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Final Step > Psych > Flashcards

Psych Flashcards

1
Q

How long does a panic attack typically last?

A

10-20 minutes

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2
Q

What type of hallucinations are most common in schizophrenia auditory, visual or olfactory?

A

auditory

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3
Q

What causes anorexic patients to have osteopenia?

A

a decrease in estrogen

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4
Q

When treating psychiatric patients are benzodiazepines used more commonly for acute or chronic treatment?

A

acute

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5
Q

What is the most common precipitating event for posttraumatic stress disorder in women?

A

rape

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6
Q

A patient’s wife complains that he is hypervigilant and has a hyperstartle response. What is the most likely diagnosis?

A

PTSD

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7
Q

Are patients with speci c phobias aware they are strange?

A

Yes

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8
Q

A patient complains of having suddenly developed stage fright. It is very important to his career that he be able to speak in front of groups. What medication might you treat him with?

A

Beta Blocker - Propanolol

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9
Q

A doughnut shaped burn should make you think of what issue?

A

Abuse either child or elder

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10
Q

What is the generic name for Prozac?

A

Fluoxetine

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11
Q

How long must symptoms last before diagnosing ADD?

A

6 months

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12
Q

A patient’s mother has recommended that he see you. He lives on his own and is a computer programmer. He works from home. He has no friends and seldom leaves the house. She is concerned that clearly, he would like to meet people, but he is terrified of doing so. What is the most likely diagnosis?

A

Avoidant personality disorder

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13
Q

A 6 year old boy seems to have all of the symptoms of ADD while at school, but at home he has no problems. Does he have ADD?

A

No, symptoms must occur in both settings for diagnosis.

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14
Q

An 18 month old is not yet speaking. He does not point to objects. He does not make eye contact with others. What is the most likely diagnosis?

A

Autism

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15
Q

List three positive symptoms of schizophrenia.

A

Hallucinations, delusions, movement disorders

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16
Q

When is the typical onset of Tourette’s syndrome?

A

3- 8 years old

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17
Q

Is anorexia egosyntonic or ego-dystonic? What about bulimia?

A

Anorexia is egosyntonic. Bulimia is ego-dystonic.

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18
Q

List 3 cluster A personality disorders

A

odd and eccentric - “Mad” schizoid, schizotypal and paranoid

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19
Q

How long does menstruation need to be absent before secondary amenorrhea can be diagnosed?

A

If cycles have been previously normal: 3 months. If cycles have been previously irregular: 6 months.

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20
Q

A 16-year-old has just moved schools. He is quiet, moody and not like himself at all. Within six months he seems to have completely changed back to his previous personality. What is the most likely diagnosis?

A

Adjustment disorder

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21
Q

ou have a patient with major depressive disorder. Once his symptoms have completely resolved how long should you continue with treatment?

A

A six month minimum is recommended due to very high relapse rates.

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22
Q

What medication is often used to treat postpartum depression in a woman who is breastfeeding?

A

Sertraline (Zoloft)

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23
Q

A patient has very strange magical thinking. What is the most likely diagnosis?

A

Schizotypal personality disorder

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24
Q

List four symptoms of serotonin syndrome.

A

Hyperthermia!, seizure, mental status change, tremor

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25
Q

What is the term for a chronic mild depression which has lasted greater than two years?

A

Dysthymia

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26
Q

What is necessary to diagnose a patient with bipolar 1?

A

One manic episode. They do not have to have the depressive episode for the diagnosis.

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27
Q

What is the major concern with using lithium?

A

It has a very narrow therapeutic window. Blood tests are needed every four weeks.

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28
Q

A patient believes that her 15 year old daughter is sleeping with the mailman. She has no evidence of this. She has confronted her daughter who denies it. It is not interfering with her daily activities, but she does spend time thinking about it. What is the most likely diagnosis?

A

Delusional disorder

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29
Q

At what BMI should a patient be hospitalized for anorexia?

A

BMI of <17.5 or 20% below appropriate body weight

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30
Q

What is the term for being afraid of being out in a terrible situation with no help available?

A

Agoraphobia

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31
Q

Borderline personality disorder is on the border of what two psychological disorders?

A

Neurosis and psychosis

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32
Q

Waxy fexibility should make you think of what diagnosis?

A

Catatonic schizophrenia

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33
Q

How long before normal grief resolves?

A

about 1 year

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34
Q

A patient of yours always craves attention, often using sex as a tool to gain it. She often acts like a child when she does not get her way? What is the most likely diagnosis?

A

Histrionic personality disorder

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35
Q

What is Russell’s sign?

A

Abraded knuckles from forcing oneself to vomit.

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36
Q

Posturing should make you think of what diagnosis?

A

Catatonic depression

37
Q

A patient complains of acute paralysis in his left arm. This does not seem to bother him, but his wife made him come in. There was no traumatic event. A complete neurologic workup is negative. What is the most likely diagnosis?

A

Conversion disorder

38
Q

A psychiatric patient presents with confusion, fever and lead pipe rigidity. What is the most likely diagnosis?

A

Neuroleptic malignant syndrome, this can occur with high dose antipsychotics.

39
Q

What is the time frame for the first symptoms of withdrawal from alcohol?

A

Tremor 8-18 hours

40
Q

How do you treat alcohol withdrawal?

A

Benzodiazepines

41
Q

List the four cluster B personality disorders.

A

Dramatic, emotional and erratic “Bad” antisocial, borderline, histrionic and narcissistic

42
Q

List the two cluster C personality disorders.

A

Anxious & Fearful “Sad” avoidant, obsessive-compulsive, and dependent

43
Q

What medication is clearly contraindicated in anorexia and bulimia?

A

Bupropion (Wellbutrin) because it can increase risk of seizures.

44
Q

What two psychiatric issues are more common in males than females?

A

Autism and ADD, the rest are all either equal or more common in females.

45
Q

A patient’s mother has recommended that he see you. He lives on his own and is a computer programmer. He works from home. He has no friends and seldom leaves the house. She is concerned that he expresses no interest in meeting people and seems perfectly happy to be home alone all the time. What is the most likely diagnosis?

A

Schizoid personality disorder

46
Q

Name three SSRI’s

A

Fluoxetine, paroxetine, sertraline, citalopram, escitalopram, dapoxetine, zimelidine, mesembrine, seproxetine

47
Q

A patient expresses concern that he can’t trust anyone. That everyone is out to get him, and his problems are all the faults of others. He has held very long grudges due to perceived past wrongs. What is the most likely diagnosis?

A

Paranoid personality disorder

48
Q

A patient is very charming during his interview. You note during your interview that he has no concern for hurting or using other people. He seems to show no remorse for any of his actions. What is the most likely diagnosis?

A

Antisocial personality disorder

49
Q

Antisocial personality disorder may not be diagnosed until what age?

A

18 years old

50
Q

A patient exhibits all of the characteristics of antisocial personality disorder, but he is only 14 years old. What is the most likely diagnosis?

A

Conduct disorder

51
Q

A patient exhibits splitting, seeing others as all good or all bad. What is the most likely diagnosis?

A

Borderline personality disorder

52
Q

What type of behavioral therapy works best for borderline patients?

A

Dialectical behavior therapy

53
Q

A patient is arrogant with an infated self image. He feels he is special and should be treated that way. What is the most likely diagnosis?

A

Narcissistic personality disorder

54
Q

What two things are needed to make a diagnosis of bipolar 2?

A

One major depressive episode and one hypomanic episode

55
Q

What medication is a good place to start treating bipolar 1 or 2?

A

lithium

56
Q

How is acute stress disorder different than posttraumatic stress disorder?

A

Acute stress disorder occurs within 1 month of event and resolves within about a month. PTSD begins at about 1 month after event and can last indefnitely.

57
Q

A spiral fracture should make you think of what issue?

A

Abuse, either child or elder

58
Q

During an interview a patient states “I have been anxious for as long as I can remember.” This statement should make you think of what diagnosis?

A

Generalized anxiety disorder

59
Q

Are hallucinations normal during a normal grieving period?

A

Yes, as long as they are not persistent or intrusive.

60
Q

Is Naloxone an opioid antagonist or agonist?

A

opioid antagonist

61
Q

What does opioid withdrawal look like?

A
62
Q

Side effects of lithium

A

wt gain, tremor, nausea, inc thirst, and urination, & risk of renal insufficiency, drowsiness, hypothyroidism, arrhythmias and seizures

63
Q

what medications can precipitate mania?

A

antidepressants

64
Q

Pt always appears to be in a state of crisis, what is the Dx?

A

Borderline personality disorder

65
Q

what can be a treatment for borderline personality disorder?

A

dialectical behavior therapy

66
Q

pt has intense social anxiety and feels inadequacy, they are shy and has great desire for companionship. Have a fear of rejection, what do they have

A

avoidant disorder

67
Q

which SSRIs can be helpful in managing anxiety?

A

Paroxetine, sertraline or escitalopram

68
Q

What is the recommended tx for cyclothymia?

A

Olanzapine

69
Q

What is recommended for alcohol abuse; seeing alcohol withdrawal sx - after 2-3 days?

A

Long-acting benzodiazepine like Chlordiazepoxide

70
Q

what is first-line treatment schizophrenia?

A

Atypical (SGA) Antipsychotics like Olanzapine

71
Q

what kind of med does a person with delusional disorder get?

A

SGA - Apiprazole

72
Q

what lab will you see increased in bulimia?

A

Amylase

73
Q

what will diagnostic studies look like for Bulemia?

A

metabolic alkalosis, urinary chloride < 20 mEq, hypokalemia

74
Q

what is Exhibitionistic Disorder

A

Sexual gratification obtained by exposing genitals to unsuspecting strangers

75
Q

Fetishistic Disorder

A

A paraphilic disorder consisting of recurrent and intense sexual urges, fantasies, or behaviors that involve the use of a nonliving object or nongenital part, often to the exclusion of all other stimuli, accompanied by clinically significant distress or impairment. (people who are attracted to toes)

76
Q

Sexual Masochism Disorder

A

A paraphilic disorder characterized by repeated and intense sexual urges, fantasies, or behaviors that involve being humiliated, beaten, bound, or otherwise made to suffer

77
Q

Voyeuristic Disorder

A

A paraphilic disorder in which sexual arousal is derived from observing unsuspecting individuals undressing or naked

78
Q

what can you use to asses OCD?

A

Yale-Brown Obsessive Compulsive Scale

79
Q

What medication should be given with the haloperidol to reduce the risk of severe extrapyramidal symptoms including dystonias?

A

diphenhydramine or benztropine to minimize the risk

80
Q

how does bupropion work

A

acts by inhibiting dopamine and norepinephrine reuptake

81
Q

What TCA can you use for post-herpetic neuralgia?

A

Amitriptyline

82
Q

what MAOI can you give for refractory depression?

A

Phenelzine

83
Q

what can you get with MAOI and tyramine containing food?

A

hypertensive emergency/ urgency

84
Q

pt has hypothermia, AMS and clonus, what do they have?

A

serotonin syndrome

85
Q

how do you treat diabetes inspidus induced by lithium?

A

amiloride

86
Q

what should you monitor with carbamazepine?

A

CBC for agranulocytosis

87
Q

main side effect for valproic acid?

A

pancreatitis

88
Q

what is common SE of Thioridazeon (1st gen antipsychotic)

A

irreversible retinitis pigmentosa

89
Q

what is a first-line treatment for generalized anxiety disorder?

A

Venlafaxine and SNRI

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