Psych Shelf Flashcards by Jaleh Akhavan

Risperidone side effects?

(serotonin &amp; dopamine antagonist)
postural hypotension
movement disorders (esp. extrapyramidal withdrawl syndrome)
increased prolactin
weight gain
sedation
decreased concentration

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carbamazepine side effects?

aplastic anemia
SIADH
agranulocytosis
teratogenic (craniofacial defects)

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pneumonic for major depressive disorder?

S- sleep disorder
I- loss of interest
G- guilt
E- loss of energy
C- poor concentration
A- loss of appetite
P- psychomotor retardation or agitation
S- suicidality

At least 5 of these everyday for 2 weeks + depressed mood

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First line treatment for specific phobia?

behavioral therapy

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Which drugs have side effects of diabetes/hyperlipidemia/metabolic syndrome?

atypical antipsychotics - clozapine, risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole

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What’s an erotomaniac delusion?

False belief that someone is in love with you

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treatment for extrapyramidal symptoms d/t antipsychotics?

anti-cholinergics - benztropine

or diphenhydramine

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What is akathisia and what’s the treatment?

Akathisia = “inability to sit;” restlessness seen most commonly with high-potency typical antipsychotics (haloperidol & chlorpromazine)

Treatment = beta-blocker (propanolol is the best) -> think inability to sit is like inhibition of parasympathetic system so give beta-blocker to turn off the sympathetic branch a little

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Treatment for pediatric OCD?

1- cognitive behavioral therapy
2- serotonergic reuptake inhibitors
-> SSRIs (fluoxetine, fluvoxamine, sertraline) or clomipramine (a TCA that inhibits serotonin & NE reuptake)

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Treatment for negative symptoms of schizophrenia?

Olanzapine & Clozapine

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Which antidepressants affect warfarin metabolism?

sertraline, paroxetine, fluvoxamine

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pharmacotherapy for Tourette’s?

dopamine antagonists -> fluphenazine, pimozide, haloperidol

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Thioridazine side effects?

QT prolongation

retinitis pigmentosa

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Olanzapine side effects?

orthostatic hypotension
increased prolactin
anticholinergic
weight gain
somnolence

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Side effects of all TCAs

anticholinergic: dry mouth, blurry vision, urinary retention, constipation, sedation,
Anti-alpha: orthostatic hypotension, tachycardia
QT prolongation
weight gain

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Which antidepressant can also treat ADHD?

buproprion

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What’s the concordance rate for mood disorders (like depression) in identical (homozygotic) twins?

90%

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lifetime risk of suicide in mood disorders?

10-15%

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Best antidepressant atypical depression?

MAOi

Best antidepressant for melancholic depression?

TCAs

What are the CAGE questions?

Have you ever felt the need to CUT down on drinking?
Have you ever felt ANNOYED by criticism on your drinking?
Have you ever felt GUILTY about drinking?
Have you ever had to take a morning EYE-OPENER?

> 1 Yes = alcoholism likely

Acronym for personality disorders?

M- maladaptive
E- enduring
D- deviates from norm
I- inflexible
C- causes impaired social functioning

Cluster A personality disorders

WEIRD

Paranoid - perceive attacks on self that are not apparent to others
Schizoid - social isolation; cold & detached
Schizotypal - magical thinking; “out-of-body” perceptual experiences

Cluster B personality disorders

WILD

Borderline - impulsive; unstable; labile moods; lots of SI; chronic feelings of emptiness
Histrionic - need to be “center of attention;” provocative
Narcissistic - grandiosity about self; lack of empathy
Antisocial - impulsive; deceitful; lack of remorse; failure to conform to social norms/lawful behavior

Cluster C personality disorders

WORRIED/WIMPY Obsessive-compulsive - needs control; perfectionist; inflexibility of morals and values Avoidant - excessive shyness; hypersensitive to rejection; fears being disliked or ridiculed Dependent - submissive; clingy; can't be alone

Somatization Disorder

* Begins before age 30 * lasts several years * 1% prevalence * 5:1 Female:Male * 4 pain symptoms, 2 GI, 1 sexual, 1 pseudoneurologic *Tx: psychotherapy; regular, brief PCP visits

Conversion Disorder

* neurologic complaint * symptoms are NOT feigned * patient is indifferent -> la belle indifference *Tx: anxiolytics; can spontaneously remit

Hypochondriasis

* worry/fear of having a serious disease * >6 months * onset usually 20-30 yo *Tx: group therapy; frequent reassurance

Pharmacotherapy for GAD?

SSRIs imipramine (a TCA) buspirone

Treatment for TCA overdose?

sodium bicarbonate

3 "C"s of TCA toxicity?

Convulsions Coma Cardiac arrhythmias

anaclitic depression

AKA hospitalism from Rene Spitz infants that are emotionally deprive can fail to thrive

absolute contraindication to buproprion?

seizure disorder (buproprion can lower the seizure threshold)

main nucleus releasing NE?

locus ceruleus! * in pons near 4th ventricle and para-cerebral aqueduct * involved in physiologic response to stress/panic * hyperactivity here could be part of PTSD symptoms

function of nucleus basalis of Meynert?

* associated with memory formations * supplies ACh * degenerates in Alzheimer's

function of nucleus accumbens?

* associated with reward and addiction | * supplies serotonin

dystonic reaction? What is it & how to treat.

* due to neuroleptics (high potency, like haloperidol) * sustained spasmodic contraction -> like torticulous * treat with diphenhydramine * usually occurs within 3 days of beginning treatment * more common in men

Broca's area?

* located in left lateral frontal lobe * lesion = normal comprehension; inability to speak * usual deficit due to left middle cerebral artery stroke

origin of partial complex seizures?

* temporal lobe | * usually start with bad odor

anterior nucleus of hippocampus?

sexual behavior lesion = suppressed sexual interest

ventromedial nucleus of hippocampus?

satiety center for appetite lesion = get fat

lateral nucleus of hippocampus?

stimulates appetite lesion = anorexia

posterior nucleus of hippocampus?

works with RAS to control arousal lesion = lethargy & somnolence

supraoptic & paraventricular nuclei of hippocampus?

produce ADH & oyxtocin -> neurons take these to the posterior hypothalamus

Most worrisome side effects of clozapine?

agranulocytosis | seizure

neuroleptics causing photosensitivity?

low-potency typicals - esp. chlorpromazine

blood alcohol level at which most people have slurred speech/memory impairment/blackout

200-300 mg/dL