Psych Flashcards
Medical causes of psychosis?
CNS injury (trauma, mass, infection, CVA, seizure) Metobolits - Porphyria, Wilson's) Systemic dz (SLE, thyroiditis)
What is one problem with taking St. John’s wort?
Drug-drug interactions, especially making OCPs less effective
Does seems to have some efficacy of mild-to-moderate depression
Which SSRIs can be activating?
Fluoxetine, Buproprion
anxiety that is persistent x 6 month
General anxiety disorder
anxiety that is episodic
Panic disorder
Common side effects when starting a SSRI
GI (nausea) and activating syx
Self-limiting
If a pt shows improvement on max dose of an SSRi but not full resolution of depressive syx, what can you do?
You can add a second agent ( like a SNRI)
What are good prognostic factors in schizophrenia
Acute onset
Older age at onset
Having predominant positive symptoms
Early intervention
What is the difference between acute stress disorder and PTSD
Acute stress is 3-30 days past the traumatic event
PTSD is when syx are for > 1 month
What should be considered before starting varenicline
Psych history and h/o SI
Has a neuropsychiatric side effects
Tourette’s is associated with what two other psych conditions?
OCD
ADHD
Non medication intervention for OCD?
Exposure and response prevention therapy
Medication to reduce alcohol cravings
Naltrexone
Can be initiated in ppl that are still drinking but not on opioids
Treatment for catatonia
Benzo or ECT
Tx for Tourettes ?
Second gen anti psychotics (risperidone, aripiprazole), these are preferred because of favorable side effect profile
Which antihypertensives can raise lithium levels?
Thiazides
ACEI/ARB
Seems like the ones that act on the kidney raise Lithium
How do antipsychotics affect the mortality of elderly pts
Increases risk of mortality, but sometimes the benefits of short term use out weigh the risks
Intoxication with bizare behaviors and agitation lasting 8 hours
PCP intox
Do better with benzos
When do you need to HD lithium toxicity?
Li >4
Or >2.5 in the setting of renal failure
What age is it typical to see kiddos with night terrors?
Usually age 4-12
Looks like a seizure but no accidents
Self-resolves in 1-2 years
When a patient has anxiety and is fixated on >1 somatic symptoms
Somatic symptom disorder
pt on antipsychotics has the feeling of restlessness and can’t sit still. Dx Tx?
Akathesia
Propanolol or reduce dose of anti psychotic
How long does a patient have to wash out from an SSRI before starting an MAOI
5 weeks
if too soon, they’re at risk of serotonin syndrome
1st line SSRI in breastfeeding mothers?
Sertraline or paroxetine
What needs to be monitored in a patient taking clozapine?
Neutrophil counts
Increased risk of neutropenia
After a patient gets halloo they have torticolis. What wrong?
Acute dystonia
Give Benadryl
