Psychiatric/Behavioral & Substance Abuse Flashcards
not thinking about behavior modification =
thinking about it =
planning behavior modification =
putting plan into action =
maintaining new behavior
Precontemplation
contemplation
preparation
action
maintenance
recurrent episodes of binge eating, followed by compensatory behavior, excessive preoccupation with body weight and shape, normal weight weight or above normal =
treatment with nutritional rehab, CBT, and ________
bulimia nervosa
SSRI fluoxetine
_______ blocks the ________ receptor and blocks the rewarding and reinforcing effects of alcohol to reduce CRAVING
naltrexone
mu opioid
evaluation of a patients access to _____ is a key part of suicide risk assessment
guns
depressed mood, low energy, loss of interest, insomina, weight loss, poor concentration almost every day for >2 weeks =
even if hypothyroidism diagnosed, TSH is _______, so not a consequence of this
Major Depressive Disorder
normal
_______ is a pure opioid Receptor antagonist and used to treat opioid intox and OD. It has the greatest affinity for ____ receptor
Naloxone
Mu
acute onset of tremulousness, agitation, elevated pulse and BP 48hrs following admission is suggestive of _______. FIrst line therapy is _______ such ________ in order to prevent progression to seizure and delrium. Long acting agents are preferred unless the patient has liver disease, then shorter acting agents like lorazepam and oxazepam are preferred
alcohol withdrawal
benzos
chlordiazepoxide or diazepam
based on the principle of _____ the prescription of medications likely to do more harm than good should be avoided, even if requested by patients (stimulants for ADHD in patient with many risk factors)
nonmaleficence
_______ for Bipolar Disorder has a very narrow therapuetic index and presents toxicity as gradual worsening confusion, agitation, ataxia, tremors/fasciculations. This toxicity can be precipitaed by volume depletion and drug interactions with _______, ACEI, and NSAIDs
Lithium
thiazide diuretics
_____________ in college student preparing for finals can present with paranoid ideation and must be differentiated from primary psychiatric disorders. Physical signs of stimulant intoxication include tachycardia, HTN, hyperthermia, diaphoresis, and mydriasis
Stimulant intoxication
_______ medications are the first line treatment for ADHD. They work by increasing the availability of _______ and _____ in the PFC
Stimulant
NE and DA
Key defense mechanisms:
expressing unacceptable feelings through actions =
behaving as if an aspect of reality does not exist =
transferring feelings to a more acceptable object =
using intellect to avoid uncomfortable feelings =
avoiding conflict by expressing hositility convertly =
attributing ones own feelings to others =
justifying behavior to avoid difficult truths =
responding to a manner opposite to one’s actual feelings
reverting to earlier developmental stage =
seeing others as all good or all bad =
channeling impulses into socially acceptable behaviors =
putting unwanted feelings aside to cope with reality =
acting out
denial
displacement
intellectualization
passive aggression
projection
rationalization
reaction formation
regression
splitting
sublimation
suppression
depression, suicidal ideation, impulsivity in women in the setting of feeling rejected; persistent pattern of unstable and intense relationships, substance abuse, unsafe sex, recurrent suicidal behaviors or threats, inappropriate or intense anger, chronic feelings of emptiness =
Borderline personality disorder
pervasive pattern of distrust and suspiciousness beginning in early adulthood and occurring in a variety of settings
paranoid personality disorder
intentional falsification or inducement of symptoms (induction of infection in the absence of obvious rewards)
Factitious disorder
_________ involves a neutral stimulus being repeatedly paired with non neutral stimulus that elicits an unconditioned response. Over time the neutral stimulus (stethoscope) is able to evoke a conditioned response (sweating, anxiety) in absence of non neutral stimulus (physician girl is scared of)
Classical conditioning
the new onset of anxiety in a patient with no prior psychiatric history and prominent physical findings on examination suggest that the anxiety is more likely due to a _______ such as ________
medical condition
hyperthyroidism
patient initially presents with depression and insomnia, given a medication, then comes back 3 weeks later in a full blown manic episode, with a family history of bipolar disorder. Disorder?
induced by __________ such as ________
Bipolar disorder
antidepressants, sertraline
buspirone is a _________ used in the treatment of GAD. It is not useful in the treatment of acute anxiety due to its ________, lacks muscle relaxant or anticonvulsant properties, and carries no risk of dependence
nonbenzodiazepine anxiolytic
slow onset of action
treatment resistant schizophrenia or schizophrenia assoicatied with suicidality =
adverse effects =
clozapine
agranulocytosis (monitor neutrophil count)
_______ is characterized by psychotic symptoms (delusions, hallucinations, disorganized speech, behavior, negative symptoms) lasting greater than 1 month and less than 6 months
greater than 6 months =
less than 1 month =
Schizophreniform disorder
Schizophrenia
Brief Psychotic disorder
recurrent, unexpected panic attacks and avoidance of potential triggers =
Panic disorder
in order to manage somatic symptom disorder, physicians should __________, limit unnecessary workout and referrals, reassure the patient that a serious illness has been ruled out, legitimize symptoms, decrease stress, improve coping strategies, and only refer to mental health once a physician/patient relationship is well established
schedule regular visits with the same provider
smoked drug, uncoordinated, jerky movements, assaults bouncer, fights off 4 officers, immune to pain, visual hallucinations, agitation and sedation altering states, HTN, tachycardic, vertical nystagmus =
works primarily as a n
PCP induced psychosis
NMDA receptor antagonist
acute treatment of agitation, psychosis in the presence of delirium in an elderly patient with UTI =
haloperidol
sexual dysfunction is seen in up to 50% of patients treated with ______. Bupropion, a _____________ is a first line treatment for MDD that does not cause this side effect
SSRIs
NDRI
mature defense mechanism involving the conscious choice not to dwell on a particular thought or feeling =
suppression
___________ are the most common adverse effects of psychostimulate medications used to treat ADHD such as methylphenidate
decreased appetite and insomnia
acute panic disorder treatment =
acts by positive allosteric modulation of the ____ receptor
Benzodiazepine
GABAa
multiple persistent deficits in social communication and interactions currently or history involving lack of social engagement, repetitive play, insistence on sameness =
Autism spectrum disorder
reversible, acute confusional state in the presence of a likely bacterial infection =
gradual progressive irreversible confused state with remote memory sparing =
delirium
dementia
recurrent episodes of chest pain, tachycardia, SOB, sweating, and tremulousness in a young, otherwise healthy patient with normal ECG are consistent with _______
administration of _______ results in rapid relief
panic disorder
benzos
_________ consists of anxiety >4 weeks in children and >6months in adults due to separation from those to whom the patient is attached. Physical symptoms and nightmares may accompany anxiety
Separation anxiety disorder
in the US, the majority of OD deaths are caused by
opioids
distracted, impulsive, grandiosity, flight of ideas, increased activity, decreased need for sleep, talkativeness (DIGFAST) is most likely _______ and can occur with or without psychotic features. _______ involves hypomanic episodes and major depressive episodes
BPDI
BPDII
replacing unacceptable feelings and impulses with their extreme opoosites =
reaction formation
______ acts by inhibiting the presynaptic reuptake of NE, DA, and 5HTP. Intoxicated patients develop agitation, tachycardia, HTN, and light responsive mydriasis due to increase ______ activity. It is also a potent vasoconstrictor and can cause myocardial ischemia and atrophy of nasal mucosa and septum
Cocaine
sympathetic
chlorpromazie and thioridazine are ______ first generation anti-psychotics, while haloperidol and fluphenazine are _______ first generation anti-psychotics. Fluphenazine will have a higher chance of ________ symptoms as an adverse effect
low potency
high potency
extrapyramidal
______ is typically the first symptom of alcohol withdrawal
tremulousness