Psych EOR Exam Cards Flashcards
Panic attack definition
4 of 10 symptoms develop abruptly peak in 10 minutes and resolve in 30
Symptoms for panic attacks (10 need?)
Must have 4
Palpitations
Sweating
Trembling
Dyspnea
Choking feeling
Nausea
Dizziness
Chills/Hot flashes
Fear of dying
Paresthesia
Panic disorder
Recurrent and unexpected panic attacks (may be triggered)
Criteria for panic disorder
4+ symptoms recurring followed by a month of worrying and maladaptive behavior
Treatment for panic disorder
Antidepressants + Psychotherapy for long term
Benzodiazepines - for expectant or short term use
Agoraphobia criteria (?/5)
Marked fear or anxiety of 2+ of:
Public transport
Being in open spaces
Being in enclosed spaces - ie. cinema/store
Standing in line or crowds
Being outside of home
6+ months with no danger
MC group for agoraphobia
Females - often seen with panic disorder
Generalized anxiety disorder
Excessive worry for most days in 6 months about multiple things
Criteria for GAD (?/6)
3+ out of:
Restlessness
Fatigue
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance
Treatment for GAD
SSRI
Buspirone is also good
Social anxiety disorder
Fear in social situation with avoidance with significant interference
Must be present for 6+ months
Triggered by an EVENT
Treatment for social anxiety disorder
CBT and SSRI
Separation anxiety disorder
Anxiety about leaving an attachment figure - decreases with age
How long does separation anxiety disorder need to be present
Must be present 4 weeks in kids, 6 months in adults
Diagnostic criteria for separation anxiety disorder (?/8)
3 out of:
Recurrent excessive distress when anticipating or experiencing separation
Worry about loosing major attachment figures
Persistent worry about experiencing an event that will cause separation
Reluctance to go to school, work, etc. due to fear of separation
Fear of being alone
Fear of sleeping away from home/attachment figures
Nightmares involving separation
Physical symptoms related to separation
Treatment for separation anxiety
CBT and SSRI
Phobia
Intense fear for 6+ months
Marked persistent fear that the patient recognizes is unreasonable
5 phobia groups
Animal insect
Natural
Situational (flying, bridges)
Blood
Other
Management of phobias
Most childhood resolve with age
Exposure therapy - no medications
Selective mutism
Failure to speak in specific settings when you should be speaking
Interferes with social or occupational function - can’t be due to lack of knowledge
1+ month (but not the first month of school
Max length of benzo use
Longer than 2 weeks
Beta blockers for anxiety
For symptoms of anxiety - not first line
Presentations of Bipolar
Manic, Hypomanic, Mixed or Depressive
Usually either manic moods or depressive moods dominate
Criteria for a manic episode (how long it should last)
Persistently elevated, expansive or irritable mood lasting at least 1 week
Incidence of Bipolar
MC teens through 30s
Not common to present over 50
Men=Women
Bipolar I
Involves manic episodes with or without depression or psychosis
Bipolar II
Involves hypomanic episodes with major depression
No mixed episodes
MC in females
Medication induced bipolar causes - 3
Cocaine - classic
May be caused by steroids or TCAs
Required elements for a manic episode (not how long it needs to last) (?/7)
Three or more of:
Inflated self esteem or grandiosity
Decreased need for sleep
Increased talkativeness
Flight of ideas
Distractibility
Increased goal directed activity
Risk taking in the pursuit of pleasure
Disqualifying criteria for a manic episode - 2
Cannot meet criteria for mixed
Must cause marked impairment or have psychotic features
Hypomanic episode criteria
Lasts 4+ days
NO psychotic features!!
Bipolar treatment
Therapy and mood stabilizers
Treating only depression can trigger manic episodes
3 mood stabilizers for mania/bipolar
Lithium, Valproate, 2nd gen antipsychotics (ie. seroquel (quetiapine))
Major depressive disorder criteria
One or more episodes with 5+ symptoms during a 2 week period and at least 1 core symptoms
Core Symptoms of MDD - 2
Depressed Mood and Diminished interest (boards may put both and 1 non-core)
Non core symptoms of depression (7)
Significant weight change (5%)
Insomnia or hypersomnia
Psychomotor agitation/retardation
Feelings of guilt/worthlessness
Loss of concentration
Thoughts of death/suicide
Fatigue
Exclusion criteria for MDD - 4
No mania/hypomania
Causes impairment
Not bereavement
Rule out hypothyroid etc.
Incidence of depression
Women (30-40) more than men
Common in cancer patients
+ Fam Hx is a risk factor
Treatment for MDD
Psychotherapy for mild to moderate
Treatment for MDD with psychotic features
Need to add a medication as well
Indication for Electroconvulsive therapy for MDD
Suicidal patients or those worried about drug side effects
Anti OCD SSRI
Fluvoxamine (Luvox)
Anti OCD non SSRI that may be used for depression
Clomipramine (Anafranil)
TCAs
Amytryptilline
Nortryptilline
Tofranil
More SEs than SSRIs
Persistent Depressive Disorder
AKA Dysthymia
Mild and chronic depression
2+ years
Same tx as MDD
Premenstrual dysphoric disorder
Symptoms present in the final week before menses and improve within a few days of menstrual onset absent week following
Criteria for Premenstrual Dysphoric Disorder (?/9)
Marked affective lability
Marked irritability or anger
Marked depressed mood
Marked tension/anxiety
Decreased interest
Difficulty concentrating
Lethargy
Appetite change
Sleep disorders
Treatment for premenstrual dysphoric disorder - 3
Lifestyle modifications
SSRIs
OCP
Peak age for suicidal/homicidal behavior
Men 25-30
Women 45-50
Diagnostic criteria for SI/HI
Direct verbal warnings
Have a Plan
Hospitalize if both met
Disruptive Mood Disregulation Disorder
Severe verbal or physical outbursts that are disproportionate to situation
3+ times weekly
Angry baseline
Timing for disruptive mood dysregulation disorder
Present for 12 months in 2 different settings
After age 6 but before age 18 (must be in range
Exclusion criterion for Disruptive mood dysregulation disorder
Cannot coexist with ODD or Bipolar
Treatment for DMDD
Psychotherapy
Oppositional defiant disorder
Pattern of hostile, defiant behavior for 6 months
4 symptoms directed to at least 1 non-sibling
ODD symptoms (3 types, 7 symptoms)
Angry irritable types - Loosing temper, easily annoyed, resentful
Argumentative and Defiant types - Argues, defies, annoys, blames
Vindictive types - Spiteful
Tx for ODD
Assess social situation
Behavioral therapy
Conduct disorder criteria including TIMING
Repetitive behavior violating the rights of others at least once in the past 6 months and three times in the past year
Bully, rape, torture animals, etc.
Demographics for conduct disorder
Males MC
Must be under 18
Lack of remorse - often develop antisocial PD
Tx for conduct disorder
Difficult to treat - psychotherapy
Dissociative Identity Disorder
Multiple personalities
MC in females
Associated with trauma or abuse
Inability to recall information
Treatment for DID
Psychotherapy
Dissociative amnesia
Inability to recall due to association - triggered by a traumatic event
Tx with psychotherapy
BMI cutoff in danger for refeeding syndrome
Under 14
Anorexic cutoff BMI
Under 17.5
Underweight cutoff BMI
Under 18.5
Anorexia nervosa
Distorted body image - refuse to maintain normal weight
Take pride of weight loss - feel in control
Demographics of anorexia
MC in females
MC presenting in teens
Introverted
Bullimia
Binge eating followed by behavior to prevent weight gain (purge)
Minor weight change - normal or overweight
Extroverted and sexually active
Feel out of control
Demographics of bullimia
Late teens, MC than anorexia
Physical signs of bullimia
MAY have low body weight, may be normal or high but usually not very low
Abrasions on knuckles
Dental carries
Pharyngitis
Russel’s sign
Knuckle abrasions see in bullimia from purging
Medical complications of eating disorders
GI disturbances
Electrolyte imbalance = Cardiac issues
Amenorrhea - low body fat
MCC of death for anorexia
Cardiac issues
Treatment for eating disorders
Therapy
Fluoxetine ONLY FOR Bullimia
No pharm therapy for anorexia
Obsessive-Compulsive Disorder
Recurrent or persistent thoughts that are not normal worries
Recognizes that these obsessions are unreasonable - just can’t stop
Leads to a compulsive behavior
Criteria for OCD
Must realize they are unreasonable
Cause distress in life
Five major areas of OCD
Contamination - germs
Doubt - check locks
Symmetry/Precision - Lining things up
Intrusive thoughts w/o compulsion
Other (ie. hoarding, nail biting)
Tx for OCD
Need an SSRI at a higher dose than normal
Therapy
TCAs may also be used
Trichotillomania
Recurrent hair pulling
MC in females
Treat with CBT, SSRI, 2nd Gen antipsychotic
ADHD
Distractibility, short attention span, hyperactivity, and impulsivity
Present in more than 1 setting
Longer than 6 months and before 12
Treatment for ADHD
Behavior modifications and stimulants: ritalin, adderal, cylert, atomoxetine
Side effect of ritalin
Can stunt growth - give drug holidays
Autism spectrum disorder
Persistent defects in social interaction and communication across multiple context
Stereotyped behavior, special interest
Lack of emotional reaction
Typical onset for ASD
Typically before age three
Tx for autism
Depends on where on spectrum
Cluster A personality disorders
Social detachment - Weird, odd, eccentric
MC in men
MAD
Cluster B personality disorders
Drama - emotional, wild, impulsive, erratic
MC in women (except antisocial)
BAD
Cluster C personality disorders
Anxious and fearful - worried and in conflict
MC in men (except dependent personality)
SAD
Paranoid personality disorder
Cluster A
Bear grudges and won’t confide in others - don’t trust
Schizoid personality disorder
Cluster A
Loner - aloof
Detached socially
Don’t see benefit of sharing time with others
Schizotypal personality disorder
Cluster A
Eccentric with magical thinking
Vague speech
Inept and uncomfortable
Can progress to schizophrenia
3 cluster A personality disorders
Paranoid, Schizoid, Schizotypal
Antisocial personality disorder
Disregard for others
Lack of remorse or empathy
Must be 18 to diagnose
Charming and engaging
Borderline personality disorder
Unstable self image
Low self esteem
Substance abuse and high risk activity
Unstable relationships with black and white thinkiing
Histrionic personality disorder
Need to be center of attention
Think they are attractive
Seductive
Easily influenced
Vain
Narcissistic personality disorder
Conceited and arrogant
Fragile and inflated self image
Think they are special - rules don’t affect me
No empathy
Cluster B personality disorders
Antisocial
Histrionic
Borderline
Narcissistic
Mneumonic for 3 personality clusters
Weird - A
Wild - B
Worried - C
Dependant personality disorder
Difficulty Making decisions
Need to be taken care of
Need reassurance, will not initiate
Fear separation
Passive - anything to fit in
Avoidant personality disorder
Want attention but avoid it
Feel inadequate for relationships
Obsessive compulsive personality disorder
Feel a need to be in control, rule followers
Feel their obsessions and compulsions make sense unlike OCD
Treatment for personality disorders
Psychodynamic psychotherapy
Group and family therapy may help
Pharm may help with symptoms but not cure actual disorder (ie. antipsychotic for schizotypal, antidepressant for borderline)
Anticonvulsants for personality disorders
Carbamazepine, topiramate or valproate can help with impulse control (affect gamma receptors)
Antipsychotics for personality disorders
For borderline of schizotypal
Approach to questions about treating a personality disorder
Treat the DISORDER with therapy
Treat the SYMPTOMS with medication
Schizophrenia duration
Over 6 months of symptoms
Schizophreniform duration
Under 6 months
Brief psychotic disorder
1-30 day duration
Often follows a catastophic event
Delusional disorder
NON-bizzarre delusions over a month disrupting normal activty
Tx for delusional disorder
Antipsychotics - ziprasidone or aripiprazole
May also consider CBT
Presenting age for schizophrenia
Mainly between 15 and 45
Criteria for schizoprenia diagnosis with 4 positive sympoms
Six months of illness with 1 month of acute symptoms
2+ of:
Delusions
Hallucinations
Disorganized speech
Disorganized to catatonic behavior
3 symptoms that are required for schizophrenia diagnosis (well at least you need one of them)
Delusions
Hallucinations
Disorganized speech
Negative symptoms of schizophrenia
Social withdrawal
Lack of emotional expression
Lack of communication
Imaging for schizophrenia
May see enlarged ventricles and decreased cortical volume on CT
May see increased uptake in the frontal lobes on a PET scan
NOT DIAGNOSTIC
Treatment for schizophrenia
Antipsychotics - 2nd gen are usually first line
2nd gen antipsychotic leading to agranulocytosis
Clozapine
2nd gen antipsychotic leading to increased prolactin levels
Risperidone (also causes hypotension)
2nd gen antipsychotic leading to marked weight gain
Olanzapine
Neuroleptic malignant syndrome
Side effect of 1st gen antipsychotics
Rare but lethal
Presentation of neuroleptic malignant syndrome
Hyperthermia
Rigidity
Confusion
Diaphoresis
Increased WBCs
LOOKS LIKE SEPSIS
Tx for neuroleptic malignant syndrome
d/c medication
Give dopamine agonist (ie. diazepam)
Narcolepsy
Day time sleepiness and sleep paralysis
May have hallucinations
Diagnostic of choice for narcolepsy
Sleep studies - polysomnography and multiple sleep latency test
Criteria for narcolepsy
Irrepressible daytime sleep for 3 months plus either cataplexy or CSF hypocretin levels are low
Treatment for narcolepsy
Good sleep hygeine
Modafanil
Methylphenidate
Parasomnias
Undesirable behaviors during sleep
Autonomic symptoms
Somatic symptom disorder
Patients usually have had many surgeries
More common in women
Criteria for somatic symptom diagnosis
4 pain symptoms
2 GI symptoms
1 Sexual symptom
1 Neurological symptom other than pain
Must cause significant impairment
7 Key somatic symptom disorder symptoms (board questions will present two of these)
Shortness of breath
Dysmenorrhea
Burning in sex organ
Lump in throat
Amnesia
Vomiting
Painful extremities
(Somatization disorder besets ladies and vexes physicians)
Tx for somatic symptom disorder
Schedule regular follow up with patient - build rapport
Avoid excessive surgery or medication - group or psycho therapy is best treatment
Converson disorder
Loss in sensory function or motor function suggestive of a disorder but caused by psychological factors
Due to psychosocial stress
Tx for conversion disorder
Psychotherapy
Pain disorder
Pain that causes all of the problems in their life
Pain is everywhere without pattern
Negative workup
Behavioral therapy - pain meds don’t help
Illness anxiety disorder
Must cause impairment for at least 6 months
MC in 20-30
SSRI treatment, group therapy helps
Factitious disorder
Self induced disorders
MC in women with medical background
Therapy to treat
Substance abuse symptoms - 11
Failure to fullfill major obligations
Recurrent use in hazardous situations
Craving or strong desire to use the substance
Recurrent use despite social or personal problems
Tolerance
Withdrawal
Larger amount than intended
Persistent failed efforts to decrease use
Excessive time spent
Reduction in important activities
Continued use despite awareness of problems caused
SUbstance abuse severity stratification
2-3 is mild
4-5 is moderate
6+ is severe
Length of substance abuse disorder with four criteria
12 month period with one of four criteria impaired
Not fullfilling responsibilities
Recurrent use in dangerous situations
Legal entanglements
Used despite social problems
Substance dependancy
No longer part of DSM-V
Maladaptive pattern with signs of increasing tolerance
SIgns of withdrawal
CAGE questions
Felt they need to cut down
Annoyed by people asking
GUilty
Eye opener needed
Other alcohol screening tools
AUDIT
SAS-Q
Who should be screened for alcohol use disorder
All adults and pregnant women
Criteria for alcohol use disorder
4 general categories
Impaired control
Social impairment’
Risky use
Tolerance
Recommended screening frequency for dangerous alcohol use
Every 12 months in adults
Adjustment disorder
Change in emotional state due to an identified non-life-threatening stressful event
DIsproportionate response lasting 3 months typically resolving by 6 months
Tx for adjustment disorder
Psychotherapy may treat depression or anxiety with medication
PTSD
Exposed to an event with threat of death, injury or sexual violation
May experience or witness, or learning of it happening to family member
Most recover in 1st year
Criteria for PTSD (?/5)
Trauma is persistently reexperienced with increased arousal indicated by 2+ of:
Difficulty falling or staying asleep
Irritability
Difficulty concentrating
Hypervigillance
Exaggerated startle response
Lasts over a month
Tx for PTSD
Antidepressant - SSRI or TCA with therapy
Acute stress disorder
PTSD that is 3 days but less than a month
Psychotherapy only (meds take too long to work
Benzodiazepines indication
Used for anxiety, agitation and insomnia, status epilepticus
Benzodiazepines MOA
Augment GABA function in the limbic system - rapid onset
Potential for overdose and abuse
Benzos for anxiety
Alprazolam
DIazepam
Lorazepam
Benzos for Sleep disorders
Temazepam
Oxazepam
SSRIs
For depression
Inhibit serotonin reuptake
Take 6 weeks
Indications for SSRIs - 4
Depression, Anxiety, Bullimia, PMDD
Herbal that can increase risk of serotonin syndrome
St. John’s wart
Serotonin syndrome presentation
Something cognitive - HA, agitation, confusion
Something autonomic - Sweating tachycardia
Somatic effects - myoclonus or hyperreflexia
N/V
3 SSRIs that don’t end with oxetine
Sertraline
Citalopram
Escitalopram
SNRIs indications
Depression
ADHD
OCD
Use caution in HTN
Side effects of SNRIs
Weight loss
Appetite loss
Sleep disturbance
3 SNRIs
Venlafaxine
Desvenlafaxine
Duloxetine
SE of cymbalta
Hepatic failure caution
MOA and indications of TCAs
Block serotonin and norepi uptake
Depression, anxiety, phobias, OCD, neuropathic pain
4 SE of TCAs
Dry mouth
Blurred vision
Arrhythmias
Weight gain
6 TCAs
Nortryptilline
Imipramine
Desipramine
Amitryptiline
Doxepin
Tofranil
MAOIs MOA and info
Inhibits monoamine oxidase which breaks down norepi, dopamine, serotonin
Avoid tyramine high foods (beer, red wine, aged cheese)
4 MAOIs
Isocarboxazid
Phenelzine
Tranylcypromine
Selegiline
MAOI side effects
HYpotension sexual dysfunction
Pt. ed for MAOIs
Do not take with another antidepressant
Avoid tyramine rich foods
Bupropion MOA
Inhibits uptake of dopamine and norepi
Bupropion/Zyban indications
Depression and smoking cessation
Preserves sexual function
COntraindicated with seizure risk
Remron MOA
Central presynaptic alpha-2-adrenergic antagonist, increases release of serotonin and norepi
Depression - sedation and weight gain
Buspirone
Non benzo anxiety agent
ONLY for GAD
Extrapyramidal symptoms
Lithium
MOA not well known
Mood stabilizer for bipolar/mania
6 SEs of lithium
Tremor, Weight gain, polyuria
Ataxia, sinus arrythmia, teratogenicity (Ebsteins anomaly)
MOA of antipsychotics
Block dopamine receptors, 2nd gen (but not first) blocks serotonin
1st gen antipsychotics - 4
Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol
2nd gen antipsychotics - 4
Clozapine
Olanzapine
Risperidone
Aripirazole
Stimulants MOA
Increase norepi and dopamine
Can cause weight loss - growth stunting
Stimulants - 4
Amphetamine
Methylphenidate
Lisdexamphetamine
Modafanil
Presentation of acute alcohol abuse
Slurred speach, facial flushing, ataxia
`Presentation of chronic alcohol abuse
Palmar erythema, contracture, acne rosacea
3 pharm therapies for alcohol abuse
Benzos for acute withdrawal, Disulfiram for deterrance, Naltrexone or acamprosate for long term
Presentation of opioid abuse
Respiratory distress, pinpoint pupils, flushing
Presentation of opioid withdrawal
Increased secretions, Hypertension, N/V
Pharm for opioid abuse
Naloxone for acute overdose
Methadone, Buprenorphine, Clonidine - can all be used
Stimulants that may be abused - 5
Cocaine, Caffeine, Amphetamines, Diet pills, Pseudoephedrine
Presentation of stimulant intoxication/Overdose
Aggression, Psychosis, Dilated pupils, Hypertension
Presentation of stimulant withdrawal
Fatigue, Sweating, Depression, Muscle cramps, Hunger
Pharm for stimulant abuse
Benzos and short term antipsychotics if needed
4 drugs for nicotine withdrawal
Nicotine replacement (gum, lozenge, patch)
Varecycline
Bupropion
Clonidine
Drugs for MJ and Hallucinogen withdrawal
Benzos, haldol for psychosis if present
Tx for sedative/benzo use
Taper medication
Flumazenil for acute intoxication
May use Pentobarbital
Risk factors associated with valproate
Often used for bipolar disorder
Associated with hepatotoxicity and congenital malformations
Weight gain
Risk factors associated with lamictal
Used for bipolar
Associated with SJS
5 Risk factors associated with quetiapine
Parkonsonism (tardive dyskenesia), hyperglycemia, and QT prolongation,
Higher rates of abuse, sedation
Two diseases caused by lithium
Diabetes insipidus
Hypothyroidism
First line maintainance therapy for bipolar
Whichever drug resolved the acute episode
2nd line drugs for bipolar maintainance - 4
Lithium, Lamictal, Seroquel, Valproate
3 drugs for acute mania tx
Lithium, Valproate, Maybe an antipsychotic (ie. haldol)
Tx for bipolar depressive episode, 3 drugs
Lithium, Lamictal, Quetiapine
4 lab values indicative of chronic alcohol use
AST:ALT of 2:1
GGT over 30
Albumin under 3.4
MCV over 96 (think folate deficiency)
1st and 2nd line tx for serotonin syndrome
1st - Benzos
2nd cyprohepatadine
MOA of atomoxetine
SNRI - no dopamine action
MOA of methylphenidate
Inhibits uptake of dopamine AND norepinephrine
How long should a patient be monitored before switching or increasing an SSRI
6 weeks
5 As of tobacco cessation
Ask
Advise
Assess
Assist
Arrange
Triad of thiamine deficiency
Encephalopathy
Oculomotor dysfunction
Gait ataxia
Ideas of reference
Associated with schizotypal PD
Believing innocuous events have strong personal significance
Monitoring for patients on clozapine and red flags - 4
Weekly for first 6 months and biweekly after 6 months CBC for ANC - 1500=RF
Blood glucose
Baseline and weekly troponin, CRP, BNP
Baseline Monitoring for lithium - 3
Baseline kidney and thyroid function
Baseline EKG if over 50
Weight (assoc. with weight gain)
Maintenance monitoring for lithium
Kidney, Thyroid, EKG Q6 months
Drug levels every 1-2 weeks until therpeutic level reached
Every 2-3 months for 6 months after reached
Monitor for dehydration
Therapeutic and toxic lithium levels
THerapeutic - 0.8-1.2 (1.0 for Maintainance)
Who can prescribe clozapine
Certified providers - pharmacy and patient must also be registered
Risk factors for autism - 4
Advanced parental age
Premature birth weight
Rapid head circ growth
Valproate use
Broadband ADHD assessment meaning and examples
Screen for symptoms of disorders other than just ADHD
Child Behavior CHecklist/Teacher report form
Narrow band ADHD assessment tools - 3
Connor’s third ed short version
Childhood attention problems scale
Disruptive behavior rating scale
Vanderbilt assessment scale
Anorexia nervosa admission criteria - only needs 1 of 5
BP under 80/60
BMI under 15
HR under 40-50bpm
Orthostatic pulse increase of 20bpm
Orthostatic SBP decrease of 20mmHg
Schizoaffective disorder
Schizophrenia with marked psychotic or depressive symptoms
Recommended age to screen for autism
18-24 months
Verbigeration
WHen a patient word salads, or repeats words
Circumstantial speech
Patient eventually answers questions after long rambling
Loose association
Patient rapidly shifts between disconnected ideas
Treatment for extra pyramidal symptoms induced by antipsychotics
Benadryl
Side effect of amitryptilline
Lowers seizure threshold
Monitoring needed for SNRIs
Blood pressure
8 risk factors for schizophrenia
Birth during the late winter or spring
Living further from the equator,
Living in an urban area,
Immigration,
Advanced paternal age at conception,
Perinatal obstetric complications,
Childhood trauma or central nervous system infections, and
Cannabis use during adolescence
Diagnostic test for restless leg syndrome
Iron studies
Adult ADHD diagnostic criteria
Over 17
5+ symptoms of hyperactivity or 5+ symptoms of inattentiveness
Under 17 ADHD dx criteria
6+ symptoms of hyperactivity or inattentiveness
6 MC Fetishes
Womens underpants
Bras
Hair
Feet
Toes
Shoes
Things associated with NREM2 sleep
Benzodiazepine use
Largest percentage of total sleep
When is pharmacotherapy first line for children
When they are school age - psych first if younger
SSRIs safe in breastfeeding - 2
Sertraline and Paroxetine
Most commonly used substance in schizophrenia
Tobacco
CLinical monitoring for 2nd gen antipsychotics
Baseline fasting blood glucose, A1c and lipids
Baseline EKG
CHecks FBG at 6 weeks, 3 months, 12 months and then annually
Applied tension technique
Used during blood draws for those with syncopal episodes
Tx for MRI claustrophobia
Benzo administration
Mild, Mode, Severe and Extreme anorexia BMI criteria
Mild - Over 17
Mod - 16-16.99
Severe - 15-15.99
Extreme - Under 15
2nd line agent for ADHD after stimulants
Atomoxetine - can cause nausea
Akathisia
Common SE of antipsychotics
SUbjective symptom
Feelings of restlessness
6 Lab values of anorexia
Long QT
Hyponatremia
Thrombocytopenia
Leukopenia
Elevated BUN and CHolesterol
3 antipsychotics with the LEAST QT prolongation
Lurasidone
Paliperidone
Aripirazole
3 antipsychotics with the MOST QT prolongation
Sertindole
Clozapine
Thioridazine
Ziprasidone
2 opioids detected on UDS
Codeine
Morphine
Criteria for complicated grief
12+ months of symptoms:
Extreme persistent yearning
Preoccupying thoughts
Loneliness
Unbearable to live/SI
Treat w/ CBT
Presentation of marajuana intoxication
Tachycardia, Dry mouth, Increased appetite, Nystagmus, Ataxia, Slurred speach
Presentation of ecstacy intoxication
Increased alertness
Euphoria
Serotonin syndrome
SSRI associated with sedation
Paroxetine
SSRI associated with nausea and vomiting
Fluvoxamine
Electrolyte abnormality that drives complications of refeeding syndrome
Hypophosphatemia
Medication for bipolar linked to neural tube defects in pregnancy
Carbamazepine
Synthetic cannabinoid that won’t show on a UDS
Spice
Disorder often comorbid with conduct disorder
ADHD
Best approach to malingering patient
Subtle confrontation
Non-psych benefit of duloxetine
Helps with diabetic neuropathy
Sleep med for sleep maintainance only and sleep med for sleep onset only
Maintainance only - doxepin
Onset only - ramelteon
Indication for atomoxetine for ADHD
Patients with a hx of substance abuse (can’t take stimulants)
3 medications for severe cannabis withdrawal
Dronabinol or Gabapentin
Zolpidem for sleep disturbances
