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1
Q

DSM criteria for MDD?

A

Depressed mood and/or anhedonia for at least 2 weeks.

SIGECAPS

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2
Q

What does SIGECAPS stand for?

A 
Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor agitation or retardation
suicidal agitation
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3
Q

What are the contraindications to Bupropion? (Wellbutrin)

A

Hx of anorexia or seizure disorder

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4
Q

What is the treatment of serotonin syndrome?

A

BZDs, Crytohepatdine, and removing the offending agent

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5
Q

What is the criteria for adjustment disorder?

A

develops less than 3 months after a stressor and resolves within 6 months.

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6
Q

What are the only psychotropic medications FDA approved for use in a child/adolescent diagnosed withautism?

A

Risperdal and Abilify

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7
Q

What is the first line treatment for ADHD?

A

Methylphenidate

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8
Q

How do you treat lithium induced DI?

A

Amiloride

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9
Q

What heart findings is commonly found in patients with anorexia?

A

Sinus bradycardia

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10
Q

What is the triad of Wernicke Encephelopathy?

A

Confusion, ataxia, oculomotor dysfunction

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11
Q

What is cyclothymic disorder?

A

Multiple episodes of hypomanic and depressive symptoms that cannot be diagnosed as hypomanic episodes of major depressive episodes.

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12
Q

What is the difference between acute stress disorder and PTSD?

A

Acute stress disorder is less than one month, PTSD is greater than one month

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13
Q

What is the DOC for nocturnal enuresis?

A

TCAs

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14
Q

What is the major inhibitory neurotransmitter?

A

GABA

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15
Q

What is the MOA of barbiturates?

A

They bind to the GABA receptor and stimulate chloride influx, INDEPENDENT of GABA. Because it is independent of GABA, there is no ceiling effect.

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16
Q

What are the side effects of of Barbiturates?

A

CNS depression (drowsiness, distortion of mood), Paradoxical excitement, and psychological and physiological dependence

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17
Q

Brand name of Zolpidem.

A

Ambien

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18
Q

Brand name of Zaleplon.

A

Sonata

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19
Q

Brand name of Eszopiclone.

A

Lunesta

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20
Q

What is the MOA of the “Z drugs?”

Zolpidem, Zaleplon, and Eszoplicone

A

Bind to BZ subtype of the GABA receptor to increase GABA mediated inhibition

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21
Q

Side effects of Z drugs?

A

Sleep related behaviors, drowsiness, GI upset, rebound insomnia

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22
Q

What anticonvulsants have a high risk of stevens johnsons?

A

Drugs that block Na+ channels -Carbamazepine, lamotrigine, Phenytoin, and valproate

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23
Q

Side effects of Depakote?

A

GI upset, weight gain, hepatotoxicity (checking LFTs required)

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24
Q

Side effects of Lamotrigine?

A

Dizziness, HA, somnolence, GI upset, skin rash, SJS

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25
Q

What kind of drugs affect both positive and negative symptoms of schizophrenia?

A

Atypical antipsychotics. Classic antipsychotics only affect positive symptoms.

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26
Q

What are the two classical antipsychotics?

A

Chlorpromazine and Haldol

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27
Q

What are the side effects of Olanzapine?

A

Sedation, weight gain, orthostatic hypotension, hyperglycemia, and diabetes (Zyprexa diabetes)

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28
Q

What are the 3 cluster A personality disorders?

A

Schizoid PD, schizotypal PD, and Paranoid PD

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29
Q

What is schizoid PD?

A 
Lifelong pattern of voluntary social withdrawal and anhedonic introversion, most common in males
AVOID:
Anhedonic
Voluntary social withdrawal
Odd and eccentric
Introverted
Detached
30
Q

What are the cluster B disorders?

A

Antisocial, borderline, histrionic, and narcissistic

31
Q

What are the Cluster C disorders?

A

Avoidant, dependent

32
Q

What personality disorder is this: behaviors deviating from norms, values, and laws of society. May commit criminal acts. Disregard and violation of the rights of others.

A

Antisocial PD

33
Q

What is the difference between schizophreniform and schizophrenia?

A

Schizophreniform symptoms last between 1 and 6 months. Schizophrenia lasts more than 6 months.

34
Q

What is schizoaffective disorder?

A

Schizophrenia + mood disorder (major depressive or manic episode)

35
Q

What is neuroleptic malignant syndrome?

A

life-threatening reaction to antipsychotic drugs characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction.

36
Q

What kind of hallucination is most common in schizophrenia?

A

Auditory

37
Q

What is tardive dyskinesia?

A

Repetitive involuntary movements mostly involving the face (lip smacking, teeth grinding) seen with long term antipsychotic use

38
Q

What is the management for neuroleptic malignant syndrome?

A

discontinue drug, supportive care. Dopamine agonists (bromocriptine), Dantrolene for fever and rigidity

39
Q

What is the difference between Factitious disorder and malingering?

A

Factious disorder is not for external reward, but primary gain is to be seen as injured or ill. Malingering is for external reward (money, drugs)

40
Q

What is delirium tremens?

A

DT is defined by hallucinations, disorientation, tachycardia, hypertension, hyperthermia, agitation, and diaphoresis in the setting of acute reduction or abstinence from alcohol.

41
Q

What is considered rapid cycling in bipolar disorder?

A

Having 4 or more episodes in one year

42
Q

What is the main cause of positive symptoms in schizophrenia?

A

Excess dopamine in the mesolimbic tract (antipsychotics block D2 receptors)

43
Q

What causes Wernicke-Korsakoff syndrome?

A

Complication of thiamine deficiency from alcoholism

44
Q

What is the treatment for wernickes encephalopathy?

A

immediate parenteral administration of thiamine

45
Q

What is Korsakoff syndrome?

A

A chronic complication of Wernickes encephalopathy characterized by anterograde and retrograde amnesia.

46
Q

What kind of drugs are Phenelzine, Tranylcypromine, and isocarboxazid?

A

MAOIs

47
Q

Phenelzine brand name?

A

Nardil

48
Q

What is the MOA of MAOIs?

A

Blocks the breakdown of NTs by inhibiting monoamine oxidase.

49
Q

What is the MOA of cocaine?

A

Produces a stimulant effect via inhibition of the rey-take of DA, NE, and Epi in the synaptic cleft

50
Q

What is male/female hypoactive sexual desire disorder?

A

Lack of sexual thoughts/desires for >6 months, causes distress, and not the result of disease or drug

51
Q

What is the treatment for male hypoactive sexual desire disorder?

A

Psychosocial therapy or medications (Wellbutrin or testosterone)

52
Q

What is the treatment for female sexual interest/arousal disorder?

A
  • if interest, but no lubrication: treat underlying cause and artificial lubricants
  • Flibanserin (Serotonin, DA, and NE modulator)
  • Psychosocial therapy
53
Q

What is genito-pelvic pain/penetration disorder?

A

Persistent difficulties in one of the follow for >6 months

  • vaginal penetration during intercourse
  • marked vulvovaginal or pelvic pain during intercourse
  • marked anticipatory fear or anxiety about pain
  • marked tension or tightening of pelvic floor during attempted penetration
54
Q

What is Exhibitionism disorder?

A
  • Indecent exposure or flashing, usually male to female
  • recurrent, intense, sexually arousing fantasies, urges, or behaviors that involve exposing their genitals to unsuspecting strangers, evoking shock and fear in victim.
55
Q

Before what day of alcohol sobriety is delirium tremens uncommon?

A

day 3

56
Q

What is the MOA of methylphenidate?

A

Blocks re-uptake and increases NE and DA in the extra neuronal space, leading to increased attention

57
Q

What is the treatment for BPD?

A

-There are no proven therapies to reduce severity of BPD, but most promising is DBT. SSRIs are not recommended

58
Q

What electrolytes are depleted in referring syndrome?

A

Phosphate and magnesium

59
Q

Blockade of which receptor helps to reduce the incidence of extrapyramidal effects?

A

Muscarinic ACh receptors

60
Q

What is superior mesenteric artery syndrome?

A

Loss of the fat pad surrounding the superior mesenteric artery in severe anorexia nervosa which leads to compression of the third portion of the duodenum between the superior mesenteric artery and the aorta, causing a small bowel obstruction.

61
Q

What lab is often elevated in patients with bulimia nervosa?

A

Amylase, due to hyper secretion from salivary glands. Amylase levels may offer a rough estimate of purging activity or the presence of purging in patients who deny this behavior.

62
Q

What two antipsychotics are least likely to cause weight gain?

A

Abilify (aripirazole) and Geodon (ziprasidone)

63
Q

What medication do you give to treat benzodiazepine withdrawal?

A

Slow taper of Diazepam

64
Q

What medications can be given for delusional disorder?

A

Second-generation antipsychotics such as aripiprazole or ziprasidone should be initiated at a low dose and increased slowly to make sure that effects are tolerable and provide relief.

65
Q

What is the MOA of THC?

A

partial agonist at both the cannabinoid 1 and cannabinoid 2 receptors

66
Q

When administering Haldol, what medications can be given to help avoid EPS?

A

Benadryl or Benztropine

67
Q

What is considered early remission in regards to alcohol use?

A

If the patient has been sober for three to twelve months.

Sustained remission is more than 12 months.

68
Q

What is the treatment of DTs?

A

Fluids, benzos

69
Q

What is the MOA of varenicline?

A

Partial nicotinic receptor agonist, prevents nicotine stimulation of mesolimbic dopamine system associated with nicotine addiction.

70
Q

What is the MOA of PCP?

A

NMDA receptor antagonist

71
Q

Which SSRIs are most likely to cause prolonged QT?

A

Celexa and Lexapro

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