psychiatry Flashcards
bipolar 1 vs 2
1 - manic
2 = hypomanic (not as severe; not interfereing w/life)
perseveration
repetition of thoughts or ideas during conversation
tangentiality
an abrupt deviation of thought/ideas and never returns to original idea
circumstantial thought process
drift away from current topic, then come back to it
common in schizophrenia
definition somatic symptom disorder
obsession about one or more somatic symptoms (worked up and -) for 6 or more months
(formerly hypochondriasis)
drug class for tx of dystonia from antipsychotics
anticholinergics (benztropine or benadryl)
tx of neuroleptic malignant syndrome
a dopamine agonist like dantrolene, amantadine, or bromocriptine
head CT finding in schizophrenia
enlargement of the ventricles
head CT finding in OCD (2) (where are abnormalities fount)
orbitofrontal cortex
basal ganglia
timeline after initial SSRI start to increase dose
4-6 weeks
timeline for GAD
over 6 mos
trihexyphenidyl, class and use
anticholinergic for Parkinson’s
difference between schizoaffective disorder and MDD or bipolar with psychotic features
in schizoaffective, psychosis is present MOST of the time, and also in the absence of mood disorders
side effect ziprasidone
prolongs QT
tx of serotonin syndrome
cyproheptadine
MDD timeline (sx present for how long before dx)
2 weeks
kleptomania associations (2)
OCD
bulimia
time for dysthymia
At least 2 years
this is Eore
cyclothymia (s)
hypomania
dysthymia
No loss of function
tx of cyclothymia
mood stabilizers
normal bereavement
time and function
6-12 mos. no loss of function
following death:
adjustment disorder vs persistent complex bereavement disorder
timing and function
both have mild loss of function
adjustment 6-12 months
PCBD greater than 1 yr
psychosis for:
less than 1 mo.
1-6 months
acute psychotic disorder
schizophreniform disorder
psychosis with mood disorders
schizoaffective disorder
antidepressant absolutely contraindicated in bulimia
buproprion
-increased seizures
dissociative fugue
dx?
amnesia of an “old life” - usually move and start new life
amital interview
tx of cocaine OD htn
Phentolamine, alpha blockade
If beta blocker only later!!!!!!THEN beta blockade
length of time for SSRI washout
3 weeks
venlafaxine side effect
diastolic htn
mandatory test prior to TCA rx
ECG
due to QT elongation of TCAs
B52 (3)
lorazepam
haloperidol
benadryl
tx of Neuroleptic malignant syndrome
dantrolene
class to tx acute dystonia
anticholinergics
for example, benztopine or benadryl
neuroleptic malignant syndrome test (if suspected)
CK
Clang associations
Come out in rhyming pattern
Jarvis hearing
Court order for neuroleptic Meds
Price sheppard
Court order for ect
Tarasoff decision
Duty to warn
Derealization
Sense environment not real.
dementia with little people
lewy body dementia
lillepucian hallucinations
dementia with Personality changes in 50s
oral/sexual fixation
fronto-temporal dementia
dementia with depression symptoms
pseudodementia
8 yo who falls off growth chart.
Picky eater
Arfid
Avoidant/restrictive food intake disorder
Phenelzine class
MAOI
Dementia pugilistica
Punchdrunk syndrome
Dementia following chronic trauma like boxing.
Delusions in delusional disorder vs a psychotic disorder
In delusional, they are believable
Ideal target receptor for antipsychotics
D2
2 receptors affected less by atypical antipsychotics
Less d1
Antagonism 5ht against negative sx
Ziprasidone side effect
Qt prolongation
Eat with fat!
Aripriprazole MOA
Agonist antagonist d2
Can tx gynecomastia
Receptor that clozapine blocks
D4
Feelings by a clinician that the patient provoked
Countertransferance
Fluvoxamine class (Luvox)
Ssri
3 month mortality of a delirium pt
33%
Response rate of ssri
70%
Frotteurism
Sexually rubbing up against nonconsenting others
Masochism
Being sexually dominated
Sadism
Dominating others sexually
PMDD vs PMS
PMDD disrupts life more
Duration of mdd with tx
3 months
Indication for EMDR therapy
PTSD
Class of antidepressants most likely to induce mania
Tc a
Idea of reference
Idea that something relates to you but it doesn’t.
Example of someone who thinks the tv is talking to them
Mesolimbic pathway
Positive symptoms
Mesocortical pathway
Negative sx
formication
tactile hallucination of bugs crawling on skin. Cocaine intox, ETOH w/d
synesthesia
secondary sensation of a perception.
ex: tasting a “color” while using LSD
scanning speech
irregular pauses in speech
palinopsia
persistence of visual image after the stimulus has been removed
circumlocution
substitution of descriptors for words. common in Alzheimer’s
projection
one’s unacceptable ideas are seen as coming from another
ex: a cheating husband blames accuses his wife of cheating
projective identification
someone’s thoughts become true in a defence mechanism
ex: a person thinks “all people hate me”
and does stuff to make people break off relationships with her.
3 benzoes not metabolized by liver (good for DTs)
LOT
lorazepam
oxazepam
temazepam
tx for neuroleptic-induced akathisia
propanolol or other beta blocker
tx for neuroleptic induced dystonia or parkinsonism
anticholinergic (ex: benztropine)
tx for an acute dystonia
antihistamine like benadryl
classic side effect of thioridazine
retinal pigmentation
most potent benzo
clonazepam (klonopin)
mood stabilizer that IS NOT anti-manic
lamotrigine
Eps (3)
Akathisia
Parkinsonism
Dystonia
2 Meds that reduce si
Clozapine, lithium
Asenapine unique (2)
Sublingual
Rapid onset
Ssri with shortest half life
Paroxetine
Teratogenic ssri
Paroxetine. Heart effects
Duloxetine also treats
Pain
Desipramine unique
Bed wetting
1st line tx of bulimia
Ssri
2nd line tx bulimia
Topirimate
Most common side effect transcranial magnetic stimulation (rTMS)
HA
Mood stabilizer that causes pancreatitis
Valproic acid
Tx for sialorrhea
Clonidine
Zaleplon unique
Short half life for middle insomnia
Opisthotonos
Arching forward. Spasm of back and neck, a type of Dystonia
Topirimate side effect
Renal stones
Rate of dementia in 65+
1 in9
Timeline for mania
Greater than 1 week
Timeline for hypomania
4 days, greater than
Antipsychotic that also treats bipolar depression
Queitiapin
Capgras syndrome
Humans have been replaced by imposters
abreaction
a pt relives an emotional experience to get rid of megative emotions and move on.
probabability of sibling getting schizophrenia
10%
anti-psychotic where person gets purple-grey metallic rash over sun-exposed areas and jaundice
chlorpromazine
anti-psychotic that gives prolonged QT and pigmentary retinopathy
thioridazine
1st line tx Tourette
Clonidine
Most common PD associated with somatization disorder. Females? Males?
Females histrionic
Males antisocial
Tx of hypertensive crisis
Phentolamine (alpha blocker)
Classic side effect of clozapine besides agranulocytosis
Seizure
atypical antipsychotic that causes cataracts and orthostasis
quietiapine
classic side effect aripriprazole
akathisia (A,A)
2 changes in depressed polysomnogram
less REM latency
more REM
SSRI with most drug-drug interactions
paroxetine
serotonin discontinuation classic with
sertraline
possible psychiatric sx of R MCA stroke
mania
possible psychiatric sx of L MCA stroke
depression
meds that precipitate lithium toxicity
NSAIDS
“gold standard” drug for OCD
clomipramine
Gander syndrome
Giving approximate or ridiculous answers. Most common in prisoners
Catalepsy
Maintaining an immobile position. A type of catatonia
tx narcolepsy (2)
naps
modafinil
EEG in delirium vs psychosis
slow waves in delirium
normal in psychosis
contraindicated class in Lewy Body Dementia
anti-psychotics (paradoxical effect)
EEG of Creutzfeld-Jakob
triphasic bursts
tx for autonomic sx (htn, etc) from heroin w/d
clonidine
1st line tx (2 classes) vs most effective tx tourette’s
1st line = Clonidine or atypical antipsychotic
most effective = haloperidol
Risk of recurrent mdd
50%
2 agents for bipolar depression
Quietiapine
Lamotrigine
Timeline of normal development in pdd vs rett
Pdd is normal fist two years
Rett is normal first 5 mos
Ssri that is the most anticholinergic and should be avoided in old people
Paroxetine