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Step 2 CK > Psych > Flashcards

Psych Flashcards

1
Q

Which 2 meds are approved for autism spectrum disorder?

A

risperidone and aripiprazole for aggression

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2
Q

What is the best treatment for ADHD?

A

Atomoxetine (norepinephrine reuptake inhibitor) because better side effect profile than methylphenidate/dextroamphetamine (stimulants)

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3
Q

Disruptive Mood Dysregulation Disorder

A

Chronic, severe, persistent irritability w/ temper outbursts

Must be almost every day w/o period > 3 mo without symptoms

Out of proportion to situation

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4
Q

What sleep disturbances are associated w/ MDD?

A

Dec REM latency

Inc REM sleep

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5
Q

What is first line for MDD? What are some Alt Med Regimens for MDD?

A

1 = SSRI

If also have neuropathic pain - duloxetine (NE reuptake inhibitor)

If afraid of wt gain and sex side effects - bupropion

If smoking cessation - buproprion

If also trouble with sleeping - mirtazapine (sedation)

If atypical features (inc sleep, inc wt, inc appetite, worse in evening, feel heavy) - MAOIs (phenelzine, isocarboxazid, tranylcypromine)

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6
Q

Side Effect of Buproprion

A

lowers seizure threshold

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7
Q

Bipolar 1 v. 2

A

1 - mania (1 wk, warrant hospitalization) + depression

2- hypomania (< 1 wk, no hospitalization) + depression

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8
Q

Tx of bipolar disorder in pregnancy

A

may use lurasidone

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9
Q

Persistent Depressive Disorder

A

Depressed mood almost every day for > 2 yrs but less severe

Tx = SSRI + CBT

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10
Q

Cyclothymic Disorder

A

Hypomania + mild depression for > 2 yrs

Tx = lithium, valproic acid, antipsychotics + CBT

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11
Q

How do you tell normal bereavement v. MDD?

A

Normal = sad, worried about dead, dec sleep, tearful; 6 mo - 1 yr, tx is therapy alone

Red Flags = thoughts of death, morbid, marked psychomotor slowing, psychosis, functional impairment for long period of time, sx > 2 wks

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12
Q

Lithium Toxicity

A

Confusion, ataxia, lethargy, abnormal reflexes

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13
Q

What is the most effective treatment of depression?

A

ECT

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14
Q

Serotonin Syndrome + Tx

A
  • agitation, confusion, hallucinations, hypomania
  • autonomics (sweating, tachy, hyperthermia, nausea, diarrhea, shivering)
  • Tremor, myoclonus

Tx = stop meds, CYPROHEPTADINE

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15
Q

What is the first line therapy for schizophrenia?

A

Atypical antipsychotics

  • olanzapine, ziprasidone (short-acting, IM in emergency)
  • risperidone and paliperidone (long-acting, good if low compliance)
  • others … quetiapine, apiprazole, asenapine, iloperidone
  • lurasidone in pregnancy
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16
Q

Main side effect of olanzapine

A

O - obesity (wt gain and DM)

17
Q

Main side effect of risperidone

A

Movement disorders

18
Q

Main side effect of quetiapine

A

good if existing movement disorder because lowest incidence

19
Q

Main side effect of ziprasidone

A

Prolonged QT (“zips thru the QT”)

20
Q

Main side effect of clozapine

A

ONLY USE IF OTHERS FAIL

agranulocytosis (check CBC periodically) and cardiomyopathy

21
Q

Main side effect of aripiprazole

A

compulsive behavior (gambling)

22
Q

What is the timing of side effects in typical anti-psychotics?

A

1- w/in hrs to day - acute dystonia (tx = benztropine)

2- weeks - akathisia/restlessness (Tx = dec dose, switch to atypical, beta blocker)

3- 6 mo + - tardive dyskinesia (tx = switch to atypical)

**Neuroleptic malignant syndrome can occur at any time (tx = dantrolene or bromocriptine)

23
Q

What other disorders are treated w/ SSRI as first line? (8)

A
  • panic disorder (1 mo worrying about attacks)
  • OCD (ego dystonic)
  • Hoarding disorder
  • Body dysmorphic disorder
  • PTSD (paroxetine and sertraline specifically)
  • GAD (> 6 mo)
  • Anorexia and bullimia (+ CBT)
24
Q

Schizoaffective v. MDD w/ psychotic features

A

Schizoaffective = not at same time (no mood sx for at least 2 wks while having psychosis)

MDD w/ psychotic features = at same time

25
Q

Delusion Disorder

A

False but probable delusions

26
Q

PTSD v. Acute Stress Disorder

A

PTSD = sx > 1 mo

ASD = > 2 days but < 1 mo (must start w/in month of stressor)

27
Q

When is lorazepam most commonly used?

A

For emergencies and alcohol withdrawal (IM injection)

28
Q

When is alprazolam most commonly used?

A

Panic attacks (acute tx)

29
Q

When is clonazepam most commonly used?

A

If addiction (long half-life)

30
Q

Somatic Symptoms v. Factitious v. Mlaingering

A

Somatic = (includes conversion) excessive distress over symptoms to the point that it affects functioning, > 6 mo

Factitious = unconscious motivation to be a patient, often people in healthcare field

Malingering = conscious for secondary gain (avoid work, avoid jail, financial)

31
Q

Borderline Personality Disorder

A
  • unstable relationships, impulsive, suicidal behavior, feel empty, inappropriate anger
  • dissociative sx when stressed
  • psychotic features
32
Q

Schizoid v. Schizotypal Personality Disorder

A

Schizoid = do not want relationships, cold, social isolation

Schizotypal = odd, social anxiety, magical thinking, brief psychotic episodes

33
Q

Tx of binge eating disorder

A

topirimate

34
Q

What benzos should be used in someone with liver problems?

A

LOT

Lorazepam

Oxazepam

Temazepam

Step 2 CK (28 decks)

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