transforming unacceptable thoughts/feelings into exactly the opposite
reaction formation
neuroimaging depression
decreased frontal lobe and hippocampus volumes
sleep analysis - decreased REM latency and slow-wave sleep
REM latency is the period between sleep onset and initiation of REM
what is the difference between schizophreniform disorder and schizophrenia?
SD duration 1-6 months
schizophrenia >6 months with at least 1 month of positive symptoms
what is the difference between acute stress disorder and PTSD?
timeline
ASD persists for >3 day and lasts less than 1 month
PTSD lasts >1 month
which antipsychotics are most associated with weight gain and metabolic effects?
what are the monitoring requirements in this regard?
olanzapine and clozapine
monthly weight/BMI; fasting glucose and lipids at 3-months then annually
which antipsychotics are most associated with hyperprolactinaemia?
first-generations and risperidone
what class of drug is fluvoxamine?
SSRI
how is vitamin A affected in anorexia?
hypercarotenaemia associated with carotene-rich foods like carrots and squash
yellowing of the skin and palms
what is lisdexamfetamine used for?
binge eating disorder in obese patients unresponsive to psychotherapy alone
which mood stabiliser is strongly associated with hepatotoxicity?
valproate
what are the features of adjustment disorder?
onset within 3 months of the stressor
doesn’t fit the criteria for MDD, PTSD etc
marked distress and functional impairment
what are the preferred SSRI for elderly depression with a cardiac history/polypharmacy?
sertraline or escitalopram
what is a defining feature of HIV dementia?
early onset of subcortical symptoms - slowed movement or jerky limb movement
other than SSRI/mood stabiliser, what are the best treatments for bipolar I depressive episode?
2nd gen antipsychoitcs - quetiapine/lurasidone
anticonvulsant - lamotrigine
when is it appropriate to give beta blockers in social anxiety disorder?
performance-only anxiety (i.e. not personal social gatherings)
predominant physcial symptoms
what are the contraindications for bupropion?
seizure disorders
eating disorders
recent (<2 weeks) use of MAO-Is
what class of drug is duloxetine?
SNRI
also works for neuropathic pain so watch out for this as can hit 2 birds with 1 stone in relevant cases
bupropion mechanism of action
noradrenaline & dopamine reuptake inhibitor
what are the short and long term side effects of SSRI that should be warned about?
short - headache, insomnia, nausea
long - weight gain and sexual dysfunction
18-24 year olds increased short term risk of suicidal thoughts
what is the key timeline factor is diagnosing schizoaffective disorder?
lifetime occurance of >2 weeks with only psychotic symtoms in the absence of depression/mania
what is the most common psychological comorbidity seen in multiple sclerosis?
depression - up to 2/3 patients with MS
what are the medications for the 3 eating disorders after CBT and nutritional rehabilitation
anorexia - olanzapine
bullemia - fluoxetine
binge eating disorder - SSRIs or lisdexamfetamine
what is the half life of fluoxetine?
long, 4-6 days
makes withdrawal after a few days of missing doses unlikely
c/o paroxetine that has a short half life (12 hours)
which commonly prescribed antidepressant leads to dose-dependant hypertension?
venlafaxine
