PSYCH COMAT Flashcards
SSRI Drugs Tx …AR …
“City Parrots Flu South”CitalopramParoxetineFluoxetineSertalineTx: First-Line for Antidepressants AR: Dec libido, delayed ejaculation, GI dysfxn, Insomnia, Seretonin Syndrome
SNRI Drugs
“SN … Venla Dulo”VenlafaxineDuloxetineCleaner but more expensive than SSRI
TCA Drugs
-“tryptiline”ImipramineDespiramineDoxepin
Bipolar Tx
Lithium or Valproate»_space; Add 2 gen Anti-psych»_space; d/c previous, use Lamotrigine (anticonvulsant)
Bupropion Class/Use/Adverse Reaction
Class: 2nd Gen AntipsychTx: Smoking cessation/DepressionAR: Dec seizure thresholdDO NOT GIVE TO ANOREXIC/BULIMIC PTS!
Smoker w/ Depression, Tx w/ …
Bupropion
Depression w/ weight loss/under weight, Tx w/ …
Mirtazapine
Depression w/ Insomnia, Tx w/ …
TrazadoneAR: Priapism
Atypical Anti-Psyche with low metabolic effects
Aripiprazole and Lurasidone
Atypical Anti-Psyche MOA and Rx
D2 Antagonist and Seretonin AntagonistQuiet CARBOLIC ZAPQuetipineCariprazineAriprazoleRisperadoneBupropionOlanzapinelurasidoneIloperidoneClozapine ZiprazidoneAsenapinePaliperadone
How to abort a panic attack
Tx w/ Benzo
Munchausen by proxy is suspected, next step …
call CPS
Polycyclic Aromatic Hydro carbons found in … bind to … and causes … in antipsychotic meds, most notably …
NicotineAHRInduction of the P450 1A2 metabolismOlanzapine
MDD w/ cc of memory impairment and cognitive impairment
Pseudodementia
Dx criteria of MDD
SIGECAPSAt least 4 of the following for 2 weeks + Low moodSleepInterestGuiltEnergyConcentrationAppetite PsychomotorSuicide
NMS presents with…
FeverRigidMydriasisCreatine KinaseD/T Anti-dopamine Med
Seretonin Syndrome presents w/ …
Hyperreflex/ClonusMydriasis+/- Elevated CKD/T Seretonin Drugs
Pt lives vicariously by helping others
Altruism Mature Defense
Pt jokes with his Palliative care doctor about the disease
Humor Mature Defense
Pt shifts the blame and justifies his actions for the disease
RationalizationNeurotic Defense
Pt seems emotionless about his condition and reasons out the cause
Intellectualization Neurotic Defense
The Pt is adamant that they are in excellent health despite an A1c of 12
DenialImmature Defense
Pt is angry with his nurse and reports to the doctor that he is being treated poorly d/t the anger the nurses have for him
ProjectingImmature Defense
Pt w/ OCD is given an SSRI. Little effect occurs. In addition to CBT, the Pt should be perscribed …
Clomipramine (TCA)
Tx for PTSD related nightmares
Prazosin
Motor immobility w/ mutism. Vitals Normal. Hx of schizophrenia. Dx?
Catatonia
First line Tx for PTSD
SSRI
First line Tx for Tourette
Aripiprazole
Specific phobia w/ highest FamHx
Injections/needles
Alpha-synuclein inclusions are found in
Lewy BodiesParkinson’s
Pt has trisomy 21 and neurofibrillary tangles. Dx?
Early onset Alzheimers
Volume loss in Caudate Nucleus and choreoathetoid movements. Dx?
Huntington
Most common metabolic abnormality w/ bulimic pt.
Non Gap Metabolic Alkalosis w/ resp compensation +hypokalemia +Increased Amylase
To interact w/ this personality disorder, you must monitor your emotions to avoid countertransference
Borderline
Unstable, suicidal, promiscuous, rapid mood change “empty”
Borderline
Dopamine pathway that controls function and movement
Nigrostriatal
Dopamine pathway that controls pleasure, delusions and hallucinations
Mesolimbic
Dopamine pathway that controls prolactin secretion
Tuberfundibular
Dopamine pathway that controls Cognitive and Affective Sx
Mesocortical
Cognitive Sx arise from this area of the brain, be specific
Dorsal Lateral Prefrontal Cortex
Affective Sx arise from this area of the brain, be specific
Ventromedial Prefrontal Cortex
Loss of the caudate nucleus results in …
Huntington Disease
Loss in the frontal and temporal lobes results in …
Frontaltemporal Dementia
Loss of the Substantia Nigra leads to
Parkison’s and Lewey Body Dementia
Diffuse cerebral atrophy leads to
Alzheimers
Diffuse spongiform lesions in the brain
Creutzfeldtz Jakob
Pt is increasingly irritable, decreased concentration, and has constipation, what electrolyte is out of balance
Hypercalcemia
Pt on a three month binge presents w/ two months of low mood and Pos SIGECAPS, Dx ?
Substance induced mood disorder
What anticonvulsant is safe in pregnancy
Lamotrigine
Tx for Impulse Control Disorders
Psychotherapy
Inappropriate sexual behavior in children may be d/t …
Sexual abuse
Schneideran First Rank Symptoms (7)
Thought Insertion, Thought W/DThought BroadcastingDelusional PerceptionVoice CommentaryVoice DiscussionAudible Thoughts
EtoH w/d is life threatening d/t this feedback mechanism
Down regulation of GABA receptors
Pt loves blood, so he becomes a phleb.
SublimationMature Defense
Pt, who is a lawyer, gets yelled at by the judge. Later, the pt yells at his wife.
DisplacementNeurotic Defense
Man w/ a sexual addiction becomes a priest
Reaction FormationNeurotic Defense
MDD second to substance abuse, no SIHI. Next step?
Rehabilitation program
Why are pts hospitalized for psych issues
Danger to self or others
Pt believes a famous person is in love w/ them
Erotomania (Erotomanic Delusion)
Pt describes secret messages from Washington in songs on the radio.
Delusion of Reference
What is Amylase increased in bulemic pts
Parotid glands are over active d/t repeat emesis
Major difference b/t acute stress disorder and adjustment disorder
Acute stress involves a traumatic stressor