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Oncology / Psych > Psych review > Flashcards

Psych review Flashcards

1
Q

How do you treat depressive symptoms in bipolar disorder?

A

lithium

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2
Q

What drugs do you have to avoid when using lithium? Why?

A

aspirin and NSAIDs since all excreted by the kidney

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3
Q

What drug do you need to check LFTs on?

A

valproic acid

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4
Q

When should you check CBC?

A

clozapine and carbamazepine

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5
Q

What drug do you need to monitor serum creatinine?

A

lithium

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6
Q

What type of therapy for BPD?

A

DBT

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7
Q

What type of therapy for bipolar?

A

interpersonal social rhythm therapy

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8
Q

What drugs (2) do you use to treat acute mania?

A

atypical antipsychotic or lithium

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9
Q

What is lamotrigine used for?

A

long term mood stabilization

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10
Q

What reaction if lamotrigine associated with?

A

Steven Johnson Syndrome

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11
Q

What are signs of lithium toxicity? (3)

A

blurry vision, GI upset, coarse tremor

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12
Q

What drug causes leukopenia?

A

carbamazepine

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13
Q

What drugs can cause hyponatremia?

A

carbamazepine or oxcarbazepine

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14
Q

What gene is associated with bipolar?

A

Clock

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15
Q

What genes (2) are associated with schizophrenia?

A

Trio and 22q11

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16
Q

When do you perform hemodialysis for Li toxicity?

A

when levels are > 4

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17
Q

When are steady state levels achieved?

A

after ~ 5 half lives

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18
Q

What are signs of normal sadness vs. depression?

A

able to function, comes in waves, no suicidal thoughts, connection to others

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19
Q

What are signs of Wernicke’s encephalopathy? (3)

A

ataxia, nystagmus and opthalmoplegia

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20
Q

What do pupils do in opioid overdose?

A

constrict

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21
Q

What drug for acute reversal of opioid overdose?

A

naloxone

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22
Q

What do you need to give in alcohol withdrawal?

A

GABA-A agonist

(benzodiazepines)

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23
Q

What drug can help with long term management of alcohol use disorder?

A

acamprosate

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24
Q

What helps improve long term outcomes in ASD?

A

early diagnosis

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25
What neurotransmitter difference is seen in positive symptoms of schizophrenia?
increased dopamine transmission in mesolimbic system
26
What neurotransmitter difference is seen in negative symptoms of schizophrenia?
decreased dopamine activity in the mesocortical pathway
27
Fluphenazine vs. fluvoxamine which is the SSRI?
fluvoxamine
28
What is most common side effect of aripiprazole?
akathisia
29
What is most common side effect of olanzapine?
metabolic syndrome
30
What is the MOA of phenelzine?
MAOI
31
What are symptoms of opioid withdrawal?
flushing, diaphoresis and diarrhea
32
What is MOA of benztropine? When do you use it?
M1 antagonist (decrease levels of AcH to balance the decrease in dopamine) give when you have extrapyramidal symptoms
33
When do you give B-blockers for psych drug side effects? Which drug?
give propanolol for akathisia induced by apripiprazole
34
Which drug is associated with agranulocytosis?
clozapine
35
Where is serotonin synthesized in the brainstem?
dorsal raphe nucleus
36
What is the only drug approved for depression in children?
SSRIs
37
If you have good premorbid functioning, what does this predict for suicide risk?
less likely
38
If you have low negative symptoms, what does this predict for suicide risk?
less likely
39
What do pupils do with cocaine intoxication?
pupils dilate
40
How does cocaine heighten the sympathetic response?
blocks reuptake of dopamine, norepinephrine and serotonin
41
What drug is a first-line treatment for alcohol use disorde?
naltrexone
42
How does naltrexone work?
blocks the rewarding effects of alcohol use
43
Can Parkinson and Huntington's disease cause hallucinations?
yes
44
Can thyroid and parathyroid disorders cause hallucinations?
yes
45
How does disulfiram work?
blocks aldehyde dehydrogenase which leads to build up of acetaldehyde leads to more negative symptoms associated with alcohol use
46
How does methadone work?
full agonist at the mu-opioid receptor, producing similar effects to heroin but without the euphoria
47
What is varenicline? What is MOA?
Varenicline is the preferred smoking cessation drug partial nicotinic receptor agonist that causes a lower risk of withdrawal symptoms compared to other drugs
48
What does buproprion act on?
blocks norepinephrine and dopamine
49
What are classic symptoms of Functional Neurological Disorder (conversion syndrome)?
sudden blindness inability to move one body part swallowing problems
50
What pathology is La Belle indifference associated with?
Functional neurological symptom disorder
51
What is treatment for functional symptom disorder?
pretty conservative treatment as the disease is normally self-limiting
52
What do pupils do during opioid withdrawal?
pupils are dilated
53
What lab value can you see to confirm a diagnosis of neuroleptic malignant syndrome? Why?
increased CK due to the severe muscle rigidity
54
What does carbamazepine due to cytochrome P450?
it acts as an inducer
55
Which atypical antipsychotic has the greatest risk for torsades?
ziprasidone
56
What is the MOA of escitalopram?
SSRI
57
What distinguishes factitious disorder from malingering?
Factitious disorder is very concerned with their disorder
58
Which opioid treatment can only be given in facilities?
methadone
59
Which opioid treatment is more widespread?
buprenorphine / naloxone
60
What drug is often used first line in alcohol withdrawal?
benzos
61
When is the highest risk for autonomic instability and seizures in alcohol withdrawal?
3-5 days later
62
What is the time period for acute stress disorder?
3 days to 4 weeks
63
What changes in the brain happen in ADHD?
delayed cortical maturation in prefrontal cortex which leads to problems with impulse control
64
What drug classes can help irritability and aggression in ASD? (4)
1. atypical antipsychotics 2. alpha agonists (ex: clonidine) 3. SSRIs 4. stimulants
65
When is ECT particularly useful for treatment of bipolar disorder?
during pregnancy since the other drugs have teratogenicity
66
What type of amnesia can ECT cause?
retrograde amnesia
67
What drugs do you give for management of acute mania?
antipsychotics – olanzapine or risperidone
68
What lab value indicates refeeding syndrome?
hypophosphatemia
69
What is the monoamine hypothesis?
suggests that depression is caused by a deficiency in the levels of serotonin, norepinephrine and/or dopamine
70
What memories often go first in ECT?
retrograde memories close to the time of treatment
71

Oncology / Psych (3 decks)

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