Psych treatments: Childhood, mood, and psychosis Flashcards

1
Q

What is the treatment for mental retardation

A

Genetic counseling for expectant mothers, special education, and behavior therapy to reduce negative behaviors

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2
Q

The four pervasive developmental disorders occur before age 3 and include autistic disorder, rett disorder, childhood disintegrative disorder, and asperger disorder. What is the treatment for autistic disorder and childhood disintegrative disorder

A

Make them achieve independant living, use behavior modification programs

If aggressive, antipsychotics

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3
Q

The four pervasive developmental disorders occur before age 3 and include autistic disorder, rett disorder, childhood disintegrative disorder, and asperger disorder. What is the treatment for rett disorder?

A

Symptomatic

  1. ) Behavior therapy for self injurious behavior
  2. ) Physiotherapy for muscular dysfunction
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4
Q

The four pervasive developmental disorders occur before age 3 and include autistic disorder, rett disorder, childhood disintegrative disorder, and asperger disorder. What is the treatment for asperger syndrome

A

None

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5
Q

What is the treatment and side effects for attention deficit hyperactivity disorder

A

First line: Methylphenidate and dextroamphetamine - side effects are insomnia, decreased appetite, and headache

Second line: Atomexetine (NE reuptake inhibitor) - even though second line, less side effects so choose this on USMLE

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6
Q

Two disruptive behavior disorders are oppositional defiant disorder (argue but don’t break law) and conduct disorder (breaks laws). What is the treatment for oppositional defiant disorder

A

ODD: Teach parents appropriate child management skills

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7
Q

Two disruptive behavior disorders are oppositional defiant disorder (argue but don’t break law) and conduct disorder (breaks laws). What is the treatment for conduct disorder

A

Behavior intervention - rewards for prosocial or nonaggressive behavior

If aggressive, use antipsychotics

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8
Q

What is the treatment for tourette disoder

A

Antipsychotics (dopamine antagonists), i.e. risperidone

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9
Q

What is the most common medical cause of major depression and must be ruled out

A

Hypothyroidism

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10
Q

What is the treatments for depression

A

SSRI’s and cognitive psychotherapy to develop positive ways of thinking

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11
Q

What is depression + neuropathic pain treated with

A

Desvenlafaxine

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12
Q

What is depression but people who are afraid of weight gain and sexual side effects given

A

Buproprion

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13
Q

For bipolar disorder, what other causes must be ruled out

A

Cocaine and amphetamines - get urine drug screen

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14
Q

If someone with bipolar disorder is in the acute manic stage, what medications should you use

A

Lithium

Can also use valproic acid, atypical antipsychotics

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15
Q

If someone with bipolar disorder is in the depression stage, what medications should you use

A

Lithium or lamotrigine

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16
Q

Atypical depression is composed of reverse vegetative symptoms, depression worse in evening, and feeling of heaviness. What is the treatment

A

SSRI’s or MAOi’s

Choose SSRI’s on USMLE if both given, but MAOi’s are usually the answer

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17
Q

What is the treatment for seasonal affective disorder

A

Phototherapy and buproprion

18
Q

What is the treatment for postpartum blues, postpartum depression, and postpartum psychosis. Postpartum depression and above have negative feelings towards babies

A

Postpartum blues: Supportive

Postpartum depression: Antidepressants. Postpartum psychosis: Antipsychotics and lithium

19
Q

Bereavement (grief) lasts less than 6 months. What is the treatment

A

Psychotherapy (never medical therapy)

20
Q

What is the treatment for serotonin syndrome

A

Stop SSRI, symptomatic treatment, and cyproheptadine

21
Q

What is the difference between brief psychotic disorder, schizophreniform, and schizophrenia

A

Duration of time

Brief psychotic is only hallucinations, delusions, disorganized speech, and disorganized behavior

Schizophreniform has added negative symptoms

Schizophrenia is really bad functioning - affects men earlier but affects both groups equally

22
Q

Like mania, what must be ruled out with brief psychotic disorder, schizophreniform, and schizophrenia

A

Cocaine and amphetamine abuse - always get urine drug screen

23
Q

After distinguishing schizophrenia from the other forms, schizophrenia can be further divided into paranoid, catatonic, disorganized, residual and undifferentiated. What is the paranoid type

A

Delusions and hallucinations of persecutory type

24
Q

After distinguishing schizophrenia from the other forms, schizophrenia can be further divided into paranoid, catatonic, disorganized, residual and undifferentiated. What is the catatonic type

A

Psychomotor disturbances - stupor, rigidity, excitement, posturing

25
Q

After distinguishing schizophrenia from the other forms, schizophrenia can be further divided into paranoid, catatonic, disorganized, residual and undifferentiated. What is the disorganized type

A

Disinhibited with little contact with reality. Early age of onset and worst prognosis

26
Q

The five kinds of psychosis are paranoid, catatonic, disorganized, residual and undifferentiated. What is the residual type

A

Lack of positive symptoms

27
Q

After distinguishing schizophrenia from the other forms, schizophrenia can be further divided into paranoid, catatonic, disorganized, residual and undifferentiated. What is the undifferentiated type

A

Not meet criteria for other types

28
Q

After distinguishing schizophrenia from the other forms, schizophrenia can be further divided into paranoid, catatonic, disorganized, residual and undifferentiated. What are all five types summed up

A
  1. ) Paranoid: Delusions and hallucinations of persecutory or grandiose type
  2. ) Catatonic: Psychomotor disturbances
  3. ) Disorganized: Disinhibited behavior, disheveled, and bizarre emotional responses
  4. ) Residual: Only negative symptoms
  5. ) Undifferentiated: Not meeting criteria for other types
29
Q

Someone with psychosis presents as acutely psychotic. What is the treatment

A

Atypical antipsychotic and ensure patient safety

30
Q

Someone with psychosis presents as acutely psychotic in an emergency situation. What is the treatment

A

IM injection of olanzapine or ziprasidone

31
Q

Someone with psychosis is not compliant with their medications. What should you give them

A

Long acting antipsychotic

32
Q

If patient does not respond to antipsychotic, what is the second line treatment

A

Clozapine

33
Q

What are the side effects of olanzapine and who should you avoid it in

A

Weight gain and diabetes. Avoid in obese patients and diabetics

34
Q

What is the side effects of risperidone

A

Highest chance of movement disorders. Medium risk of obesity and diabetes

If movement disorder does occur, best management strategy is replace with clozapine

35
Q

What is the side effects of quetiapine

A

Lowest chance of movement disorders. Medium risk of obesity and diabetes

36
Q

What is the side effects of ziprasidone

A

QT prolongation, avoid in patients with conduction defects. Lowest chance of weight gain and obesity

37
Q

What is the side effect of clozapine

A
  1. ) Agranulocytosis - monitor CBC regular basis
  2. ) Lowers seizure threshold
  3. ) Lowest chance of movement disorder (EPS) of all
38
Q

What is the treatment for delusional disorder

A

Atypical antipsychotics

39
Q

What is neuromalignant syndrome and its treatment?

A

Side effect of dopamine antagonists (antipsychotics) that results in muscle rigidity (main hallmark) with hyperthermia, altered mental status, fever

Leads to elevated CPK levels, and potential complication is rhabdomyolysis leading to myoglobinuria

Treated with Dantrolene (muscle relaxant) and bromocriptine (dopamine agonist)

40
Q

What is serotonin syndrome and its treatment?

A

Induced by having too much serotonin (i.e. combining SSRI and MAOi) causing clonus (rhythmic contractions) with hyperthermia, altered mental status, and dilated pupils

Treated by stopping SSRI and give cyproheptadine

41
Q

What are the similarities and differences between serotonin syndrome and neuromalignant syndrome

A

Similarities: Both cause altered mental status with hypertonia and autonomic overdrive (hyperthermia, tachy, hypertension, etc)

Differences: Neuromalignant syndrome has a lot of rigidity in all muscle groups, while serotonin syndrome has clonus (rhythmic contractions) with mild hypertonicity. Serotonin syndrome has hyperreflexia and neuromalignant syndrome has hyporeflexia