Psych - Case Files, UW, etc. Flashcards
What is the risk of recurrence of a major depressive episode if SSRIs or other treatments are discontinued?
50-85%
What are the major side effects of SSRIs?
GI sx (pain, nausea, diarrhea), sleep disturb (sedation or insomnia), tremor, dizzy, sex dysfunction
What is retinitis pigmentosa, and which psychiatric medication can cause this disorder?
Pigmentation of retina that may cause poor night vision
Side effect of first generation AP Thioridazine
What is an appropriate treatment of priapism from Trazadone?
Epinephrine injection into corpus of penis
What are contraindications for using bupropion?
Patients with eating or seizure disorder
What are symptoms of life threatening lithium overdose, and how do you best treat?
Seizures and coma
Dialysis to treat
What can be useful for excessive daytime sleepiness in shift workers?
Modafinil
What must be ruled out to make a diagnosis of schizophrenia?
Psychosis secondary to substance abuse and or general medical conditions
Schizoaffective DO and mood DO must be R/O
What symptom is most specific to a diagnosis of schizophrenia?
Bizarre delusions
What symptom is most specific to a diagnosis of schizophrenia?
Bizarre delusions
What is the immediate treatment for panic attacks? Long term treatment for panic disorder?
- Short acting benzo (alprazolam) - discontinue after initial few weeks
- SSRI + CBT
What is the definition of agoraphobia?
Anxiety about being in situations or places from which escape will be difficult, or in which help may not come if panic attack occurs
What differentiates social phobia vs. specific phobia?
Social phobia involves social or performance situations while specific involves a specific object or situation
How can ADHD be differentiated from hypo mania?
ADHD has distractibility, impulsivity and hyperactivity present on daily basis since age 7 (also look for preschool age sx)
And often oppositional defiant disorder and conduct disorder present
What needs to be monitored closely in patients taking lithium or carbamazepine?
Li - thyroid and kidney fxn
Carba - aplastic anemia or agranulocytosis
What mood stabilizers are a better option in young women of child bearing age?
Atypical APs - olanzapine risperidone seroquel
How can one differentiate schizoid PD from avoidant?
Avoidant find loneliness as ego-dystonic and strongly wish for relationships with others
Schizoid do not feel need for relationships at all
What defense mechanism is frequently seen in schizoid PD?
Intellectualization
What is the best course of therapy for major depression with psychotic features? (Especially in elderly with SI)
ECT
What medical conditions should raise caution before doing ECT?
Raised ICP, unstable angina, recent MI, electrolyte imbalance
What pharma tx can be given for anxiety associated with performance situation just before the feared situation?
Beta blockers - atenolol and propranolol
What are typical exam findings of PCP intoxication?
Angry, belligerent, dysarthria, vertical nystagmus
How does treatment for PCP intoxication vary based on the symptoms?
Benzodiazepines if psychotic symptoms not present
Haldol if severe psychosis but this may worsen anti-cholinergic side effects, hyperthermia, dystonia
What should be avoided in patients with generalized anxiety disorder?
Benzodiazepines, because habit forming and will make buspirone and to lesser extent SSRIs less effective