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U World Step 2 > Psychiatric/Behavioral & Substance Abuse > Flashcards

Psychiatric/Behavioral & Substance Abuse Flashcards

1
Q

Treatment for acute dystonia

A

Anti-cholinergics

Diphenydramine

Benztropine

Trihexyphenidyl

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2
Q

Pathophysiology of Fragile X

A

Hypermethylation and impaired transcription of the protein FMRP

More than 200 repeats lead to total silencing of the gene and absence of the protein

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3
Q

Typical features of fragile X

A

Delayed milestones

Autistic behavior

Intellectual disability

Elongated face

Large testes

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4
Q

Initial medical workup for new-onset psychosis

A

Basic metabolic panel

CBC

Thyroid function tests

Urine toxicology

Syphilis screening

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5
Q

Factitious disorder

A

A patient intentionally produces illness with the goal of assuming the sick role.

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6
Q

Malingering

A

Patients feign symptoms to obtain external rewards

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7
Q

Borderline personality disorder

  1. Diagnostic criteria
  2. Treatment
A
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8
Q

Paranoid personality disorder

A

Pervasive pattern of suspiciousness and mistrust of others

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9
Q

Schizoid personality disorder

A

Lifelong pattern of detachment from social relationships and restricted range of emotions.

Do not experience delusions or dissociative symptoms.

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10
Q

Schizotypal personality disorder

A

Odd, holding magical beliefs

Strange, but not overtly psychotic though processes

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11
Q

Hypothyroidism (psychiatric symptoms)

A

Depression

May experience psychotic symptoms in severe cases

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12
Q

Signs of alcohol withdrawal

A

Sympathetic overactivity

Tachycardia, elevated blood pressure, restlessness, tremulousness

Dilated pupils

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13
Q

HIV medication with neuropsychiatric side effects

A

Efavirenz

Insomnia with vivid dreams

Depression

Anxiety

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14
Q

Signs of opioid intoxication

A

Decreased respiratory rate and tidal volume (respiratory acidosis)

Hypotension

Hypothermia

Myosis

Decreased bowel sounds

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15
Q

Fetal exposure to phenytoin

A

Neural tube defects

Cardiac anomalies

Dysmorphic facies: Cleft lip, narrow bifrontal diameter, midface hypoplasia, broad and depressed nasal bridge, long philtrum

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16
Q

Fetal exposure to phenytoin

A

Nail and digit hypoplasia

Dysmorphic facies

Mental retardation

Growth deficiency

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17
Q

Fetal alcohol syndrome

A

Growth deficiency

Long, smooth philtrum

Small palpebral fissures

Thin upper lip

CNS abnormalities, including mental retardation

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18
Q

Prenatal exposure to cocaine

A

Jitteriness

Excessive sucking

Hyperactive Moro reflex

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19
Q

Key features of somatic symptom and related disorders

  1. Somatic symptom disorder
  2. Illness anxiety disorder
  3. Conversion disorder (functional neurologic symptom disorder)
  4. Factitious disorder
  5. Malingering
A
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20
Q

Social anxiety disorder

  1. Diagnosis
  2. Treatment
A
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21
Q

Distinguishing between Bipolar I and Bipolar II

A
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22
Q

Antipsychotic extrapyramidal effects

  1. Extrapyramidal symptoms
  2. Treatment
A
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23
Q

Psychosocial intervention that decreases risk of relapse in patients with schizophrenia

A

Minimizing stress and conflict in the home

24
Q

Narcolepsy

  1. DSM-5 diagnostic criteria
  2. Associated features
A
25
Q

Panic disorder

  1. Clinical features
  2. Treatment
A
26
Q

Assessment and managment of suicidality

  1. Assessment
  2. Managment
A
27
Q

Differential diagnosis of a depressed mood

A

Treatment of choice for adjustment disorder focuses on psychotherapy that promotes coping skills and a return to function.

28
Q

Attention-deficit hyperactivity disorder

  1. Clinical features
  2. Treatment
A
29
Q

Somatic symptom disorder

  1. Clinical features
  2. Management
A
30
Q

Anti-emetics that are also dopamine antagonists

A

Metoclopramide

Prochlorperazine

Promethazine

31
Q

Anorexia nervosa

  1. Clinical features
  2. Treatment
  3. Complications
A
32
Q

Neuroleptic malignant syndrome

A
  1. Signs/symptoms
  2. Precipitating factors
  3. Treatment
33
Q

Catatonia

  1. Clinical features
  2. Management
A
34
Q

Persistent depressive disorder (dysthymia)

  1. DSM-5
  2. Specifiers
A
35
Q

Generalized anxiety disorder

  1. DSM-5 criteria

2. Treatment

A

Benzodiazepines should be reserved for non-depressed patients without a history of substance abuse who fail to respond to or cannot tolerate antidepressants.

36
Q

Gender dysphoria

  1. Clinical features
  2. Management
A
37
Q

Drug intoxication (Drug, class, clinical features)

  1. PCP
  2. LSD
  3. Cocaine
  4. Methamphetamine
  5. Marijuana
  6. Heroin
A
38
Q

Secondary causes of acute-onset psychosis in children and adolescents

A
39
Q

Bath salts

A

Amphetamine analogues

Cause severe agitation, compativeness, psychosis, delirium, myoclonus, and rarely, seizures.

Most distinguishing feature is prolonged duration of effect. Delirium and psychosis due to bath salts may last from days to weeks, whereas the effects of intoxication with other amphetamines or hallucinogens are usually of much shorter duration.

Not detected on routine tox screens

40
Q

Normal aging versus Dementia

  1. Memory loss
  2. Word-finding difficulty
  3. Independence and functioning
A
41
Q

Antidepressant classification and major drugs

  1. SSRI
  2. SNRI
  3. NDRI
  4. TCA
  5. MAOI
  6. Other
A
42
Q

Metabolic effects of second-generation antipsychotics

  1. Metabolic syndrome

2. Highest-risk drugs

3. Monitoring guidelines

A

Assess BMI monthly

Fasting plasma glucose and lipids, blood pressure, and waist circumference assessed at baseline, 3 onths, then annually.

43
Q

Tourette syndrome

  1. DSM-5

2. Treatment

A

Alpha-2 adrenergic receptor agonists: clonidine, guanfasine

Behavioral therapy: Habit reversal training (HRT)

44
Q

First-line treatments for smoking cessation

A

Nicotine replacement therapy

Buproprion

Varenicline

45
Q

Key features of DSM-5 personality disorders

  1. Paranoid
  2. Schizoid
  3. Schizotypal
  4. Antisocial
  5. Borderline
  6. Histrionic
  7. Narcissistic
  8. Avoidant
  9. Dependent
  10. Obsessive-Compulsive
A
46
Q

Ramelteon

A

Melatonin agonist used for sleep onset insomnia

Demonstrated safety in older adults and requires o dosage adjustment

47
Q

Delusional disorder

  1. Clinical features
  2. Differential diagnosis
  3. Treatment
A
48
Q

Cognitive impairment in elderly patients

  1. Normal aging
  2. Mild neurocognitive disorder
  3. Major neurocognitive disorder (dementia)
  4. Major depression
A
49
Q

Signs and symptoms of major depression

A
50
Q

Differential diagnosis of DSM-5 anxiety disorders

  1. Social anxiety disorder
  2. Panic disorder
  3. Specific phobia
  4. Generalized anxiety disorder
A
51
Q

Lithium toxicity

  1. Etiology
  2. Features
  3. Management
A
52
Q

Eating disorders

  1. Anorexia nervosa
  2. Bulimia nervosa
  3. Bing-eating disorder
A

The binge-purge subtype of anorexia is distinguished from bulimia by body weight: Anorexia: Underweight (<18.5 kg/m^2)

Bulemia: Normal to overweight

53
Q

LSD intoxication

A

Euphoria, hallucinations, subjective perceptual intensification, depersonalization, and allusions.

2 or more of the following signs are often present: Sweating, tachycardia, pupillary dilation, palpitations, tremors, poor coordination

54
Q

3,4-Methylenedioxy-methamphetamine (MDMA) intoxication

A

Also known as ecstasy

Synthetic amphetamine with mild hallucinogenic properties.

Enhances euphoria, sociability, empathy, sexual desire

55
Q

Trichotillomania

  1. DSM-5

2. Treatment

A
56
Q

Antisocial personality disorder

  1. Clinical features
  2. Managment
A
57
Q

Reaction formation

A

Transforming an unacceptable feeling or impulse into its extreme opposite.

U World Step 2 (22 decks)

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