Psych Qbank (on Anki) Flashcards
What is liftetime risk of developing bipolar?
1% for general population, 5-10% for 1st degree relative
What is the psychotic disorder where one person’s delusion is transferred to another?
Folie a deux (madness shared by two)
What is required to diagnose MDD?
4 of SIGECAPS + depressed mood or loss of interest
What is required to diagnose adjustment d/o w/ depressive features?
Sx occur w/in 3 mo of identifiable stressor (non life-threatening, otherwise PTSD), and end w/in 6 mo
Difference btw panic and anxiety d/o?
Panic d/o characterized by recurrent, unexpected panic attacks. And concern about additional attacks (not necessarily trigger)
Length of sx required for ADHD dx?
6 mo of intattention, short attenttion span, or hyperactivity in 2 settings
Why do stimulants work in ADHD (2 pathways)?
- NE and 2. dopaminergic pathways of attention
First and second line for ADHD?
- Dextroamphetamine, methylphenidate
Patient with depression and neuropathic pain?
Use duloxetin (approved for both) rather than SSRI
Length of sx for MDD?
2 weeks (5 total sx)
What is Zolpidem (category)
Hypnotic = sedative
Tx for patient w/ depression and insomnia?
Mirtazepine
Dx of dysthymia?
Persistent depressive sx for >2 years
Rx for OCD other than SSRIs?
Clomipramine (TCA) - used second given side effects
Psychotic symptoms occur exclusively during mood episodes in (2)?
MDD w/ psychotic featurs, bipolar I
Significant mood episode w/ concurrent psychotic sx in addition to a period of psychosis w/o mood sx for at least 2 weeks - dx?
Schizoaffective
Schizophreniform - a form of schizophrenia
Lasting >1 to
What is typical duration of bereavement?
No longer than 2 months
What is the rx for NMS?
Dantrolene
What is the neurotic defense mechanism?
Substitute behavior/feelings tat are exact opposite of feelings
In addition to epilepsy, what’s another contraindication to buproprion?
Hx of anorexia/bulemia or current EtOH or benzo use (electrolyte abnormality)
Difference between repression and denial defense mechanism?
Repression - block inner states - block upsetting ideas/impulses from entering consciousness. Denial - block external sensory data (ie. Refuse to acknowledge the presence of a mass)
What is time frame for adjustment disorder?
Within 3-6 months after stressor
Rx of amphetamine w/drawal?
Buproprion and/or bromocriptine
Who are good candidates for LAI (long-acting injectable) antipsychotic
Patients w/ unstable illness,live alone, poor social support, poor insight, frequent medication noncompliance
Personality d/o: patients who like being alone
Schizoid (I in zoid for me myself and I)
Feelings of borderline patients?
Anger, chronic emptiness (parttern of instability in relationships, marked impulsivity)
What side effect is most commonly seen with Olanzapine?
Weight gain (in addition to clozapine)
MOA of olanzapine?
Primarily a serotonin-dopamine antagonist. Also affinity for histamine, alpha-1 adrenergic, muscarinic. Antagnism of histamine and 5HT –> weight gain. Histamine –> sedation
Rx for anxiety in adjustment d/o?
Buspirone and clonazepam
Rx for depression + insomnia?
Trazodone
Rx for acute dystonia?
Anticholinergics (benztropine) or antihistamines (diphenhydramine)
Avoid Li in what?
Renal dz
Aviod Valproate in what?
Liver dz
When to use adjunctive benzos?
Insomnia, agitation
Difference btw normal stress response vs. adjustment d/o w/ depression
Significant functional impairment
What is d/o characterized by inability to resist impulse to steal objects of low monetary value/not needed for personal use, and rx?
Kleptomania (not premeditated, and patient normally feels guilt/shame) –> CBT
Which antipsychotic associated w/ cataracts?
Quetiapine
Conversion disorder vs. somatic symptom d/o?
Conversion - sudden onset neuro sx incompatible w/ nl neuro exam (aka functional neuro sx d/o) triggered by stressor
What is factitious d/o?
Intentional production of physical or psychological sx w/ the goal of assuming sick role
What is malingering?
Intentional production of FALSE or exagerated physical or psychological sx w/ the motivation of 2ndary gain
What are comorbidities commonly associated w/ panic d/o (4)?
Major depression, bipolar, agoraphobia, substance abuse
Patients who have been sexually assaulted at higher risk of (3)?
PTSD, MDD, suicide contemplation/attempts (NOT necessarily substance abuse)
What neurotransmitter associated w/ psychosis?
Increased dopaminergic activity
What neurotransmitter reduces likelihood of EPS?
Serotonin receptor binding
Review #38 - presentation of NMS
(Sx of fever, rigidity, AMS, autnomic instability)
Organic causes of neurocog deficits?
Autoimmune, heavy metals, Wilson’s, carcinoid, pheo
Rx for social phobia (2 kinds)?
If generalized: SSRI/SNRI and CBT. If performance-only: benzo/BB 30-60” before event and CBT
Serotonin syndrome sx?
Tachycard, bp
What can eating cheese with MAO-I cause?
Hypertensive crisis
Dissociative disorders
- Dissociative identity d/o = multiple personality d/o. 2. D amnesia = 1+ more episodes of inability to recall important personal info. 3. D fugue = sudden travel. 4. Derealization d/o = state of experiencing familiar persons/surroundings as if strange/unreal
In addition to excessive anxiety about multiple events, what additional sx needed for 6 mo for GAD?
3 of: impaired sleep, poor concentration, fatigue, irritability, musc tension, restlessness
Dx of bipolar
Elevated/irritable mood + increased energy + 3 of the DIGFAST sx
Timeframe for dystonia?
4 hrs to 4 days after receiving antipsychotic - muscle spasms/stiffness, tongue protrustion/twisting, etc
What labs should be monitored with Li?
Kidney, TFT
How long to wait before switching SSRI when starting one?
4-6 weeks
Tree in a dark forest is a monster
Example of illusion
God has given me a mission
Grandiose delusion
The radio has a special implicated message for me
Ideas of reference
What are treatment options for narcolepsy?
Modafinil first line. Amphetamine stimulants. Sodium oxybate (Xyrem) reduces the cataplexy
Sx of narcolepsy?
Daytime drowsiness, cataplexy (sudden loss of muscle tone with strong emotions)
Contraindication for lithium?
Elevated Cr
What are neuroimaging findings of autism?
Increased total brain volume
What are neuroimaging findings of OCD?
Abnormal Orbitofrontal cortex & striatum
What are neuroimaging findings of panic d/o?
Decreased volume of amygdala
What are neuroimaging findings of PTSD?
Decreased hippocampus
What are neuroimaging findings of schizophrnia?
Enlargement of cerebral ventricles
What is projection?
Putting internal thoughts on others
What is denial?
Block acceptance of external seonsory data
What is repression?
Blocking upsetting ideas/impulses from entering consciousness
What is dissociation?
Disruptions/alterations in memory, identity, consciousness, perception
Psychosis characterized by one or more of_
Delusions, hallucinations, and d/o speech/behavior
Psych med whose use can cause seizures
Buproprion (dose-dep)
Psych med whose d/c can cause seizures
Short-acting benzo
Elevated prolactin caused by antipsychotic vs. prolactinoma?
Meds cause mildly elevated prolactin, vs. prolactinoma causes very high levels >200
First line treatment for specific therapy?
Behavioral therapy
What is displacement?
Transferring emotions to a safer alternate object or person
Sx of persistent depressive disorder
Chronic depressed mood 2+ years, no sx-free period for >2 mo, w/ 2 of the sx: SECA, low self-esteem, hopelessness
GAD anxiety about -
Multiple issues for >= 6 mo
Defense mech: attributing inner feelings to others
Projection
Defense mech: returning to earlier stage of development
Regression
Defense mech: source stays the same but target changes (mom yells at child b/c husband yelled at her)
Displacement
Defense mech: forgetting it so it’s nonretrievable
Repression
Defense mech: the unacceptable is transformed into its opposite (man who has libidinous thoughts enters monastery)
Reaction formation
Defense mech: moving an unacceptable impulse into acceptable channel
Sublimation
Defense mech: forgetting it but it’s still retrievable (don’t worry about it now)
Suppression
Timing of bipolar I?
7 days
Timing of bipolar II?
4 days
L frontal lobe lesion mimics this psych condition
Depression
Temporal lobe epilepsy mimics this psych condition
Psychosis
R frontal lobe lesion mimics this psych condition
Mania
Cushing’s dz mimics this psych condition
Mania
Lewy body dementia mimics this psych condition
Psychosis
Neurofibrillary tangles and plaques
AD
Bilateral caudate atrophy
HD
Ventricular enlargement
Schizophrenia
Timing of dx of anorexia or bullemia
3 mo
Rx for PTSD nightmares
Prazosin
Rx for catatonia
Benzo
Tangentiality is seen in
Mania
Thought blocking is seen in
Depression, psychosis
These antipsychotics associated w/ EPS
Haloperidol, Risperidone
This antipsychotic associated w/ akathesia
Aripiprazole
This antipsychotic associated w/ orthostatic hypotension
Quetiapine