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🧠📖💯 > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Which of the following is NOT TRUE of anxiety?

A) Twice as frequent in women
B) Average age of onset 35-40 years
C) High familial incidence
D) Autosomal dominant

A

B) Average age of onset 35-40 years

Average age of onset: 25 years

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2
Q

Anger provokes an excessive secretion of _________, while fear is accompanied by increased secretion of ________

A

Anger - Norepinephrine

Fear - Epinephrine

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3
Q

Fear of being in places or situations from which escape might be difficult or extremely embarrassing is spoken of as ________

A

Agoraphobia

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4
Q

Most common phobia

A

Claustrophobia

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5
Q

Treatment of Guilles de la Tourette

A

Dopamine antagonists

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6
Q

Classic hysteria is more common in

Men/women

A

Women

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7
Q

Malingering is more common in

Men/women

A

Men

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8
Q

Anorexia nervosa commonly occurs at what age?

A

After puberty, before 30 years of age.

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9
Q

Often, _____% or more of the body weight will have been lost by the time the patient’s family insists on medical consultation (Anorexia)

A

30%

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10
Q

___ and ____ are indicators for hospitalization. (Anorexia)

A

Bradycardia

Hypotension

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11
Q

Which of the following is NOT true of pts w/ Anorexia Nervosa?

A) Amenorrhea is always present, may precede weight loss
B) Clomiphene citrate will stimulate a rise in LH
C) T3 and T4 are low
D) There are no neurologic signs of nutritional deficiency

A

B) Clomiphene citrate will stimulate a rise in LH

CC fails to stimulate a rise in LH (as it does normally)

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12
Q

What is the rate of recovery for anorexia patients?

A

50%

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13
Q

Which of the following medications is NOT known to evoke a depressive reaction?

A) Sedative drugs
B) Beta-adrenergic blocking agents
C) Beta-interferons
D) Phenothiazines
E) None of the above
A

E) None of the above

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14
Q

Patients with left ANTERIOR cerebral lesions involving ____ have a greater frequency and severity of depression than do patients with lesions/strokes in other locations.

A

Lateral frontal cortex or basal ganglia

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15
Q

Which of the following is NOT true?

A) Psychotic depression with hallucinations and delusions are common in patients with RIGHT temporoparietal infarcts
B) There is a relationship between the degree of motor and language disability and the severity of poststroke depression
C) There relationship of stroke to depression is more consistent with location of the stroke rather than the degree of disability
D) None of the above

A

C) There relationship of stroke to depression is more consistent with location of the stroke rather than the degree of disability

  • There is a less predictable relationship to the location of the lesion
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16
Q

Which is NOT true of depression during and after pregnancy?

A) Main risk of depression during pregnancy is a hx of previous depressions
B) A/w an increased rate of miscarriage
C) Maternal depression may affect fetal growth and infant temperament
D) Post partum depression is not related to the frequency of prenatal depression

A

D) Post partum depression is not related to the frequency of prenatal depression

Postpartum depression is more common in women w/ prenatal depression

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17
Q

Which patient group has the highest rate of completed suicides?

A

Older white men

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18
Q

Which of the following is TRUE of Bipolar Disorder?

A) Manic episodes are more than twice as frequent as depressive ones
B) The most common form of the illness is characterized with episodic depression alone
C) Many patients have several episodes of mania before their first episode of depression
D) Bipolar I entails an episode of hypomania

A

TRUE: B) The most common form of the illness is characterized with episodic depression alone

  • DEPRESSIVE episodes are more than twice as frequent as manic ones
  • Many patients have several episodes of DEPRESSION before their first episode of mania
  • Bipolar I entails an episode of FULL mania; Bipolar II - hypomania
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19
Q

Age of onset for Bipolar disease

A

55-65 years

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20
Q

Most important predictor of unfavorable outcome in bipolar disorder?

A

Duration of illness before treatment

Others:

  • Anxiety, high degrees of
  • Family history, strongly positive for similar psych illnesses
  • Circumstances, presence of depression-provoking ones
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21
Q

Allelic variations in this gene were associated w/ a sevenfold increased risk of major depression

A

Serotonin transporter gene

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22
Q

For depression, hypometabolism in this region is among the most consistent findings

A

Left frontal cortex

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23
Q

Histologic findings in both depression in stress showed a depletion of and changes in which neurons/region?

A

Pyramidal neurons
CA3 region
Hippocampus

24
Q

Which biogenic monoamines are implicated in depression?

A

Norepinephrine
Serotonin
Dopamine

25
Q

Which SSRI has a tendency to produce insomnia and weight loss?

A

Fluoxetine

26
Q

The use of which antidepressant medications is associated with an increased risk of pulmonary hypertension in the babies of mothers exposed to them during pregnancy?

A

SSRIs

27
Q

These drugs are helpful in alleviating insomnia

Therapeutic effect evident after 2-4 weeks

Common SEs: orthostatic hypotension, dry mouth, constipation, tachycardia, urinary hesitancy or retention, tremor, drowsiness, closed-angle glaucoma

Serious SE: heart block, arrhythmia

A

Tricyclic Antidepressants

28
Q

In shifting from SSRIs to MAO inhibitors, what condition should you be cautious of?

A

Serotonin Syndrome

29
Q

In order to avoid serotonin syndrome, how long should you wait before starting a MAO inhibitor (after discontinuing SSRIs)?

A

1-2 weeks

30
Q

Which antidepressants are superior in depression with atypical features such as increased appetite?

A

MAO inhibitors

31
Q

What is the most serious risk of MAO inhibitors (SE)?

And what should pts taking these drugs avoid?

A

Hypertensive crisis

Avoid:

  1. Food w/ high TYRAMINE content
  2. Medications w/ sympathomimetic agents or L-dopa
32
Q

How long should treatment for depression be continued?

A

6-9 months

33
Q

Which antidepressant is most likely to cause anticholinergic effects?

A

Amitriptyline (TCA)

34
Q

Which antidepressants (2) are the most sedating?

A

Mirtazapine

Trazodone

35
Q

Which antidepressant has the highest propensity to cause weight gain?

A

Mirtazapine

36
Q

Which antidepressant drug class is most likely to cause nausea/GI effects?

A

SSRIs

37
Q

Electroconvulsive therapy continues to be a highly effective treatment for ___ and can also be used to _____

A

Severe endogenous depression

To interrupt manic episodes

38
Q

What is the only absolute contraindication for ECT?

A

Increased intracranial pressure

39
Q

Which side effect is considered as the major drawback of ECT?

A

Transient impairment of recent memory

40
Q

ECT technique modifications that can lessen memory loss

A

1) Place both electrodes on nondominant side

2) Use lower amount of current, briefer pulse

41
Q

On Lithium Carbonate as treatment for bipolar disease:

1) When does it become effective?
2) Usual dosage
3) Desired level

A

1) 4-5 days
2) 1,200-2,400 mg daily
3) 0.9-1.4 mEq/L

42
Q

Which type of medication is used to bring both the depression and episodic cycling into mania under control?

A

Antipsychotic medications

43
Q

Which of the following is NOT associated with risk of suicide?

A) Bipolar illness
B) Endogenous depression
C) Depression resulting from a debilitating disease (Huntington, CA, HIV)
D) Pathologic grief
E) Depression in a smoker
A

E) Depression in a smoker

*Depression in an alcoholic or schizophrenic

44
Q

Which of the following is NOT a known deterrent to suicide?

A) Devout Catholicism
B) Concern about suffering of family
C) Fear of death expressed by patient
D) Previous suicide attempt

A

D) Previous suicide attempt

  • actually adds to risk
45
Q

What are the 3 clusters of schizophrenia?

A

Negative symptoms
Positive symptoms/ Reality distortion
Thought disorder

46
Q

Which of the neuropathologic findings is NOT found in Schizophrenia?

A) Pyramidal cells smaller, denser, thinning of laminae II and III
B) Density of dendritic spines decreased in frontotemporal cortices
C) Aberrant distribution of interstitial neurons in the frontal lobe WM
D) Reduced # of small neurons in the anterior cingulate cortex, layer II
E) None of the above

A

E) None of the above

47
Q

What gives rise to positive symptoms of schizophrenia?

A

Excess dopaminergic activity, mesolimbic system

48
Q

What gives rise to negative symptoms of schizophrenia?

A

Decreased dopaminergic activity, mesocortical system

49
Q

2 NTs implicated in Schizophrenia?

A

Dopamine

Serotonin

50
Q

Which atypical antipsychotic causes the ff side effects?

Orthostatic hypotension, transaminase elevation, hyperprolactinemia

A

Olanzapine

51
Q

Which atypical antipsychotic causes the ff side effects?

Orthostatic hypotension, cataracts, transaminase elevation

A

Quetiapine

52
Q

Which atypical antipsychotic causes the ff side effects?

Agranulocytosis, transient fever, anticholinergic activity, hyperglyceia

A

Clozapine

53
Q

Which atypical antipsychotic causes the ff side effects?

Less weight gain. Prolonged QT

A

Aripiprazole

Ziprasidone

54
Q

What is the most common delusiona theme?

A) Erotomanic
B) Grandiose
C) Persecutory
D) Somatic

A

D) Somatic

55
Q

Drugs that have a tendency to produce paranoia in otherwise nonpsychotic individuals

A

CAPS

Cocaine
Amphetamine
Phencyclidine
Steroids

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