PSYCH COMAT Flashcards
1
Q
SSRI Drugs Tx …AR …
A
“City Parrots Flu South”CitalopramParoxetineFluoxetineSertalineTx: First-Line for Antidepressants AR: Dec libido, delayed ejaculation, GI dysfxn, Insomnia, Seretonin Syndrome
2
Q
SNRI Drugs
A
“SN … Venla Dulo”VenlafaxineDuloxetineCleaner but more expensive than SSRI
3
Q
TCA Drugs
A
-“tryptiline”ImipramineDespiramineDoxepin
4
Q
Bipolar Tx
A
Lithium or Valproate»_space; Add 2 gen Anti-psych»_space; d/c previous, use Lamotrigine (anticonvulsant)
5
Q
Bupropion Class/Use/Adverse Reaction
A
Class: 2nd Gen AntipsychTx: Smoking cessation/DepressionAR: Dec seizure thresholdDO NOT GIVE TO ANOREXIC/BULIMIC PTS!
6
Q
Smoker w/ Depression, Tx w/ …
A
Bupropion
7
Q
Depression w/ weight loss/under weight, Tx w/ …
A
Mirtazapine
8
Q
Depression w/ Insomnia, Tx w/ …
A
TrazadoneAR: Priapism
9
Q
Atypical Anti-Psyche with low metabolic effects
A
Aripiprazole and Lurasidone
10
Q
Atypical Anti-Psyche MOA and Rx
A
D2 Antagonist and Seretonin AntagonistQuiet CARBOLIC ZAPQuetipineCariprazineAriprazoleRisperadoneBupropionOlanzapinelurasidoneIloperidoneClozapine ZiprazidoneAsenapinePaliperadone
11
Q
How to abort a panic attack
A
Tx w/ Benzo
12
Q
Munchausen by proxy is suspected, next step …
A
call CPS
13
Q
Polycyclic Aromatic Hydro carbons found in … bind to … and causes … in antipsychotic meds, most notably …
A
NicotineAHRInduction of the P450 1A2 metabolismOlanzapine
14
Q
MDD w/ cc of memory impairment and cognitive impairment
A
Pseudodementia
15
Q
Dx criteria of MDD
A
SIGECAPSAt least 4 of the following for 2 weeks + Low moodSleepInterestGuiltEnergyConcentrationAppetite PsychomotorSuicide
16
Q
NMS presents with…
A
FeverRigidMydriasisCreatine KinaseD/T Anti-dopamine Med
17
Q
Seretonin Syndrome presents w/ …
A
Hyperreflex/ClonusMydriasis+/- Elevated CKD/T Seretonin Drugs
18
Q
Pt lives vicariously by helping others
A
Altruism Mature Defense
19
Q
Pt jokes with his Palliative care doctor about the disease
A
Humor Mature Defense
20
Q
Pt shifts the blame and justifies his actions for the disease
A
RationalizationNeurotic Defense
21
Q
Pt seems emotionless about his condition and reasons out the cause
A
Intellectualization Neurotic Defense
22
Q
The Pt is adamant that they are in excellent health despite an A1c of 12
A
DenialImmature Defense
23
Q
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
A
ProjectingImmature Defense
24
Q
Pt w/ OCD is given an SSRI. Little effect occurs. In addition to CBT, the Pt should be perscribed …
A
Clomipramine (TCA)
25
Tx for PTSD related nightmares
Prazosin
26
Motor immobility w/ mutism. Vitals Normal. Hx of schizophrenia. Dx?
Catatonia
27
First line Tx for PTSD
SSRI
28
First line Tx for Tourette
Aripiprazole
29
Specific phobia w/ highest FamHx
Injections/needles
30
Alpha-synuclein inclusions are found in
Lewy BodiesParkinson's
31
Pt has trisomy 21 and neurofibrillary tangles. Dx?
Early onset Alzheimers
32
Volume loss in Caudate Nucleus and choreoathetoid movements. Dx?
Huntington
33
Most common metabolic abnormality w/ bulimic pt.
Non Gap Metabolic Alkalosis w/ resp compensation +hypokalemia +Increased Amylase
34
To interact w/ this personality disorder, you must monitor your emotions to avoid countertransference
Borderline
35
Unstable, suicidal, promiscuous, rapid mood change "empty"
Borderline
36
Dopamine pathway that controls function and movement
Nigrostriatal
37
Dopamine pathway that controls pleasure, delusions and hallucinations
Mesolimbic
38
Dopamine pathway that controls prolactin secretion
Tuberfundibular
39
Dopamine pathway that controls Cognitive and Affective Sx
Mesocortical
40
Cognitive Sx arise from this area of the brain, be specific
Dorsal Lateral Prefrontal Cortex
41
Affective Sx arise from this area of the brain, be specific
Ventromedial Prefrontal Cortex
42
Loss of the caudate nucleus results in ...
Huntington Disease
43
Loss in the frontal and temporal lobes results in ...
Frontaltemporal Dementia
44
Loss of the Substantia Nigra leads to
Parkison's and Lewey Body Dementia
45
Diffuse cerebral atrophy leads to
Alzheimers
46
Diffuse spongiform lesions in the brain
Creutzfeldtz Jakob
47
Pt is increasingly irritable, decreased concentration, and has constipation, what electrolyte is out of balance
Hypercalcemia
48
Pt on a three month binge presents w/ two months of low mood and Pos SIGECAPS, Dx ?
Substance induced mood disorder
49
What anticonvulsant is safe in pregnancy
Lamotrigine
50
Tx for Impulse Control Disorders
Psychotherapy
51
Inappropriate sexual behavior in children may be d/t ...
Sexual abuse
52
Schneideran First Rank Symptoms (7)
Thought Insertion, Thought W/DThought BroadcastingDelusional PerceptionVoice CommentaryVoice DiscussionAudible Thoughts
53
EtoH w/d is life threatening d/t this feedback mechanism
Down regulation of GABA receptors
54
Pt loves blood, so he becomes a phleb.
SublimationMature Defense
55
Pt, who is a lawyer, gets yelled at by the judge. Later, the pt yells at his wife.
DisplacementNeurotic Defense
56
Man w/ a sexual addiction becomes a priest
Reaction FormationNeurotic Defense
57
MDD second to substance abuse, no SIHI. Next step?
Rehabilitation program
58
Why are pts hospitalized for psych issues
Danger to self or others
59
Pt believes a famous person is in love w/ them
Erotomania (Erotomanic Delusion)
60
Pt describes secret messages from Washington in songs on the radio.
Delusion of Reference
61
What is Amylase increased in bulemic pts
Parotid glands are over active d/t repeat emesis
62
Major difference b/t acute stress disorder and adjustment disorder
Acute stress involves a traumatic stressor
63
Pt is on haloperidol, citalopram, methadone. Long term affect?
QT prolongation through potassium channel inhibition
64
Type of therapy where repressed childhood feelings are uncovered
Psychoanalysis
65
Therapy based on the learning theory
Behavioral
66
Therapy to treat maladaptive beliefs
Cognitive
67
A chronic schizophrenic brain will have volume loss of the ...
hippocampus and medial temporal lobe
68
A chronic schizophrenic brain will have volume increase of the ...
hypothalamus
69
Ralphe nuclei are associated w/ ...
Serotonin re-uptake inhibition
70
Pt hear colors or sees tastes
Synesthesia
71
Process of the brain "filling in" a perception following a traumatic stressor
Pseudohallucination
72
Elderly pt taking an SSRI for MDD is not improving. Next step?
ECT
73
GAD and OCD are treated w/
SSRI
74
Buspirone is indicated to Tx ONLY
GAD
75
Most common physical manifestation of GAD is
Insomnia
76
Visual Hallucinations ParkinsonismFluctuating CognitionAdverse effects to Neuroleptics
Lewey Body Dementia
77
Knife like frontal temporal atrophy<65 yo
Pick Disease
78
Focal Neuro DeficitsStep-wise Decline
Vascular Dementia
79
Lewey Body Tx
Cholinesterase inhibitor (Donepezil)
80
Akathsia
Continuous movement when attempting to sit still
81
Most concerning side effect of Lamotigine
TENS/SJS
82
Pt has orthostatic hypotension and schizophrenia. What neuroleptic should he be on
Haloperidol
83
Wandering off topic during regular conversation
Derailment
84
Rapid cycling through ideas w/ no connection
Flighty
85
Lose track of intended purpose of a sentence
Loss of Goal
86
Decreased speech, but complete sentences
Poverty of Speech
87
Adequate speech, but lack of content
Poverty of Thought
88
Wandering off topic during an explanation or responding to a question
Tangentiality
89
Thoughts go blank mid sentence
Thought blocking
90
Wandering off topic but returns to it
Circumstantiality
91
Pt afraid of:Public peeingPublic Speaking
Social Phobia
92
Pt is having trouble in school but not at home
Learning Disorder
93
Tics that last less then 12 months
Provisional Tic Disorder
94
Monoclonic jerks, typically in the morning and UE along w/ absence seizures
Juvenile Monoclonic Epilepsy
95
Chronic alcoholism will cause this on a CBC
MCV > 100 d/t B12 deficiency
96
ECT is indicated for
Mood and Psych Disorders, NOT Anxiety Disorders
97
Rapid acting opioid antagonist, used for Opiate overdose
Naloxone
98
Long acting opioid antagonist in the endorphin system.Only active if given IM. Often paired w/ Buprenorphine in tablet formAlso used to Tx alcoholism
Naltrexone
99
Used to Tx the autonomic Sx of Opioid w/d
Clonidine
100
Partial opioid agonistCan cause w/d if taken after heroinTaken orally
Buprenorphine
101
Causes adverse effects if alcohol is drank
Disulfiram
102
Intrusive idea that is hard for the Pt to dismiss
Obsession
103
Delusional type thinking, but the Pt is able to see it might be inaccurate
Overvalued Idea
104
This lab can differentiate b/t psychogenic and epileptic seizures
Prolactin
105
This personality disorder is categorized by:Maladaptive coping strategyImmature Defense Childhood trauma
Boderline
106
Long acting bento to Tx w/d from alcoholism or tapering from short acting benzos
Chlordiazepoxide
107
HTN med that can cause MDD Sx (4)
ClonidineReserpineMethyldopaPropranolol
108
Tx for akathisia
Propranolol
109
Tx for acute dystonia and parkinsonism
BenztropineDiphenhydramine
110
Pramipexole treats
Restless Leg
111
Tx for Fibromyalgia
TCA
112
Difference b/t Fibromyalgia and Polymyalgia Rheumatica
FM has normal labs
113
Echolalia
Pt mimics speech
114
Echopraxia
Pt mimics movement
115
Pt interacts w/ hallucinations that he knows are not real. What substance did they ingest?
Psilocybin (Mushrooms)
116
Pt being Tx w/ Buprenorphine takes this med and the result is Resp Depression, Miosis, Wheezes, Somnolance
Alprazolam (Benzo)
117
Triad of MDD
Neg about selfNeg about worldNeg about future
118
Tx for narcolepsy
Modafinil
119
MDD w/ Psychotic features, Tx w/ ...
Risperadone
120
Anticonvulsant that can depresses cognitive ability that does not improve w/ time
Topiramate
121
Tetrabenazine may cause a depressive mood by
depleting dopamine in the synaptic cleft
122
OCD Pt will have this change on a brain MRI
Basal Ganglia (Vol increase in Caudate Nucleus)
123
Med to reduce Alcohol Craving
Acamprosate
124
Med to cause adverse effects if Alcohol is ingested
Disulfiram
125
Med to reduce the pleasure acquired from drinking
Naltrexone
126
Panic disorder is defined by
Non specific stimuliFear of having another
127
Epstein Abnormally disassociated w/ this mood stabilizer
Lithium
128
Pt is on Lithium and becomes preggo, next step is
Switch med to haloperidol
129
Nephro DI d/t Lithium has a urine osmo that is ...
normal
130
Inability to measure distance/field depth
Dysmetria
131
Impaired ability to perform rapid, alternating movements
Dysdiadochokinesia
132
Mental illness in which the affected person holds the delusional belief that they are already dead, do not exist, are putrefying, or have lost their blood or internal organs.
Cotards Syn
133
Delief that different people are in fact a single person who changes appearance or is in disguise -- Delusion of Doubles
Fregoli Syn
134
Delusion that a friend, spouse, parent, or other close family member (or pet) has been replaced by an identical impostor
Capgras Syn
135
Elderly pt has delirium d/t UTI and is hospitalized. She is quite agitated, so you prescribe ...
Haloperidol (or another High potency Antipsych)High potency: Halo Tries Flying High H = Haloperidol T = Trifluoperazine F = Fluphenazine
136
How to determine the difference b/t the combined mood and psychotic.
What is present at baseline is the basis
137
Background of schizophrenia that develops MDD, Dx...
Schizoaffective
138
major difference b/t schizophrenia/phreniform and MDD w/ psychosis?
schizophrenia/phreniform do not have depressive features
139
mental condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation.
Conversion
140
Obsession with the idea of having a serious but undiagnosed medical condition.
Illness anxiety disorder
141
occurs when a person feels extreme anxiety about physical symptoms such as pain or fatigue. The person has intense thoughts, feelings, and behaviors related to the symptoms that interfere with daily life, no medical cause found
Somatic Symptom Disorder
142
sleep disorder characterized by persistent episodic hypersomnia and cognitive or mood changes. Many patients also experience hyperphagia, hypersexuality and other symptoms.
Kleine–Levin syndrome "Sleeping Beauty Syndrome"
143
Acute Stress Disorder vs PTSD
PTSD = ASD>1 Month
144
Dementia plus non-dilating pupils and anisocoria
Tert Syphilis
145
Unequal pupils
anisocoria
146
Pt has FM and takes Benadryl to relieve allergies. She starts to have cholinergic sx d/t this FM medication
TCA
147
syndrome in which symptoms of a delusional belief and sometimes hallucinations are transmitted from one individual to another.
Folie à deux
148
NMDA Antagonist to Tx Alzheimers Sx
Memantamine
149
Cholinesterase inhibitors to slow the progress of Alzheimers
DonezepilGalantamineRivastigmine
150
Tx for tourettes
Anti-psych
151
Feelings a physician has for a pt
Countertransference
152
Key features of alcohol use disorder include ...
ToleranceW/D
153
Time Dx Criteria for tourettesTx?
> 1 Year<18 yoTx: Impairment -- pharm Non- Impair -- Reassure/reasses
154
Hormone that blocks pain in trauma
Endorphin
155
First line med for sedation in the ER
Lorazepam +/- Haloperidol
