Psych Uworld Flashcards
adjustment disorder vs GAD timeline
adjustment disorder occurs within 3 months of a stressor
GAD for greater than 6 months
acute stress disorder vs PTSD
ASD: more than 3 days less than 1 month
PTSD: longer than 1 month
pt on antipsychotic develops restlessness, consider ?
how to treat?
akathisia
reduce antipsychotic dose and give B-blocker, benztropine, or a benzo
differentiating feature between normal aging and dementia
loses ability to perform ADLs, loses social interest, may get lost in familiar territory
neuropathic abdominal pain, +/- vomiting, +/- constipation, sensory/motor neuropathies, anxiety, mood changes think ?
how to dx?
acute intermittent porphyria (AIP)
dx: urinary porphobilinogen
shizo timeline
brief psychotic disorder: more than 1 day-1 month
shizophreniform: 1 month to 6 months
schizophrenia: more than 6 months
what is acute dystonia?
how to treat?
sudden, sustained contraction of neck, mouth, tongue, eye muscles
tx: benztropine or diphenhydramine
what is akathisia?
how to treat?
subjective restlessness
tx: B-blocker (propranolol) or benzo (lorazepam)
what is parkinsonism?
how to treat?
gradual onset tremor, rigidity, bradykinesia
tx: benztropine or amantadine
what is tardive dyskinesia?
how to treat?
dyskinesia of mouth, face, trunk, extremities
gradual onset after prolonged therapy (6+ mos)
tx: no definitive tx, but switching to clozapine may help
test to get before lithium treatment
creatinine, thyroid function test
causes: nephrogenic diabetes insipidus, nephrotoxicity, hyperparathyroidism with hypercalcium, thyroid dysfunction
NMS s/s
severe muscle rigidity, AMS, autonomic instability, high fever, elevated CK, leukocytosis
paranoid delusions and auditory, visual and tactile hallucinations, weight loss, tooth decay, excoriations think ?
methamphetamine abuse
bipolar disorder: can you discontinue lithium?
not typically, as BP requires long-term maintenance as it has high recurrence
hallucinations, euphoria, increased sexual desire, HTN, tachy, hyperthermia, serotonin syndrome, hyponatremia, think?
ecstasy (MDMA) intoxication
synthetic amphetamine
how long to continue SSRI?
if single episode of MDD: additional 4-9 months rolling acute response
recurrent, chronic, severe episodes: 1-3 yrs or indefinitely
second gen antipsychotic with higher risk increased PRL
risperidone
1st line for alcohol use disorder
naltrexone: mu-opioid receptor antagonist
contraindicated in pts taking opioids and pts with acute hepatitis or liver failure
decreases craving and heavy drinking
acamprosate: glutamate modulator; only used once pt is abstinent to maintain abstinence
indicator of TCA intoxication severity
QRS duration greater than 100 msec
meds for treatment of acute bipolar depression
quetiapine and lurasidone (2nd gen antispsychotics)
also: lithium, valproate, combo of olanzapine and fluoxetine
avoid antidepressants alone
syndrome seen in severe psych and medical illness characterized by immobility, mutism, posturing
how to treat?
catatonia
benzos and ECT
