Psych Flashcards
Fluctuation between mild depressive and hypomanic symptoms for greater than or equal to two years, with symptoms present at least half the time.
-no more than 2 months of remission
Cyclothymic
5 or more SIGECAPS criteria for 2 weeks or more. But has psychotic features that occur ONLY in the CONTEXT of the Major Depressive episode
MDD w/ psychotic features
Streee related, 1 or more positive symptoms for LESS than one month
Brief psychotic disorder
Mood episode w/ concurrent active-phase symptoms of schizophrenia + 2 or more weeks of delusions or hallucinations in the ABSENCE OF PROMINENT MOOD SYMPTOMS
Schizoaffective
2 or more depressive symptoms lasting 2 or more years w/ no more than 2 months without depressive symptoms
Persistent depressive disorder (dysthymia)
Stages of grief
Denial, anger, bargaining, depression, acceptance
Can occur in any order.
Can you use convulsive therapy in pregnant patients and old people
Yes
Highest suicide risk factor
Previous attempt
Irrational fear of 2 or more specific situations
Agoraphobia
First line tx for Generalized anxiety disorder
Second line tx for Generalized anxiety disorder
First line is CBT, SSRI, SNRI.
Second line is buspirone, TCAs, benzodiazepines
Used to reduce nightmares in PTSD
Prazosin
Trauma disorder that lasts between 3 days and 1 month.
-what therapy is indicated
Acute stress disorder: 3 days- 1 month
Pharm therapy usually not indicated
CBT is indicated
Class C personality disorders
Avoidant, Obsessive compulsive, dependent
Munchausen
Factitious disorder imposed on oneself
Facitous disorder
Symptoms are intentional, motivation is unconscious.
Somatic symptom
Symptoms are unconscious and motivation is unconscious. As opposed to facitious in which symptoms are intentional and motivation is unconscious
Loss of sensory or motor function following acute stressor, but patient doesnt care
Conversion disorder
recurring purging behaviors: laxatives, diuretics, self-induced vomiting, OR binge eating over the last three months. All of this along w/ intense fear of weight gain, body image distortion
Binge-eating/purging type of anorexia nervosa
Primary disordered behaviors include dieting, fasting, and/or over exercising. No recurring purging behaviors or binge eating over last 3 months
Restricting type of anorexia
malnourished patient eats, resulting in increased insulin, hypophosphatemia, hypokalemia, hypomagnesemia, cardiac complications, rhabdomyolysis, seizures
Refeeding syndrome
What med is contraindicated due to seizure risk in bulemics
Buproprion
Transvestism vs transvestic disorder
Transvestism is deriving pleasure from wearing other genders clothes
Transvestic disorder is transvestism that causes significant distress/ functional impairment
When do sleep terrors occur, when there are priods of inconsolable terrow w/ screaming in middle of the night.
Slow-wave/deep (stage N3) non-REM sleep with no memory of the episode, as opposed to nightmares that occur in REM sleep, you remember them
Decreased orexin (hypocretin) production in lateral hypothalamus and dysregulated sleep-wake cycles
Hypnagogic (just before going asleep) hallucinations
Hypnopompic (just before waking up) hallucinations
Narcolepsy
Tx w/ sleep hygiene, stimulants during day, and nighttime sodium oxybate (GHB) (GHB reduces cataplexy episodes by improving nightime sleep)
Stages of change in overcoming addiction
- Precontemplation
- Contemplation
- Preparation/determination
- Action/willpower
- Maintenance
- Relapse
Tx of serotonin syndrome
Cyproheptadine (5HT2 receptor antagonist)
Neuroleptic malignant syndrome has myoglobinuria, fever, encephalopathy, unstable vitals, increeased CK enzymes, muscle rigidity. How to tx
Dantrolene, dopamine agonist like bromocriptine, discontinue the causative agent
TCA overdose
NaHCO3 to help prevent arrythmia, activated charcoal, supportive treatment
Alcohol withdrawal timeline
12-24 hours: autonomic hyperactivity symptoms like tremor, tachycardia, htn
24-48 hours: seizures
48-72 hours: delirium tremens psychotic symptoms and confusion
Withdrawal from barbituates
Delirium, life-threatening cardiovascular collapse
Tx of wernicke-korsakoff
IV vitamin B1 before dextrose
Haloperidol, pimozide, trifluoperiazine, fluphenazine, thioridazine, chlorpromazine
Typical antipsychotics; block dopamine D2 receptor (Increase cAMP)
HAL TRIes to FLy HIGH
Haloperidol, trifluoperazine, fluphenazine are the typical antipsychotics. They have more neurologic side effects (extrapyramidal symptoms)
CHeating THIeves are LOW
Chlorpromazine, thioridazine are low potency typical antipsychotics; more anticholinergic, antihistamine, and alpha 1 blockade effects
Opthalmologic adverse effects of chlorpromazine (low potency typical) and Thioridazine (low potency typical)
Chlorpromazine: corneal deposits
Thioridazine: retinal deposits
Aripiprazole, “apines”, “peridones”
Atypical antipsychotics
Lithium possible moa
Phosphoinositol cascade inhibition
MOA of the GAD drug Buspirone?
Stimulates 5-HT1A receptors
Venlafaxine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran
SNRIs; inhibit 5-HT, and NE reuptake
Duloxetine, milnacipran special use
Fibromyalgia
What antibiotic should you not give a MAO-i with?
Linzolid, due to partial MAO inhibition
Bupropion is an atypical antidepressant; what is its mechanism
Inhibits NE and DA reuptake
Male specific side effect of trazodone
Priapism
Buprenorphine
Sublingual form used to prevent relapse. (Partial agonist)
