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Psych Flashcards

1
Q

Admissin for suicide if

A 
Plan+
Intention to act on the plan
Access to lethal means
Recent social stressors
Symptoms of a psychiatric disorder
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2
Q

SGA in refractory schizo

A

Clozapine

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3
Q

Route of antipsychotic administration in severe cases of schizo

A

IM q 2-4 wk

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4
Q

If schizo with aggression/impulsiveness

A

Mood stabilizer (Li, valp, carba)

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5
Q

Duration of treatment of schizo

A

At least 1-2 y after the 1st episode

At least 5 y after multiple episodes

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6
Q

If schizo with anxiety

A

Add anxiolytics

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7
Q

Schizophreniform

A

Symptoms for 1-6 mo

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8
Q

Schizoaffective Tx

A

Antipsychotics
Mood stabilizers
(Antidepressants)

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9
Q

Not to be prescribed in acute psychosis and mania

A

Antidepressants

Stimulants

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10
Q

Delusional disorder Tx

A

Psychotherapy
Antipsychotics
Antidepressants

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11
Q

W/U for mood disorders

A

CBC, TFT, extended lytes, U/A, drug screen
PEx, DHx
+/- CXR, ECG, CT head, neuro consult

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12
Q

Duration of criterion A for schizo

A

1 mo

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13
Q

Duration of pure psychosis in schizoaffective

A

2 wk

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14
Q

Duration of criterion A for MDE

A

2 wk

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15
Q

Duration of criterion A for manic episode

A

1 wk

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16
Q

Duration of delusion for delusional disorder

A

1 mo

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17
Q

Disorganized speech in schyzo

A

Derailment

Incoherence

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18
Q

Speech in mania

A

Flight if idea

Subjective: thoughts are racing

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19
Q

Hypomanic episode

A

Change in function is present, but no marked impairment in function

No psychosis

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20
Q

Clinical importance of mixed features in bipolar or depression

A

Increased risk of suicide

If found in pts with MDD, high index of suspicion for bipolar disorder

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21
Q

Symptom-free interval between depressed episodes for Dx of recurrent depression

A

2 mo

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22
Q

Parent loss before this age is a RF for depression

A

11 y/o

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23
Q

Supplement for depression

A

Zinc

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24
Q

1st line in depression Tx

A

Sertraline
Escitalopram
Venlafaxin
Mirtazapine

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25
Q

Typical response to anti-depressants

A

Physical symptoms in 2 wk

Mood/cognition by 4 wk

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26
Q

No/partial response to anti-depressants after 3-4 wk

A

Optimize dose

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27
Q

No response to dose optimization after 4-8 wk

A

Switch

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28
Q

Partial response after dose optimization of anti-depressant

A

Combine or augment

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29
Q

Fastest and most effective treatment for MDD

A

ECT

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30
Q

Persistent depressive disorder

A

2 y or more in adults

1 y or more in children/adolescence

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31
Q

St. John’s Wort

A

Tx of MDD

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32
Q

Postpartum blues

A

Begins 2-4 d postpartum
Lasts 48 h (up to 10 d)
No Tx
Prevalence 50-80%

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33
Q

MDD with peripartum onset

A 
Prevalence 10%
Onset during pregnancy or within 4 wk following delivery
Lasts 2-6 mo
Residual symptoms can last up to 1 y
\+/- psychosis
\+/- mania
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34
Q

Tx of peripartum MDD

A

CBT, IPT
SSRI
ECT

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35
Q

Risk of suicide in bipolar

A

Greatest when switching from mania to depression

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36
Q

1st line in treating BPII depression

A

Quetiapine

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37
Q

Treating mania

A 
Li
Valp
Carba (2nd line) 
SGA
ECT
Benzodiazepines ( if acute agitation)
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38
Q

Preventing mania

A

Li
Valp
Carba
SGA

(Lower dosages)

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39
Q

Treating depression of BP

A 
Li
Lurasidone
Lamotr
Quetiapine
Antidepressant(plus mood stabilizer)
ECT
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40
Q

Preventing depression in BP

A 
Li
Lurasidone
Quetiapine
Lamotrigine
Aripiprazole
Valp
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41
Q

Mixed episode,
Rapid cycling
Tx

A

Li/valp

+SGA (lurasidone, aripiprazole, olanzapune)

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42
Q

Rapid cycling BP

A

4+ mood episodes in 1 y

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43
Q

Cyclothymia

A

Numerous episodes of hypomanic/depressive symptoms for 2 y or more.

Not meeting full hypomania or MDE criteria

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44
Q

Tx of cyclothymia

A

Mood stabilizer +/- psychotherapy

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45
Q

Proven effect in preventing suicide in BP

A

Li

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46
Q

Vitamin deficiency mimicking anxiety

A

B12

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47
Q

Routine screening for anxiety

A

CBC, TFT, lytes, U/A, urine drug screen

+/- ECG, CXR, CT head, neuro consult

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48
Q

Duration of anxiety about panic attack

A

1 mo or more

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49
Q

Panic disorder Tx

A

CBT

SSRI/SNRI ( start low, go slow, aim high)

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50
Q

Duration of Tx for panic disorder

A

12 wk to see full response

Treat for up to 1 y after symptoms resolve

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51
Q

Drugs to avoid in panic disorder

A

Bupropion

TCA

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52
Q

Duration for agoraphobia Dx

A

6 mo or more

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53
Q

Duration for GAD Dx

A

6 mo or more

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54
Q

Lifestyle changes for GAD

A

Caffeine avoidance
EtOH avoidance
Sleep hygiene

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55
Q

Lifestyle changes for BP

A

Psychoeducation
Regular check ins
Emergency plan
Stable routine (sleep, meal, exercise)

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56
Q

Lifestyle changes for MDD

A

Aerobic exercise
Mindfulness
Zinc

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57
Q

GAD Tx

A

CBT (relaxation technics, mindfulness)
SSRI, SNRI (1st line)
+/- benzod

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58
Q

2nd line for GAD

A

Buspirone

Bupropion

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59
Q

Not recommended for GAD

A

BBlocker

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60
Q

Phobia duration for Dx

A

6 mo or more

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61
Q

Phobia Tx

A

CBT (exposure therapy, gradually facing feared situations)
SSRI/SNRI
MAOI
BB/benzod in acute situations

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62
Q

More efficacious Tx for phobic disorders

A

Behavioral therapy

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63
Q

OCD Tx

A

CBT (exposure with response prevention, challenging underlying beliefs)
SSRI/SNRI (12-16 wk)
Clomipeamine
+/- antipsychotics

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64
Q

Duration for PTSD Dx

A

1 mo

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65
Q

PTSD Tx

A

CBT ( emotional regulation techniques, then explore/mourn trauma, challenge dysfunctional beliefs, exposure therapy)
SSRI
Prazocin (nightmares)
Benzod (acute anxiety)
+/- SGA
Eye movement desensitization and reprocessing

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66
Q

Adjustment disorder timing

A

Starts within 3 mo of the onset of the stressor

Ends within 6 mo of the termination of the stressor

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67
Q

Adjustment disorder Tx

A

Brief psychotherapy

Benzod (significant anxiety)

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68
Q

Bereavement Tx

A

Support
Watchful waiting
Education and normalization of the grief process

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69
Q

Grief therapy indications

A

Those who need additional support
Complex grief/bereavement
Significant MDD

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70
Q

Indications of pharmacotherapy in bereavement

A

MDD present
PHx of mood disorders
Severe/autonomous symptoms

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71
Q

The most common persistent symptom in normal grief

A

Lonliness

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72
Q

Delirium w/u

A

CBC,diff, extended lytes, BUN, Cr, LFT, TFT, U/A, urine S/C, B12, folate, B1, Alb, glucose
+/- ECG, CXR, CT head, EEG, toxicology/heavy metal, VDRL, HIV, LP, B/C

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73
Q

AB causing delirium

A

Quinolons

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74
Q

CT head in delirium if:

A 
Focal signs
Hx of cancer
Anticoagulant use
Acute change in status
Gait change
Acute incontinence
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75
Q

MRI indications for delirium:

A

If suspicion of acute/subacute stroke
Multifocal inflammatory lesions
And negative CT

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76
Q

Delirium pharmacologic Tx

A

Halopridol
Risperidone
Olanzapune (sedating, less QT prolingation)
Quetiapine (if EPS)
Aripiprazole (may shorten QTc)
Benzod (for alcohol/subs withdrawal delirium)

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77
Q

Cognitive domains

A 
Learning and language
Memory
Executive
Perceptual-motor
Complex attention
Social cognition
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78
Q

4As of dementia

A

Amnesia
Aphasia
Agnosia
Apraxia

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79
Q

Mini Cog rapid assessment

A

3 word immediate recall
Clock drawn to 10 past 11
3 word delayed recall

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80
Q

Alzheimer’s disease main problem

A

Learning and memory

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81
Q

Frontotemporal degeneration

A

Language type

Behavioral type

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82
Q

Lewy body disease

A 
Visual hallucination
EPS
Autonomic impairment
Fluctuating
No well response to pharmacotherapy
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83
Q

Vascular dementia

A

Vascular RFs
Focal neurological signs
Abrupt onset
Stepwise progression

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84
Q

Normal pressure hydrocephalus

A

Abnormal gait
Early incontinence
Rapid progression

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85
Q

Investigation for dementia

A

CBC, diff, extended lytes, BUN, Cr, LFT, TFT, U/A, Urine C/S, B12, folate, Alb, Glucose
+/- VDRL, HIV, SPECT, CT head

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86
Q

CT head indications in dementia

A 
Focal signs
Anticoagulant
Hx of cancer
Gait problem
Acute change in status
Acute incontinence
Age younger than 60
Rapid onset
Duration less than 2 y
Recent significant head trauma
Unexpected neurological symptoms
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87
Q

Dementia management

A

Cholinesterase inhibitors (mild-mod)
NMDA receptor anta (mod-sev)
low-dose neuroleptics (behavioral symptoms)
Antidepressants/trazodone (emotional symptoms)
Reassess q 3 mo

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88
Q

Rivastigmine

A

Cholinesterase inhibitor

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89
Q

Donepezil

A

Cholinesterase inhibitor

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90
Q

Galantamine

A

Cholinesterase inhibitor

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91
Q

Memantine

A

NMDA rec anta

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92
Q

Sleep in dementia

A

Fragmented at night

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93
Q

Sleep in delirium

A

Reversed sleep wake cycle

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94
Q

Sleep in depression

A

Early morning awakening
Reduced Rem latency
Increased REM
reduced slow wave sleep

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95
Q

Speech in dementia

A

Echolalia

Palilalia

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96
Q

Hallmark of substance abuse

A

Dependence

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97
Q

The class of substances without withdrawal effect

A

Hallucinogens

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98
Q

1st thing to consider when approaching a pt with substance abuse

A

Pt’s current state of change

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99
Q

Legal limit of alcohol level for impaired driving

A

10.6 mmol/L

50 mg/dL

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100
Q

Reaching legal limit of alcohol for impaired driving in men and women

A

Men: 2-3 drinks/h
Women: 1-2 drinks/h

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101
Q

Coma with alcohol

A

> 60 mmol/L (non-tolerant)

>90-120 mmol/L (tolerant)

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102
Q

Alcohol withdrawal time

A

12-48 h after prolonged drinking

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103
Q

Delirium tremes timing

A

3-5 d

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104
Q

Alcohol withdrawal Tx

A

Diazepam PO
Thiamine IM then PO
Supportive

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105
Q

Lorazepam instead of diazepam for alcohol withdrawal if:

A

Age>65
Severe liver disease
Severe asthma
Respiratory failure

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106
Q

If hallucination in alcohol withdrawal

A

Halopridol (+ diazepam)

Or SGA

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107
Q

Admission for alcohol withdrawal if

A 
Still in withdrawal after 80 mg diazepam
Delirium (tremens)
Arrhythmia (recurrent)
Seizure (multiple)
Medically ill
Unsafe to discharge
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108
Q

Wernicke encephalopathy

A

Oculomotor dysfunction (nystagmus, CN VI palsy)
Gait ataxia
Confusion

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109
Q

Wernicke Tx

A

Thiamine 100 PO OD x 1-2 wk

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110
Q

Korsakoff’s syndrom

A

Anterograde amnesia
Confabulation
Persists beyond duration of intixication/withdrawal

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111
Q

Korsakoff Tx

A

Thiamine 100 PO bid/tid x 3-12 mo

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112
Q

Tx of alcohol use diorder

A

Naltrexone
Disulfiram (for abstinence)
Acampeoste (maintain abstinence)

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113
Q

Opioid overdose management

A

ABC
Glucose
Naloxone (drip until alert w/o it up to > 48 h)
Observe at least 24 h

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114
Q

Onset of opioid withdrawal

A

6-12 h

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115
Q

Duration of opioid withdrawal

A

5-10

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116
Q

Opioid withdrawal management

A

Methadone
Buprenorphine
Clonidine ( a adrenergic agonist)

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117
Q

Opioid use disorder Tx

A

Methadone
Buprenorphine
Suboxone (naloxone + buprenorphine) SL route

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118
Q

Cocaine overdose in ECG

A

Prolongation of QRS

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119
Q

Cocaine overdose Tx

A

Diazepam for seizures

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120
Q

Not recommended for cocaine overdose

A

BB

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121
Q

Cocaine withdrawal timing

A

Initial crash 1-48 h

Withdrawal 1-10 wk

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122
Q

Cocaine withdrawal Tx

A

Supportive

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123
Q

Cocaine use disorder Tx

124
Q

Diseases with cocaine

A 
CTD
Paranoia
Psychosis
Delirium
Suicide
CVD
Seizures
125
Q

Diseases by amphetamines

A 
Psychotic mania (high doses)
Paranoid psychosis (chronic use)
126
Q

Amphetamine overdose Tx

A

Psychosis: antipsychotic
Agitation: benzod
Tachycardia, HTN: BB

127
Q

Diseases by cannabis

A 
Paranoia (high dose)
Psychosis (high dose)
Schizophrenia (high dose)
Depersonalization, anxiety (high dose)
Manic episodes (chronic use)
Apathetic, amotivational state (chronic use)
128
Q

Screen for cannabis

129
Q

Cannabinoid hyperemesis syndrome Tx

A

Hot baths/ showers

130
Q

Rapid tolerance
No physical dependency
No specific withdrawal

A

Hallucinogens

131
Q

Tx of Acute intoxication with hallucinogens

A

Supportive
Reassurance
Decrease stimulation
Benzod/antipsychotic seldom required

132
Q

Diseases by hallucinogens

A

Psychosis

Mood disorders

133
Q

Jaw clenching

A

Ecstasy

GHB

134
Q

DIC

135
Q

Rhabdomyolysis

136
Q

Dissociative state

137
Q

Hallucinogen with amnestic and analgesic effect

138
Q

Catatonia in overdose with

139
Q

Appetite increasing substance

140
Q

Formication

A

Metamphetamine

141
Q

Acute lead poisoning

A

Metamphetamine

142
Q

Nystagmus (horizontal/vertical)

143
Q

Myoclonus

144
Q

Date rape drugs

A

GHB
Flunitrazepam
Ketamin

145
Q

Hallucinogen for PTSD

146
Q

Hallucinogen for rapid treatment of depression

147
Q

Hallucinogens for end of life anxiety

A

LSD

psilocybin

148
Q

Hallucinogen for treatment of addiction

149
Q

Somatic syndrome disorder duration

150
Q

Duration of illness anxiety disorder

A

6 mo or more

151
Q

Somatic symptom Tx

A 
Psychotherapy
Brief regular visits
Necessary investigations
Limit number of involved physicians
Minimize medical investigations
Anxiolytic (short term)
Antidepressants (if depression or anxiety)
152
Q

La belle indifférence

A

Conversion disorder

153
Q

Tx of paraphilia

A

Anti androgen
Behavior modification
Psychotherapy

154
Q

Tx of gender dysphoria

A

Psychotherapy
Hormonal therapy
Surgery

155
Q

Personalities susceptible to eating disorders

A

OCD
histrionic
Borderline

156
Q

Familial psychiatric disorder prevalent in bulimia nervosa

A

Affective disorders

157
Q

RF for bulimia

A

Sexual abuse

Substance abuse

158
Q

Mental illnesses exposing to eating disorders

A

Depression
Anxiety (panic, agoraphobia)
OCD

159
Q

Gold std treatment in anorexia nervosa

A

Psychotherapy

Medication of little value

160
Q

Admission of AN

A

< 65% standard body weight
< 85% for adolescence
Actively suicidal

161
Q

Supplement for prevention of refeeding syndrom

A

Phosphorus

162
Q

Admission for bulimia

A

If lytes abnormalities

163
Q

Binge-eating disorder Tx

164
Q

Bulimia Tx

165
Q

Onset of avoidant/restrictive foof intake disorder

166
Q

Eating disorder with Hx of GI conditions

A

Avoidant/restrictive

167
Q

Avoidant/restrictive treatment

A

Psychoeducation
Behavioral modification
Psychotherapy

168
Q

Important lytes in eating disorder

169
Q

Mainstay of treatment of personality disorders

A

Psychotherapy

170
Q

Personality disorders with familial association

A

Borderline
Antisocial
Schizotypal

171
Q

Borderline with aging

172
Q

Borderline treatment

A

Dialectical behavioral therapy

173
Q

Defense mechanism of borderline

174
Q

Defense mechanism of histrionic

A

Regression

175
Q

Feeling of emptiness

A

Borderline

176
Q

Age of Dx of antisocial

A

Symptoms present before age of 15

Dx age 18

177
Q

Lack of remorse

A

Antisocial

178
Q

Disregard for safety

A

Antisocial

179
Q

Lack of empathy

A

Narcissistic

180
Q

Admiration seeking

181
Q

Attention seeking

A

Histrionic

182
Q

Difficulty making decision

183
Q

Attachment style formation time

A

During 1st year

184
Q

Personality establishment time

A

By adolescence or early adulthood

185
Q

Best predictor of child’s attachment style

A

Caretaker’s attachment style

186
Q

Normal separation anxiety

A

Between 10-18 mo

187
Q

Child depression Tx

A

Psychotherapy

SSRI

188
Q

1st line for children depression

A

Fluoxetine

189
Q

2nd line for children depression

A

Escitalopram

Sertraline

190
Q

Indications for ECT

A 
Adolescents with:
Severe depression
Persistently suicidal
Catatonic
Psychotic
191
Q

BP Tx in children

A

Mood stabilizer
+/- antipsychotics
Psychotherapy

192
Q

Anxiety prognosis in children

A

Better with later onset

193
Q

Eating disorder prognosis

A

Better with earlier onset

194
Q

Anxiety Tx in children

A

Psychotherapy
SSRI ( fluoxetine)
Benzod
If OCD, fluvoxamine, sertraline

195
Q

Separation anxiety duration

196
Q

Common comorbidity associated with separation anxiety

197
Q

Increased rate if remaining single

A

Social anxiety disorder

198
Q

Child who often redoes tasks

199
Q

Associated with Rett

200
Q

Investigations for autism

A 
Hearing test
Vision test
Intellectual functioning
Learning
Chrosomal analysis
201
Q

Autism Tx

A 
Team based
Psychosocial
Tx of concomitant disorders 
SGA (irritation, agitation, aggression, tics, self mutilation)
SSRI (anxiety, depression)
Stimulants ( inattention, hyperactivity)
202
Q

Tx of tics in autism

203
Q

Tx of self-mutilation in autism

204
Q

Good prognosis in autism if

A

Early intervention
IQ> 60
Able to communicate

205
Q

Time of ADHD Dx

A

Onset before 12 y

Symptoms > 6 mo

206
Q

Supplement for ADHD

207
Q

ADHD Tx

A

1st line: stimulants
+/- antidepressant
+/- antipsychotics

208
Q

2nd line for ADHD Tx

A

Atomoxetine

209
Q

3rd line for ADHD Tx

A

Non-stimulants: a-agonists, clonidine, guanfacine, NDRI, bupropione)

210
Q

Time for ODD Dx

A

6 mo

Onset < 8 y

211
Q

ODD vs Conduct disorder

A

Absence of destructive or physically aggressive behavior in ODD

212
Q

Tx of ODD

A

Parent psychoeducation
Behavioral therapy
School interventiobs
Pharmacotherapy if comorbid disorders

213
Q

Onset of conduct disorder

A

Before 10 y: childhood onset

After 10 y: adolescent onset, better prognosis

214
Q

Tx of conduct disorder

A

Early intervention
Psychosocial, CBT
Pharmacotherapy for comorbid disorders

215
Q

Poor prognosis Conduct disorder

A 
Early age onset
High frequency/variety of behaviors
Pervasiveness
Comorbid ADHD
Early sexual activity
Substance abuse
216
Q

Age of diagnosis of intermittent explosive disorder

217
Q

Indication of interpersonal psychotherapy

A

Mood disorder

218
Q

Supportive psychotherapy

A

Adjustment disorder
Psychosomatic
Severe psychotic
Personality disorder

219
Q

Psychotherapy method for low insight individuals, low motivation, weak ego system

A

Supportive

220
Q

Difficult to treat with behavioural psychotherapy

A

Personality disorders

221
Q

Psychotherapy for conversion disorder

A

Psychoanalytic/Psychodynamic

222
Q

Psychotherapy for personality disorders

A

Cognitive therapy

223
Q

Psychotherapy for somatoform disorders

A

Cognitive therapy

224
Q

Psychotherapy method requiring openness to changing core beliefs

A

Cognitive therapy

225
Q

Psychotherapy using mindfulness

226
Q

Psychotherapy for impulsivity

227
Q

Psychotherapy for substance use

A

Motivational interviewing

228
Q

Psychotherapy for obsessional thinking

A

Psychoanalytic/psychodynamic

229
Q

Psychotherapy for sexual dysfunction

A

Psychoanalytic…

230
Q

Response of thought disorder to antipsychotics

231
Q

Treatment refractory psychosis

232
Q

No response to antipsychotic

A

Switch if no response after 4-6 wk

233
Q

Minimum of antipsychotic therapy

234
Q

Acute psychosis management

A

Halopridol +/- lorazepam IM
Loxapine +/- lorazepam
Olanzapine
Risperidone

235
Q

Medications producing obsessive behavior

236
Q

SGA with less weight gain

A

Risperidone
Quetiapine
Aripiprazole

237
Q

SGA which may treat tardive symptoms

238
Q

SGA with less risk of metabolic syndrome

A

Aripiprazole

239
Q

SGA with highest risk of EPS

A

Risperidone

240
Q

SGA with high risk of metabolic effects

A

Olanzapine

Clozapine

241
Q

Most sedating SGA

A

Quetiapine

242
Q

SGA with agranulocytosis

243
Q

SGA with minimal anticholinergic effect

A

Olanzapine

244
Q

Antipsychotics which warrant cardiac monitoring

A

Chlorpromazine
Halopridol
Clozapine
Ziprasidone

245
Q

Onset of acute dystonia

A

Within 5 days

246
Q

Tx of acute dystonia

A

Benztropine

Diphenhydramine

247
Q

Susceptible group to akathisia

A

Elderly female

248
Q

Onset of acute akathesia

A

Within 10 days

249
Q

Tx of acute akathesia

A 
Lorazepam
Propranolol
Diphenhydramine
Dose reduction
Change to lower potency
250
Q

Group susceptible to pseudoparkinsonism

A

Elderly females

251
Q

Onset of pseudoparkinsonism

A

Within 30 days

252
Q

Tx of pseudoparkinsonism

A

Benztropin
Benzod
Reduce dose
Change to lower potency

253
Q

Onset of dyskinasia

254
Q

Tx of dyskinesia

A

None
Try clozapine
Drug D/C
Dose reduction

255
Q

Anantadine

A

Anticholinergic

256
Q

Benztropine

A

Anticholinergic

257
Q

Symptoms made worse by anticholinergics

A

Tardive syndromes

258
Q

Antidepressant not needing taper

A

Fluoxetine

259
Q

Relief of neurovegetative symptoms by antidepressants

260
Q

Relief of emotional/cognitive symptoms by antidepressants

261
Q

Time of increased risk of suicide by antidepressants

A

First 2 weeks

262
Q

Antidepressants not prescribed for children

A

Paroxetine

Venlafaxine

263
Q

Antidep with fewest drug interactions

A

Citalopram

Escitalopram

264
Q

Sleep-wake neutral antidep

A

Citalopram

Escitalopram

265
Q

Safest antidep in pregnancy and breastfeeding

A

Sertraline

266
Q

Antideps for morning

A

Fluoxetine

Paroxetine

267
Q

Sedating antidep

A

Fluvoxamine

268
Q

Antidep with less sexual dysfunction

269
Q

Antidep with risk of seizures

270
Q

Antidep not recommended for anxiety

271
Q

Antidep for seasonal depression

A

SSRI

BUPROPION

272
Q

Antidep for PM

A

Fluvoxamine

273
Q

Tx of coms due to TCA overdose

A

Physostigmine

274
Q

Physostigmine

A

Acetylcholinesterase inhibitor

275
Q

Phenelzine

276
Q

Antidep with less anticholinergic/antihistaminic effect

277
Q

Duloxetine

278
Q

Antidep with discontinuation syndrome

A

Paroxetine
Venlafaxine
Fluvoxamine

279
Q

Onset/duration of antidep discontinuation syndrome

A

1-3 d

1-3 wk

280
Q

Tx of antidep discontinuation syndrome

A

Restart the same dose
Taper over several weeks
Use a drug with longer half-life

281
Q

Alcohol withdrawal symptoms

A 
Tremor
Sweating
Agitation
Anorexia
Cramps
Diarrhea
Sleep disturbance
Seizures
Hallucinations
Delirium
Autonomic hyperactivity (fever, tachycardia, HTN)
282
Q

NMS symptoms

A 
Develops over 24-72 h
1st: mental status change
Fever
Autonomic reactivity
Rigidity
Increased CPK, WBC
Myoglobinuria
283
Q

Serotonin syndrome

A 
Nausea
Diarrhea
Palpitation
Chills
Restlessness
Confusion
Lethargy
Myoclonus
Hyperthermia
Rigor
Hypertonicity
284
Q

Tx of serotonin syndrome

A

D/C

Emergency care

285
Q

Tx of NMS

A 
Supportive
D/C
Hydration
Cooling blanket
Dantrolene
Bromocriptine
286
Q

Antidep discontinuation syndrome

A 
Anxiety
Insomnia
Irritability
Mood lability
Nausea/vomiting
Dizziness
Headache
Dystonia
Tremor
Chills
Fatigue
Lethargy
Myalgia
Flu-like
287
Q

Tests before mood stabilizers

A

CBC, U/A, BUN, Cr, lytes, TSH

ECG (if >45 yr or CVD risk)

288
Q

Before Li

A 
B-hCG
TFT
Seizure/neurologic
Renal
CVD
289
Q

Full effect of mood stabilizers

290
Q

Acute mania

A 
Li
Li+ SGA
Li+ lamotrigine 
Divalproex
Divalproex+ SGA
Carbamazepine
291
Q

BP I depression

A

Li
Li+ SSRI/Divalproex/bupropion
Lamotrigine
Divalproex + Li/SSRI

292
Q

BP maintenance

A 
Li
Li+SGA
Lamotrigine (+ Li for prevention of mania)
Diva
Diva+ SGA
Carbamazepine
Carba+ Li
293
Q

Rapid cycling BPD

A

Divalproex

Carbamazepine

294
Q

Li toxicity

A 
N/V, diarrhea
Cerebellar signs
Drowsiness
Myoclonus
Tremor
UMN signs
Seizures
Delirium
Coma
295
Q

Li toxicity Tx

A 
D/C for several doses
Check Li, BUN, lytes
Begin again at a lower dose
Saline infusion
Hemodialysis if > mmol/L, coma, shock, severe dehydration, no response to Tx after 24 h, deterioration
296
Q

Relative anxiolytics contraindications

A

MDD
Hx of drug/alcohol
Pregnancy/breastfeeding

297
Q

High dose benzodiazepine withdrawal

A

Hyperpyrexia
Seizures
Psychosis
Death

298
Q

Withdrawal onset

A

1-2d (short-acting)

2-4d (long-acting)

299
Q

Withdrawal duration

A

Weeks-months

300
Q

Benzod withdrawal management

A

Taper with long-acting benzod

301
Q

Benzod antagonist

A

Flumazenil

302
Q

Benzod with high dependency

A

Alorazolam

303
Q

Memory loss resolution after ECT

304
Q

ECT contra

A

Increased ICP

within 2 weeks of MI

305
Q

Aerobic exercise indications

A

MDD
PTSD
Schizo

Med (25 decks)

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