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EOR Exams > Psych EOR Exam Cards > Flashcards

Psych EOR Exam Cards Flashcards

1
Q

Panic attack definition

A

4 of 10 symptoms develop abruptly peak in 10 minutes and resolve in 30

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2
Q

Symptoms for panic attacks (10 need?)

A

Must have 4
Palpitations
Sweating
Trembling
Dyspnea
Choking feeling
Nausea
Dizziness
Chills/Hot flashes
Fear of dying
Paresthesia

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3
Q

Panic disorder

A

Recurrent and unexpected panic attacks (may be triggered)

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4
Q

Criteria for panic disorder

A

4+ symptoms recurring followed by a month of worrying and maladaptive behavior

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5
Q

Treatment for panic disorder

A

Antidepressants + Psychotherapy for long term
Benzodiazepines - for expectant or short term use

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6
Q

Agoraphobia criteria (?/5)

A

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

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7
Q

MC group for agoraphobia

A

Females - often seen with panic disorder

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8
Q

Generalized anxiety disorder

A

Excessive worry for most days in 6 months about multiple things

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9
Q

Criteria for GAD (?/6)

A

3+ out of:
Restlessness
Fatigue
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance

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10
Q

Treatment for GAD

A

SSRI
Buspirone is also good

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11
Q

Social anxiety disorder

A

Fear in social situation with avoidance with significant interference
Must be present for 6+ months
Triggered by an EVENT

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12
Q

Treatment for social anxiety disorder

A

CBT and SSRI

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13
Q

Separation anxiety disorder

A

Anxiety about leaving an attachment figure - decreases with age

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14
Q

How long does separation anxiety disorder need to be present

A

Must be present 4 weeks in kids, 6 months in adults

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15
Q

Diagnostic criteria for separation anxiety disorder (?/8)

A

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

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16
Q

Treatment for separation anxiety

A

CBT and SSRI

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17
Q

Phobia

A

Intense fear for 6+ months
Marked persistent fear that the patient recognizes is unreasonable

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18
Q

5 phobia groups

A

Animal insect
Natural
Situational (flying, bridges)
Blood
Other

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19
Q

Management of phobias

A

Most childhood resolve with age
Exposure therapy - no medications

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20
Q

Selective mutism

A

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

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21
Q

Max length of benzo use

A

Longer than 2 weeks

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22
Q

Beta blockers for anxiety

A

For symptoms of anxiety - not first line

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23
Q

Presentations of Bipolar

A

Manic, Hypomanic, Mixed or Depressive
Usually either manic moods or depressive moods dominate

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24
Q

Criteria for a manic episode (how long it should last)

A

Persistently elevated, expansive or irritable mood lasting at least 1 week

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25
Q

Incidence of Bipolar

A

MC teens through 30s
Not common to present over 50
Men=Women

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26
Q

Bipolar I

A

Involves manic episodes with or without depression or psychosis

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27
Q

Bipolar II

A

Involves hypomanic episodes with major depression
No mixed episodes
MC in females

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28
Q

Medication induced bipolar causes - 3

A

Cocaine - classic
May be caused by steroids or TCAs

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29
Q

Required elements for a manic episode (not how long it needs to last) (?/7)

A

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

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30
Q

Disqualifying criteria for a manic episode - 2

A

Cannot meet criteria for mixed
Must cause marked impairment or have psychotic features

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31
Q

Hypomanic episode criteria

A

Lasts 4+ days
NO psychotic features!!

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32
Q

Bipolar treatment

A

Therapy and mood stabilizers
Treating only depression can trigger manic episodes

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33
Q

3 mood stabilizers for mania/bipolar

A

Lithium, Valproate, 2nd gen antipsychotics (ie. seroquel (quetiapine))

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34
Q

Major depressive disorder criteria

A

One or more episodes with 5+ symptoms during a 2 week period and at least 1 core symptoms

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35
Q

Core Symptoms of MDD - 2

A

Depressed Mood and Diminished interest (boards may put both and 1 non-core)

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36
Q

Non core symptoms of depression (7)

A

Significant weight change (5%)
Insomnia or hypersomnia
Psychomotor agitation/retardation
Feelings of guilt/worthlessness
Loss of concentration
Thoughts of death/suicide
Fatigue

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37
Q

Exclusion criteria for MDD - 4

A

No mania/hypomania
Causes impairment
Not bereavement
Rule out hypothyroid etc.

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38
Q

Incidence of depression

A

Women (30-40) more than men
Common in cancer patients
+ Fam Hx is a risk factor

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39
Q

Treatment for MDD

A

Psychotherapy for mild to moderate

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40
Q

Treatment for MDD with psychotic features

A

Need to add a medication as well

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41
Q

Indication for Electroconvulsive therapy for MDD

A

Suicidal patients or those worried about drug side effects

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42
Q

Anti OCD SSRI

A

Fluvoxamine (Luvox)

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43
Q

Anti OCD non SSRI that may be used for depression

A

Clomipramine (Anafranil)

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44
Q

TCAs

A

Amytryptilline
Nortryptilline
Tofranil

More SEs than SSRIs

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45
Q

Persistent Depressive Disorder

A

AKA Dysthymia
Mild and chronic depression
2+ years
Same tx as MDD

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46
Q

Premenstrual dysphoric disorder

A

Symptoms present in the final week before menses and improve within a few days of menstrual onset absent week following

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47
Q

Criteria for Premenstrual Dysphoric Disorder (?/9)

A

Marked affective lability
Marked irritability or anger
Marked depressed mood
Marked tension/anxiety
Decreased interest
Difficulty concentrating
Lethargy
Appetite change
Sleep disorders

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48
Q

Treatment for premenstrual dysphoric disorder - 3

A

Lifestyle modifications
SSRIs
OCP

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49
Q

Peak age for suicidal/homicidal behavior

A

Men 25-30
Women 45-50

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50
Q

Diagnostic criteria for SI/HI

A

Direct verbal warnings
Have a Plan
Hospitalize if both met

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51
Q

Disruptive Mood Disregulation Disorder

A

Severe verbal or physical outbursts that are disproportionate to situation
3+ times weekly
Angry baseline

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52
Q

Timing for disruptive mood dysregulation disorder

A

Present for 12 months in 2 different settings
After age 6 but before age 18 (must be in range

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53
Q

Exclusion criterion for Disruptive mood dysregulation disorder

A

Cannot coexist with ODD or Bipolar

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54
Q

Treatment for DMDD

A

Psychotherapy

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55
Q

Oppositional defiant disorder

A

Pattern of hostile, defiant behavior for 6 months
4 symptoms directed to at least 1 non-sibling

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56
Q

ODD symptoms (3 types, 7 symptoms)

A

Angry irritable types - Loosing temper, easily annoyed, resentful
Argumentative and Defiant types - Argues, defies, annoys, blames
Vindictive types - Spiteful

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57
Q

Tx for ODD

A

Assess social situation
Behavioral therapy

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58
Q

Conduct disorder criteria including TIMING

A

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.

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59
Q

Demographics for conduct disorder

A

Males MC
Must be under 18
Lack of remorse - often develop antisocial PD

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60
Q

Tx for conduct disorder

A

Difficult to treat - psychotherapy

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61
Q

Dissociative Identity Disorder

A

Multiple personalities
MC in females
Associated with trauma or abuse
Inability to recall information

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62
Q

Treatment for DID

A

Psychotherapy

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63
Q

Dissociative amnesia

A

Inability to recall due to association - triggered by a traumatic event
Tx with psychotherapy

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64
Q

BMI cutoff in danger for refeeding syndrome

A

Under 14

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65
Q

Anorexic cutoff BMI

A

Under 17.5

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66
Q

Underweight cutoff BMI

A

Under 18.5

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67
Q

Anorexia nervosa

A

Distorted body image - refuse to maintain normal weight
Take pride of weight loss - feel in control

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68
Q

Demographics of anorexia

A

MC in females
MC presenting in teens
Introverted

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69
Q

Bullimia

A

Binge eating followed by behavior to prevent weight gain (purge)
Minor weight change - normal or overweight
Extroverted and sexually active
Feel out of control

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70
Q

Demographics of bullimia

A

Late teens, MC than anorexia

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71
Q

Physical signs of bullimia

A

MAY have low body weight, may be normal or high but usually not very low
Abrasions on knuckles
Dental carries
Pharyngitis

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72
Q

Russel’s sign

A

Knuckle abrasions see in bullimia from purging

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73
Q

Medical complications of eating disorders

A

GI disturbances
Electrolyte imbalance = Cardiac issues
Amenorrhea - low body fat

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74
Q

MCC of death for anorexia

A

Cardiac issues

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75
Q

Treatment for eating disorders

A

Therapy
Fluoxetine ONLY FOR Bullimia
No pharm therapy for anorexia

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76
Q

Obsessive-Compulsive Disorder

A

Recurrent or persistent thoughts that are not normal worries
Recognizes that these obsessions are unreasonable - just can’t stop
Leads to a compulsive behavior

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77
Q

Criteria for OCD

A

Must realize they are unreasonable
Cause distress in life

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78
Q

Five major areas of OCD

A

Contamination - germs
Doubt - check locks
Symmetry/Precision - Lining things up
Intrusive thoughts w/o compulsion
Other (ie. hoarding, nail biting)

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79
Q

Tx for OCD

A

Need an SSRI at a higher dose than normal
Therapy
TCAs may also be used

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80
Q

Trichotillomania

A

Recurrent hair pulling
MC in females
Treat with CBT, SSRI, 2nd Gen antipsychotic

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81
Q

ADHD

A

Distractibility, short attention span, hyperactivity, and impulsivity
Present in more than 1 setting
Longer than 6 months and before 12

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82
Q

Treatment for ADHD

A

Behavior modifications and stimulants: ritalin, adderal, cylert, atomoxetine

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83
Q

Side effect of ritalin

A

Can stunt growth - give drug holidays

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84
Q

Autism spectrum disorder

A

Persistent defects in social interaction and communication across multiple context
Stereotyped behavior, special interest
Lack of emotional reaction

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85
Q

Typical onset for ASD

A

Typically before age three

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86
Q

Tx for autism

A

Depends on where on spectrum

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87
Q

Cluster A personality disorders

A

Social detachment - Weird, odd, eccentric
MC in men
MAD

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88
Q

Cluster B personality disorders

A

Drama - emotional, wild, impulsive, erratic
MC in women (except antisocial)
BAD

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89
Q

Cluster C personality disorders

A

Anxious and fearful - worried and in conflict
MC in men (except dependent personality)
SAD

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90
Q

Paranoid personality disorder

A

Cluster A
Bear grudges and won’t confide in others - don’t trust

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91
Q

Schizoid personality disorder

A

Cluster A
Loner - aloof
Detached socially
Don’t see benefit of sharing time with others

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92
Q

Schizotypal personality disorder

A

Cluster A
Eccentric with magical thinking
Vague speech
Inept and uncomfortable
Can progress to schizophrenia

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93
Q

3 cluster A personality disorders

A

Paranoid, Schizoid, Schizotypal

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94
Q

Antisocial personality disorder

A

Disregard for others
Lack of remorse or empathy
Must be 18 to diagnose
Charming and engaging

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95
Q

Borderline personality disorder

A

Unstable self image
Low self esteem
Substance abuse and high risk activity
Unstable relationships with black and white thinkiing

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96
Q

Histrionic personality disorder

A

Need to be center of attention
Think they are attractive
Seductive
Easily influenced
Vain

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97
Q

Narcissistic personality disorder

A

Conceited and arrogant
Fragile and inflated self image
Think they are special - rules don’t affect me
No empathy

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98
Q

Cluster B personality disorders

A

Antisocial
Histrionic
Borderline
Narcissistic

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99
Q

Mneumonic for 3 personality clusters

A

Weird - A
Wild - B
Worried - C

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100
Q

Dependant personality disorder

A

Difficulty Making decisions
Need to be taken care of
Need reassurance, will not initiate
Fear separation
Passive - anything to fit in

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101
Q

Avoidant personality disorder

A

Want attention but avoid it
Feel inadequate for relationships

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102
Q

Obsessive compulsive personality disorder

A

Feel a need to be in control, rule followers
Feel their obsessions and compulsions make sense unlike OCD

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103
Q

Treatment for personality disorders

A

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)

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104
Q

Anticonvulsants for personality disorders

A

Carbamazepine, topiramate or valproate can help with impulse control (affect gamma receptors)

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105
Q

Antipsychotics for personality disorders

A

For borderline of schizotypal

106
Q

Approach to questions about treating a personality disorder

A

Treat the DISORDER with therapy
Treat the SYMPTOMS with medication

107
Q

Schizophrenia duration

A

Over 6 months of symptoms

108
Q

Schizophreniform duration

A

Under 6 months

109
Q

Brief psychotic disorder

A

1-30 day duration
Often follows a catastophic event

110
Q

Delusional disorder

A

NON-bizzarre delusions over a month disrupting normal activty

111
Q

Tx for delusional disorder

A

Antipsychotics - ziprasidone or aripiprazole
May also consider CBT

112
Q

Presenting age for schizophrenia

A

Mainly between 15 and 45

113
Q

Criteria for schizoprenia diagnosis with 4 positive sympoms

A

Six months of illness with 1 month of acute symptoms
2+ of:
Delusions
Hallucinations
Disorganized speech
Disorganized to catatonic behavior

114
Q

3 symptoms that are required for schizophrenia diagnosis (well at least you need one of them)

A

Delusions
Hallucinations
Disorganized speech

115
Q

Negative symptoms of schizophrenia

A

Social withdrawal
Lack of emotional expression
Lack of communication

116
Q

Imaging for schizophrenia

A

May see enlarged ventricles and decreased cortical volume on CT
May see increased uptake in the frontal lobes on a PET scan
NOT DIAGNOSTIC

117
Q

Treatment for schizophrenia

A

Antipsychotics - 2nd gen are usually first line

118
Q

2nd gen antipsychotic leading to agranulocytosis

A

Clozapine

119
Q

2nd gen antipsychotic leading to increased prolactin levels

A

Risperidone (also causes hypotension)

120
Q

2nd gen antipsychotic leading to marked weight gain

A

Olanzapine

121
Q

Neuroleptic malignant syndrome

A

Side effect of 1st gen antipsychotics
Rare but lethal

122
Q

Presentation of neuroleptic malignant syndrome

A

Hyperthermia
Rigidity
Confusion
Diaphoresis
Increased WBCs
LOOKS LIKE SEPSIS

123
Q

Tx for neuroleptic malignant syndrome

A

d/c medication
Give dopamine agonist (ie. diazepam)

124
Q

Narcolepsy

A

Day time sleepiness and sleep paralysis
May have hallucinations

125
Q

Diagnostic of choice for narcolepsy

A

Sleep studies - polysomnography and multiple sleep latency test

126
Q

Criteria for narcolepsy

A

Irrepressible daytime sleep for 3 months plus either cataplexy or CSF hypocretin levels are low

127
Q

Treatment for narcolepsy

A

Good sleep hygeine
Modafanil
Methylphenidate

128
Q

Parasomnias

A

Undesirable behaviors during sleep
Autonomic symptoms

129
Q

Somatic symptom disorder

A

Patients usually have had many surgeries
More common in women

130
Q

Criteria for somatic symptom diagnosis

A

4 pain symptoms
2 GI symptoms
1 Sexual symptom
1 Neurological symptom other than pain
Must cause significant impairment

131
Q

7 Key somatic symptom disorder symptoms (board questions will present two of these)

A

Shortness of breath
Dysmenorrhea
Burning in sex organ
Lump in throat
Amnesia
Vomiting
Painful extremities

(Somatization disorder besets ladies and vexes physicians)

132
Q

Tx for somatic symptom disorder

A

Schedule regular follow up with patient - build rapport
Avoid excessive surgery or medication - group or psycho therapy is best treatment

133
Q

Converson disorder

A

Loss in sensory function or motor function suggestive of a disorder but caused by psychological factors
Due to psychosocial stress

134
Q

Tx for conversion disorder

A

Psychotherapy

135
Q

Pain disorder

A

Pain that causes all of the problems in their life
Pain is everywhere without pattern
Negative workup
Behavioral therapy - pain meds don’t help

136
Q

Illness anxiety disorder

A

Must cause impairment for at least 6 months
MC in 20-30
SSRI treatment, group therapy helps

137
Q

Factitious disorder

A

Self induced disorders
MC in women with medical background
Therapy to treat

138
Q

Substance abuse symptoms - 11

A

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

139
Q

SUbstance abuse severity stratification

A

2-3 is mild
4-5 is moderate
6+ is severe

140
Q

Length of substance abuse disorder with four criteria

A

12 month period with one of four criteria impaired
Not fullfilling responsibilities
Recurrent use in dangerous situations
Legal entanglements
Used despite social problems

141
Q

Substance dependancy

A

No longer part of DSM-V
Maladaptive pattern with signs of increasing tolerance
SIgns of withdrawal

142
Q

CAGE questions

A

Felt they need to cut down
Annoyed by people asking
GUilty
Eye opener needed

143
Q

Other alcohol screening tools

A

AUDIT
SAS-Q

144
Q

Who should be screened for alcohol use disorder

A

All adults and pregnant women

145
Q

Criteria for alcohol use disorder

A

4 general categories
Impaired control
Social impairment’
Risky use
Tolerance

146
Q

Recommended screening frequency for dangerous alcohol use

A

Every 12 months in adults

147
Q

Adjustment disorder

A

Change in emotional state due to an identified non-life-threatening stressful event
DIsproportionate response lasting 3 months typically resolving by 6 months

148
Q

Tx for adjustment disorder

A

Psychotherapy may treat depression or anxiety with medication

149
Q

PTSD

A

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

150
Q

Criteria for PTSD (?/5)

A

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

151
Q

Tx for PTSD

A

Antidepressant - SSRI or TCA with therapy

152
Q

Acute stress disorder

A

PTSD that is 3 days but less than a month
Psychotherapy only (meds take too long to work

153
Q

Benzodiazepines indication

A

Used for anxiety, agitation and insomnia, status epilepticus

154
Q

Benzodiazepines MOA

A

Augment GABA function in the limbic system - rapid onset

Potential for overdose and abuse

155
Q

Benzos for anxiety

A

Alprazolam
DIazepam
Lorazepam

156
Q

Benzos for Sleep disorders

A

Temazepam
Oxazepam

157
Q

SSRIs

A

For depression
Inhibit serotonin reuptake
Take 6 weeks

158
Q

Indications for SSRIs - 4

A

Depression, Anxiety, Bullimia, PMDD

159
Q

Herbal that can increase risk of serotonin syndrome

A

St. John’s wart

160
Q

Serotonin syndrome presentation

A

Something cognitive - HA, agitation, confusion
Something autonomic - Sweating tachycardia
Somatic effects - myoclonus or hyperreflexia
N/V

161
Q

3 SSRIs that don’t end with oxetine

A

Sertraline
Citalopram
Escitalopram

162
Q

SNRIs indications

A

Depression
ADHD
OCD
Use caution in HTN

163
Q

Side effects of SNRIs

A

Weight loss
Appetite loss
Sleep disturbance

164
Q

3 SNRIs

A

Venlafaxine
Desvenlafaxine
Duloxetine

165
Q

SE of cymbalta

A

Hepatic failure caution

166
Q

MOA and indications of TCAs

A

Block serotonin and norepi uptake
Depression, anxiety, phobias, OCD, neuropathic pain

167
Q

4 SE of TCAs

A

Dry mouth
Blurred vision
Arrhythmias
Weight gain

168
Q

6 TCAs

A

Nortryptilline
Imipramine
Desipramine
Amitryptiline
Doxepin
Tofranil

169
Q

MAOIs MOA and info

A

Inhibits monoamine oxidase which breaks down norepi, dopamine, serotonin
Avoid tyramine high foods (beer, red wine, aged cheese)

170
Q

4 MAOIs

A

Isocarboxazid
Phenelzine
Tranylcypromine
Selegiline

171
Q

MAOI side effects

A

HYpotension sexual dysfunction

172
Q

Pt. ed for MAOIs

A

Do not take with another antidepressant
Avoid tyramine rich foods

173
Q

Bupropion MOA

A

Inhibits uptake of dopamine and norepi

174
Q

Bupropion/Zyban indications

A

Depression and smoking cessation
Preserves sexual function
COntraindicated with seizure risk

175
Q

Remron MOA

A

Central presynaptic alpha-2-adrenergic antagonist, increases release of serotonin and norepi
Depression - sedation and weight gain

176
Q

Buspirone

A

Non benzo anxiety agent
ONLY for GAD
Extrapyramidal symptoms

177
Q

Lithium

A

MOA not well known
Mood stabilizer for bipolar/mania

178
Q

6 SEs of lithium

A

Tremor, Weight gain, polyuria
Ataxia, sinus arrythmia, teratogenicity (Ebsteins anomaly)

179
Q

MOA of antipsychotics

A

Block dopamine receptors, 2nd gen (but not first) blocks serotonin

180
Q

1st gen antipsychotics - 4

A

Chlorpromazine
Thioridazine
Fluphenazine
Haloperidol

181
Q

2nd gen antipsychotics - 4

A

Clozapine
Olanzapine
Risperidone
Aripirazole

182
Q

Stimulants MOA

A

Increase norepi and dopamine
Can cause weight loss - growth stunting

183
Q

Stimulants - 4

A

Amphetamine
Methylphenidate
Lisdexamphetamine
Modafanil

184
Q

Presentation of acute alcohol abuse

A

Slurred speach, facial flushing, ataxia

185
Q

`Presentation of chronic alcohol abuse

A

Palmar erythema, contracture, acne rosacea

186
Q

3 pharm therapies for alcohol abuse

A

Benzos for acute withdrawal, Disulfiram for deterrance, Naltrexone or acamprosate for long term

187
Q

Presentation of opioid abuse

A

Respiratory distress, pinpoint pupils, flushing

188
Q

Presentation of opioid withdrawal

A

Increased secretions, Hypertension, N/V

189
Q

Pharm for opioid abuse

A

Naloxone for acute overdose
Methadone, Buprenorphine, Clonidine - can all be used

190
Q

Stimulants that may be abused - 5

A

Cocaine, Caffeine, Amphetamines, Diet pills, Pseudoephedrine

191
Q

Presentation of stimulant intoxication/Overdose

A

Aggression, Psychosis, Dilated pupils, Hypertension

192
Q

Presentation of stimulant withdrawal

A

Fatigue, Sweating, Depression, Muscle cramps, Hunger

193
Q

Pharm for stimulant abuse

A

Benzos and short term antipsychotics if needed

194
Q

4 drugs for nicotine withdrawal

A

Nicotine replacement (gum, lozenge, patch)
Varecycline
Bupropion
Clonidine

195
Q

Drugs for MJ and Hallucinogen withdrawal

A

Benzos, haldol for psychosis if present

196
Q

Tx for sedative/benzo use

A

Taper medication
Flumazenil for acute intoxication
May use Pentobarbital

197
Q

Risk factors associated with valproate

A

Often used for bipolar disorder
Associated with hepatotoxicity and congenital malformations
Weight gain

198
Q

Risk factors associated with lamictal

A

Used for bipolar
Associated with SJS

199
Q

5 Risk factors associated with quetiapine

A

Parkonsonism (tardive dyskenesia), hyperglycemia, and QT prolongation,
Higher rates of abuse, sedation

200
Q

Two diseases caused by lithium

A

Diabetes insipidus
Hypothyroidism

201
Q

First line maintainance therapy for bipolar

A

Whichever drug resolved the acute episode

202
Q

2nd line drugs for bipolar maintainance - 4

A

Lithium, Lamictal, Seroquel, Valproate

203
Q

3 drugs for acute mania tx

A

Lithium, Valproate, Maybe an antipsychotic (ie. haldol)

204
Q

Tx for bipolar depressive episode, 3 drugs

A

Lithium, Lamictal, Quetiapine

205
Q

4 lab values indicative of chronic alcohol use

A

AST:ALT of 2:1
GGT over 30
Albumin under 3.4
MCV over 96 (think folate deficiency)

206
Q

1st and 2nd line tx for serotonin syndrome

A

1st - Benzos
2nd cyprohepatadine

207
Q

MOA of atomoxetine

A

SNRI - no dopamine action

208
Q

MOA of methylphenidate

A

Inhibits uptake of dopamine AND norepinephrine

209
Q

How long should a patient be monitored before switching or increasing an SSRI

A

6 weeks

210
Q

5 As of tobacco cessation

A

Ask
Advise
Assess
Assist
Arrange

211
Q

Triad of thiamine deficiency

A

Encephalopathy
Oculomotor dysfunction
Gait ataxia

212
Q

Ideas of reference

A

Associated with schizotypal PD
Believing innocuous events have strong personal significance

213
Q

Monitoring for patients on clozapine and red flags - 4

A

Weekly for first 6 months and biweekly after 6 months CBC for ANC - 1500=RF
Blood glucose
Baseline and weekly troponin, CRP, BNP

214
Q

Baseline Monitoring for lithium - 3

A

Baseline kidney and thyroid function
Baseline EKG if over 50
Weight (assoc. with weight gain)

215
Q

Maintenance monitoring for lithium

A

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

216
Q

Therapeutic and toxic lithium levels

A

THerapeutic - 0.8-1.2 (1.0 for Maintainance)

217
Q

Who can prescribe clozapine

A

Certified providers - pharmacy and patient must also be registered

218
Q

Risk factors for autism - 4

A

Advanced parental age
Premature birth weight
Rapid head circ growth
Valproate use

219
Q

Broadband ADHD assessment meaning and examples

A

Screen for symptoms of disorders other than just ADHD
Child Behavior CHecklist/Teacher report form

220
Q

Narrow band ADHD assessment tools - 3

A

Connor’s third ed short version
Childhood attention problems scale
Disruptive behavior rating scale
Vanderbilt assessment scale

221
Q

Anorexia nervosa admission criteria - only needs 1 of 5

A

BP under 80/60
BMI under 15
HR under 40-50bpm
Orthostatic pulse increase of 20bpm
Orthostatic SBP decrease of 20mmHg

222
Q

Schizoaffective disorder

A

Schizophrenia with marked psychotic or depressive symptoms

223
Q

Recommended age to screen for autism

A

18-24 months

224
Q

Verbigeration

A

WHen a patient word salads, or repeats words

225
Q

Circumstantial speech

A

Patient eventually answers questions after long rambling

226
Q

Loose association

A

Patient rapidly shifts between disconnected ideas

227
Q

Treatment for extra pyramidal symptoms induced by antipsychotics

A

Benadryl

228
Q

Side effect of amitryptilline

A

Lowers seizure threshold

229
Q

Monitoring needed for SNRIs

A

Blood pressure

230
Q

8 risk factors for schizophrenia

A

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

231
Q

Diagnostic test for restless leg syndrome

A

Iron studies

232
Q

Adult ADHD diagnostic criteria

A

Over 17
5+ symptoms of hyperactivity or 5+ symptoms of inattentiveness

233
Q

Under 17 ADHD dx criteria

A

6+ symptoms of hyperactivity or inattentiveness

234
Q

6 MC Fetishes

A

Womens underpants
Bras
Hair
Feet
Toes
Shoes

235
Q

Things associated with NREM2 sleep

A

Benzodiazepine use
Largest percentage of total sleep

236
Q

When is pharmacotherapy first line for children

A

When they are school age - psych first if younger

237
Q

SSRIs safe in breastfeeding - 2

A

Sertraline and Paroxetine

238
Q

Most commonly used substance in schizophrenia

A

Tobacco

239
Q

CLinical monitoring for 2nd gen antipsychotics

A

Baseline fasting blood glucose, A1c and lipids
Baseline EKG
CHecks FBG at 6 weeks, 3 months, 12 months and then annually

240
Q

Applied tension technique

A

Used during blood draws for those with syncopal episodes

241
Q

Tx for MRI claustrophobia

A

Benzo administration

242
Q

Mild, Mode, Severe and Extreme anorexia BMI criteria

A

Mild - Over 17
Mod - 16-16.99
Severe - 15-15.99
Extreme - Under 15

243
Q

2nd line agent for ADHD after stimulants

A

Atomoxetine - can cause nausea

244
Q

Akathisia

A

Common SE of antipsychotics
SUbjective symptom
Feelings of restlessness

245
Q

6 Lab values of anorexia

A

Long QT
Hyponatremia
Thrombocytopenia
Leukopenia
Elevated BUN and CHolesterol

246
Q

3 antipsychotics with the LEAST QT prolongation

A

Lurasidone
Paliperidone
Aripirazole

247
Q

3 antipsychotics with the MOST QT prolongation

A

Sertindole
Clozapine
Thioridazine
Ziprasidone

248
Q

2 opioids detected on UDS

A

Codeine
Morphine

249
Q

Criteria for complicated grief

A

12+ months of symptoms:
Extreme persistent yearning
Preoccupying thoughts
Loneliness
Unbearable to live/SI

Treat w/ CBT

250
Q

Presentation of marajuana intoxication

A

Tachycardia, Dry mouth, Increased appetite, Nystagmus, Ataxia, Slurred speach

251
Q

Presentation of ecstacy intoxication

A

Increased alertness
Euphoria
Serotonin syndrome

252
Q

SSRI associated with sedation

A

Paroxetine

253
Q

SSRI associated with nausea and vomiting

A

Fluvoxamine

254
Q

Electrolyte abnormality that drives complications of refeeding syndrome

A

Hypophosphatemia

255
Q

Medication for bipolar linked to neural tube defects in pregnancy

A

Carbamazepine

256
Q

Synthetic cannabinoid that won’t show on a UDS

A

Spice

257
Q

Disorder often comorbid with conduct disorder

A

ADHD

258
Q

Best approach to malingering patient

A

Subtle confrontation

259
Q

Non-psych benefit of duloxetine

A

Helps with diabetic neuropathy

260
Q

Sleep med for sleep maintainance only and sleep med for sleep onset only

A

Maintainance only - doxepin
Onset only - ramelteon

261
Q

Indication for atomoxetine for ADHD

A

Patients with a hx of substance abuse (can’t take stimulants)

262
Q

3 medications for severe cannabis withdrawal

A

Dronabinol or Gabapentin
Zolpidem for sleep disturbances

EOR Exams (3 decks)

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