Psych MS4 Flashcards
Tx of delusional disorder
Psychotherapy - do not support or refute delusion; maintain alliance
Time frame of delusional disorder
1 month
What is the most common psychiatric disorder
Specific phobia
Describe pathophysiology of tardive dyskinesia
• Dopamine receptor upregulation and supersensitvity resulting form chronic blockade of dopamine recepots
Medical tx of narcolepsy
Modafinil (nonamphetamine stimulant)
Onset of postpartum blues vs depression
Blues = 2-3 days after delivery
Depression = 4-6 weeks after delivery
Time frame of postpartum blues vs depression
Blues = usually resolves in 10-14 days
Depression = >2 weeks
Tx of postpartum blues vs depression
Blues = watch and wait
Depression = SSRI and CBT
Tx of postpartum psychosis
atypical antipsychotics + hospitalization (pt has increased risk of suicide and infanticide)
What may you see on head imaging in scizophrenia
Lateral ventricular enlargement
Effect of Mirtazipine on weight
Weight gain
What atypical antipsychotics are least likely to cause hyperprolactinemia
Aripiprazole
Quetiapine
Tx of catatonia
- Benzos (Lorazepam)
- ECT
First-line tx for ADHD
Stimulants (amphetamine, methylphenidate)
2nd line tx for ADHD
Non-stimulants (Atomoxetine)
What is the difference between nightmare disorder and sleep terror disorder
Nightmare -
- Diagnosis requires recurrent episodes of awakening from sleep with recall of highly disturbing and frightening dream content
- On awakening, child is fully alert, remembers the dream, and can usually be consoled
Sleep terror -
o Characterized by incomplete awakenings, unresponsiveness to comfort, and no recall of dream content
Tx of somatic sx disorder
o Regularly scheduled visits with same provider
o Limit unnecessary workup and specialist referrals
o Legitimize symptoms but make functional improvement the goal
o Focus on stress reduction and improving coping strategies
o Mental health referral if patient will accept
what psychiatric disorder might be associated with enlarged lateral ventricles
Schizophrenia
What hormone abnormality might you see in depression
Increased cortisol levels
Which antipsychotics are least likely to cause hyperprolactinemia
Aripiprazole and Quetiapine
Tx of delirium-associated agitation
Haldol
Drugs used to tx Alzheimers
Galantamine, Rivastigmine, Donepezil
Describe presentation of REM sleep behavior disorder
o Characterized by complex motor behaviors that occur during sleep
o Dream enactment can occur if the muscle atonia that usually accompanies REM sleep is absent or incomplete
Vs. nightmare disorder where people do not usually have motor activity
Which antipsychotic is least likely to cause tardive dyskinesia
Clozapine
Tx of agitation secondary to PCP intoxication
Lorazepam
Haldol is 2nd line
What are the short acting benzos
Think ‘fast ox’ and “all AM”
Oxazepam
-‘olam’ suffix (Triazolam, Alprazolam, Midazolam)
What are the long acting benzos
Diazepam
Chlordiazapoxide
Tx of Neuroleptic Malignant Syndrome (NMS)
- Discontinue antipsychotic medication
- Supportive management (cardiac monitoring, intubation)
- Dantrolene (muscle relaxant to decrease rigidity and myonecrosis)
- Bromocriptine (dopamine agonist to undo effects of antipsychotic)
Tx of tardive dyskinesia
- Reduce, stop, or change antipsychotic
- Clozapine may reduce or eliminate TD
- Tx with Valbenazine
Preferred medication to tx psychosis in Parkinson’s pt
Quetiapine - sedating + less EPS
