Psych- FA Flashcards
Nacrolepsy is associated with decrease of what protein? What is another name of this protein?
hypocretin
also called as orexin
How to treat Nacrolepsy? (3)
Modafinil or amphetamine: day time stimulator
sodium oxybate: night time
- modafinil works as dopamine reuptake blocker
tranylcypromine: what drug class is this?
MOAI-A : serotonin, dopamine, NE
Bupropion: MOA?
increased NE and dopamine with unknown mechanism
- sketchy: NET (NE) DAT (dopamine)
How to differentiate between nightmare vs. sleep terror disorder
nightmare: occurs during REM sleep, beta wave, memory of dream
sleep terror disorder: occur during deep sleep (N3), delta wave, NO MEMORY of dream
How long do major depressive episodes usually last? how long do symptoms should be present for diagnosis?
6-12 months
- symptoms need to present >2 weeks
A patient is hostile toward her female psychiatrist. History reveals a tumultuous past with her mother. What term describes this behavior?
transference: transfer of emotion to other person ONTO PHYSICIAN
vs. displacement: transfer of motion ONTO another WEAK PERSON
Persistent depressive disorder: duration?
more than 2 years
dopamine level in depression?
decreased
normal grief persists for how long?
less than 6 months
more than 6 months of prolonged grief is considered as pathologic grief
methylphenidate
- MOA
- indications
CNS stimulant (like amphetamines)
indications
- ADHD
- nacrolepsy
- appetite control
how to treat serotonin syndrome?
cyproheptadine
- 5HT antagonist
Reinforcement vs. punishment: explain each in terms of positive and negative
- positive reinforcement: giving award
- negative reinforcement: removal of aversive stimulus
- positive punishment: giving punishment
- negative punishment: removal of award
- BOTTOM LINE: positive- giving something, negative- removal of something
- Both are under category of operant conditioning- it ULTIMATELY leads to TARGET BEHAVIOR
Define paranoid
distrust and suspicious
type A personality disorder
What is key difference between acute stress disorder and PTSD?
duration
acute stress disorder: < 1 month
PTSD: > 1 month
- acute stress disorder is preform of PTSD
methadone vs. buprenorphine in heroin addiction treatement
- methadone: long acting FULL agonist, for long term maintenance
- buprenorphine: long acting PARTIAL agonist,
Explain how naloxone + buprenorphine combination is helpful for heroin addiction
naloxone: opioid antagonist
buprenorphine: long acting partial agonist
naloxone is not orally available, withdrawal symptoms (due to antagonistic effect) only occur when injected. Thus when both are given together orally, buprenorphine primarily works to prevent withdrawal symptoms
=> low abuse potential
How to treat body dismorphic disorder?
CBT (cognitive behavioral therapy)
What is agoraphobia?
phobia for closed space, crowded public, using public transportation or public restroom
postpartum blue: onset and how long does it last
few days onset, resolve in 10 days
postpartum depression: onset and how long does it last
onset within one month, it lasts until get proper treatment
brief psychotic disorder: duration? vs. psychosis?
brief psychotic disorder: < 1 month
psychosis: > 6 month
Mirtazepine: MOA? level of what neurotransmitters will be changed?
alpha 2 antagonist
NE and serotonin level would be high
- sketchy: North balloon and smile ballon next to sign
clomipramine: what drug is this?
TCA
trazodone is indicated for what? what is side effect?
mainly used for insomnia
* high dose is needed for depression
side effect: priapism
sensation of ants crawling on his skin. What is this called? What substance abuses is this associated with?
Formication (a tactile hallucination)
- cocaine abuse (Cocaine Crawlies), alcohol withdrawal
What defense mechanism is associated with borderline disorder?
splitting
- borderline disorder: unstable mood, emptiness and impulsivity. MOOD IS SPLITTED
what is used for BDZ overdose? why is this rarely used?
flumazenil, rarely used as it can precipitate seizure
What is akathisia?
restless
- common side effect of antipsychotics
- unable to sit
Difference between fixation and regression?
stress
regression is INVOLUNTARY under STRESS
fixation is not associated with stress
Two antidepressants that do not cause sexual dysfunction?
- bupropion
- mirtazapine
schizophreniform disorder: diagnostic criteria?
duration is the only factor
schizophrenia more than 1 month, less than 6 month
What is the only neurotransmitter whose level is changed in schizophrenia?
increased dopamine
- dopamine= sort of excitement neurotransmitter= schizophrenia
definition: oppositional defiant disorder vs. conduct disorder?
- oppositional defiant disorder: no violation of rules or crimes
- conduct disorder: violation of rules, <18 yo (same thing for >18 yo is antisocial)
In terms of voluntariness and maturity, how do repression and suppression differ?
Repression is involuntary and immature
suppression is voluntary and mature
*“suppression” sounds like intentional endeavor
A boy has exhibited tics for the past 6 months. How long do symptoms need to be present for Tourette syndrome to be diagnosed?
More than 1 year
PCP (phencyclidine) intoxication symptoms? (there are a lot)
jerky movements (psychomotor agitation), violence, delirium, impulsivity, seizures, nystagmus
- think PCP as something rough
PCP: MOA?
NMDA antagonist
visual and auditory perceptual distortions, depersonalization, paranoia, psychosis, and flashbacks: what intoxication?
LSD
Lsd : Light- visual distortion
Which drug intoxication shows conjunctival injection?
marijuana
- remember my eyes got really dried after marijuana
How to treat PCP intoxication
BDZ
- this makes sense: PCP intoxication is rough (violence, impulsivity, derilum, nystagmus) so you wanna depress it with depressant
busprione
- MOA
- onset
- benefit
- indication
- 5HT agonist
- slow onset: takes 1-2 weeks to take effect
- this was UWORLD question
- no sedation/ addiction/ tolerance
- second line for generalized anxiety disorder
What is vulnerable child syndrome?
Parents think their child is more susceptible to illness or injury, often following a major illness or life-threatening event
=> may result in missed school or overuse of medical device
definition: transference vs. countertransference
transference: patient project feelings onto doctor
(doctor is seen as a parent)
countertransferance: doctor project feelings on to patient (pt reminds doctor of young sibling)
Are men or women at greater risk for suicide completion?
Men (although women attempt suicide more frequently)
symptoms need to be present for how long for manic episode diagnosis?
at least 1 week
What is Russell sign?
dorsal hand calluses: indicates self- induced vomiting in bulimia nervosa
Your patient has been taking an SSRI for 2 weeks but reports no benefit. What do you do?
Reassure her because it normally takes 4 to 8 weeks for an SSRI to show clinical benefit
imipramine
- what class of drug
- indication
TCA
nocturnal bed wetting
acutely suicidal patients: what immediate treatment can be done?
electroconvulsive therapy
Which antidepressant is contraindicated in bullemia/anorexia?
bupropion: induces seizure
* sketchy: hazy girl (seizure) spills popcorn on ground
duration for diagnosis of delusional disorder?
> 1 month
MOA of varencline: how is this helpful in treating smoking cessation?
partial agonist for nicotinic Ach receptor: decreases withdrawal effect of smoking
What is depression with atypical features?
most common subtype of depression
- mood reactivity: feel happy briefly with positive stimulus
- reversed vegetative symptoms: hyperphagia, hypersomnia
- leaden paralysis: heavy feeling in arms/legs
generalized anxiety disorder vs. adjustment disorder
- generalized anxiety disorder: anxiety with unidentifiable causes.
- adjustment disorder: anxiety with identifiable stressors (moving, divorce, etc)
A woman has a desire to keep her nails trimmed to 1 cm exactly. This does not bother her. diagnosis?
obsessive compulsive personality disorder
: behaviors not conflicting with ones belief/attitude
* It dos not bother her. She believes it is right
* example: PERFECTIONISM, preoccupied with LISTS, fail to finish tasks on time because of overly strict standards, prioritize work over social relationships, be inflexible regarding ethics/morals, dislike delegating, and be rigid or stubborn.
vs. OCD ( not personality disorder): behaviors conflicting with ones belief/attitude
* It would bother patient. Even though it bothers patient, patient keeps doing it.
lithium is reabsorbed in what part of nephron segment?
PCT
Which diuretics should be avoided in bipolar patient taking lithium? why?
thiazide
thiazide -> decreased GFR -> increased lithium reabsorption at PCT ( this is pretty similar mechanism regarding why thiazides are used to treat nephrogenic DI) -> decreased lithium clearance => increased lithium toxicity
Compare schizoid and avoidant personality disorders.
Schizoid patients do not desire social contact
Avoidant patients desire social contact but have difficulty achieving it (fear against criticism)
Which drug is used for relapse prevention in heroin addiction treatment?
naltrexone, long acting opioid antagonist
- think like this: it is relapse. that is patient has been using it even after overcoming withdrawal symptoms. So you wanna shut down opioid now, while not worrying about withdrawal symptoms
How to treat neuroleptic malignant syndrome? (2)
- dopamin agonist: bromocriptine
- dantrolene
Rett syndrome
- inheritance pattern
- phenotypes (3)
- x-linked DOMINANT: seen only in girls, males are lethal
- phenotype
1. hand wringling: this is pretty specific phenotype
2. developmental delay
3. ataxia
hallucination: hypnagogic vs. hypnopompic
What disease is associated with these two?
- hypnogogic: hallucination before going to sleep
- hypnoGOGIc: GOING to sleep
- hypnopompic: hallucination after awaekning
- hypnoPOMPic: PUMPed after waking up
both are associated with nacrolepsy
piloerection (goose bump) is phenotype of what drug withdrawal?
opioid (heroin)
A boy who is abused at home begins to bully other children at school. What is the ego defense?
identification
- Identify oneself by repeating SAME BEHAVIOR to other people
vs. displacement: transfer of EMOTION (yelling) to weaker one. displacement does not involve repetition of SAME behavior
What anti-depressant drug can be used as migraine prophylaxis?
amitriptyline (TCA)
Is dendritic branching increased or decreased in schizophrenia?
decreased
Which antipsychotic causes corneal deposits? Which one causes retinal deposits?
Chlorpromazine—Corneal deposits
Thioridazine—reTinal deposits
Which drug intoxication can cause sudden cardiac arrest?
cocaine
- think like this: cocaine is stimulant. You stimulate heart too much (tachycardia), and heart is responding “alright screw you. too much work. im gonna stop”
How cAMP level changed with use of typical antipsychotics?
increased
typical antipsychotics: D2 blocker
remember D2 is Gi (MAD2). Thus D2 blockade results in increased cAMP
Difference between typical and atypical antipsychotics in terms of treating symptoms of schizophrenia?
- typical: primarily works on positive symptoms
- atypical: BOTH positive and negative symptoms
transvestism
wearing clothes (vest) of the opposite sex
- transVESTism= VEST wearing
shaken baby syndrome, type of child abuse, can be diagnosed from what physical exam finding?
retinal hemorrhage
define Pseudocyesis
person believes that she is pregnant although she is not
Define passive aggression
indirectly showing opposition
: coming in late at work indirectly showing complaint to boss
vs. reaction formation: signs of opposition is not evident, because complaint is masked by opposite behavior
how head/brain size is affected in autism spectrum disorder?
increased head/brain size
- autism patients sometimes can be genius at specific field. large brain!`
ADHD: onset age?
before age of 12
