Psych JB Flashcards
ADHD sx
sx before age 12 and present for at least 6mo
sx occur in 2 settings
ADHD tx
behavior modification
stimulants TOC (Ritalin, adrenal, Focalin)
non stimulants: Strattera, SNRI
Electroconvulsive therapy AE
short term memory loss
increased HR and BP during procedure
HA, N, muscle aches, disorientation, confusion, fatigue
agoraphobia tx
SSRI
SNRI
psychotherapy: combo of exposure therapy, relaxation, and breathing training
alcohol withdrawal tx
IV benzo, IV fluids
IV thiamine and mg (before glucose)
multivitamin (+ B12 and folate)
dextrose
avoid meds that decrease seizure threshold (buproprion, haloperidol, anticonvulsants, clonidine, BB)
anorexia nervosa dx and labs
BMI <17.5 or body weight <85 the ideal weight
labs: leukopenia, leukocytosis, anemia, hypoK, increased BUN (dehydration), hypothyroidism, osteopenia, osteoporosis
anorexia nervosa tx
hospitalization for <75 expected weight or complications
psychotherapy: CBT, supervised meals, weight monitoring
anorexia nervosa tx
depression: SSRI, atypical antipsychotics
no buproprion w/ eating disorders or seizures
calcium, vit D, estrogen
antisocial personality disorder sx
> 18yo
may commit criminal acts without regard to laws
lack of empathy
bipolar disorder I criteria
> 1 manic (1w) or mixed episode with often cycles depressive episodes.
bipolar disorder II criteria
> 1 hypomanic episode (4d) + >1 major depressive episode. mania or mixed episodes absent
strongest risk factor in bipolar disorder
family hx, first degree relative
bipolar disorder tx
mood stabilizer: lithium 1st line
valpropc acid, carbamazepine, olanzapine,
haloperidol, benzo for psychosis or agitation
ECT
brief psychotic disorder
> 1 psychotic sx w/ onset and remission <1mo
bulimia nervosa labs
hypoK
hypoMg
normal/overweight
metabolic alkalosis (from vomiting)
bulimia nervosa PE
Russel’s sign: calluses on dorsum of hands
teeth pitting/enamel erosion
bulimia nervosa tx
CBT and fluoxetine
cocaine abuse tx
benzo +/- antipsychotics (halperidol) for agitation
dissociative fugue tx
psychotherapy
analgesics overdose sx
respiratory depression, miosis
stupor, hepatic injury, hypoxemia
illness anxiety disorder sx
hypochondriasis
fear or belief that one has or will contract a serious undiagnosed disease
>6mo sx, somatic sx not present
Major depressive disorder sx
> 5 almost every day for most days for at least 2 weeks
Sleep disturbances
Interests
Guilt
Energy
Concentration
Appetite
Psychomotor
Suicide
major depressive disorder tx
CBT
SSRI
nicotine dependence tx
CBT + OTC gum, nasal spray, patch
buproprion
varencicline
OCD sx
obsessions: recurrent and persistent thoughts and images
compulsions: repetitive behaviors that they feel driven to perform
OCD tx
CBT
SSRI (fluoxetine), SNRI (venlafaxine)
panic disorder sx
recurrent unexpected panic attacks + 1mo of persistent worry for another panic attack
panic disorder tx
long term: SSRI 1st line, CBT
Acute attack: benzo
postoperative psychosis sx
patient w/ recent hx of surgery that needed anesthesia
postpartum depression tx
SSRI
brexanolone (FDA approved)
psychogenic polydipsia labs
urine specific gravity 1.005
low sodium
psychosis tx
2nd gen antipsychotics 1st line (risperidone, olanzapine, quetiapine)
clozapine for refractory cases
1st gen antipsychotics for + sx but associated with extrapyramidal sx
schizoaffective disorder sx
schizophrenia + mood disturbance (MMD/manic episode)
schizophrenia criteria
> 6mo w/ 1mo of acute sx along with functional decline
schizophrenia tx
hospital for acute psychotic episodes
2nd gen antipsychotics 1st line (risperidone, olanzapine, quetiapine)
clozapine for refractory cases
1st gen antipsychotics better for + sx
schizophreniform disorder sx
criteria for schizophrenia but <6mo
shaken baby syndrome sx
bilateral retinal hemorrhage, failure to thrive
diffuse brain injury, poor feeding
blunt head trauma
seizure
somatic symptom disorder sx
patient has physical symptoms involving >1 part of the body but no physical cause can be found
ecstasy abuse sx
HTN, tachycardia, hyperthermia, hyponatriemia (increased fluid intake)
neuro sx (confusion, seizure, cerebral edema)
hepatotoxicity (jaundice, abd pain, N/V, increased bill, increased AST/ALT)
nicotine substance disorder sx
yellowing of fingers/nails
smell of nicotine on hair and clothes
agitation to withdraw
weight gain if attempting to stop
tardive dyskinesia tx
switch to 2nd gen antipsychotic
deutetrabenazine
valbenazine