Psychiatry Flashcards
Antidepressants a/w hypertensive crisis
MAOIs
Galactorrhea, impotence, menstrual dysfcn, and decreased libido
Pt on DA antagonist
17 yo F with L arm paralysis after her BF dies in a car crash. No medical cause is found.
Conversion d/o
Defense mech: mother who is angry at her husband yells at her child
Displacement
Defense mech: pedophile enters a monastery
Reaction formation
Defense mech: F calmly describes a grisly murder
Isolation
Defense mech: hospitalized 10 yo begins to wet his bed
Regression
Life-threatening m. rigidity, fever, and rhabdo
Neuroleptic malignant syndrome (NMS)
Amenorrhea, bradycardia, and abnl body image in a young F
Anorexia
35 yo M with recurrent episodes of palpitations, diaphoresis, and fear of going crazy
Panic d/o
Most serious SE of clozapine
Agranulocytosis
21 yo M has 3 mo of social w/d, worsening grades, flattened affect, and concrete thinking
Schizophreniform d/o (dx of schizophrenia requires ≥6 mo of sxs)
Key SEs of atypical antipsychotics
Wt gain, T2DM, QT prolongation
Young wt lifter receives IV haloperidol and complains that his eyes are deviated sideways. Dx? Tx?
Acute dystonia (oculogyric crisis). -Tx: benztropine or diphenhydramine
Medication to avoid if h/o EtOH w/d szs
Neuroleptics
13 yo M with h/o theft, vandalism, and violence toward family pets
Conduct d/o
5 mo F with decreased head growth, truncal dyscoordination, and decreased social interaction
Rett’s d/o
Pt hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Dx? Tx?
Acute mania
-Tx: start a mood stabilizer (ex: lithium)
After a minor fender bender, a man wears a neck brace and requests permanent disability
Malingering
RN presents with severe hypoglycemia. Labs show no elevation in C-peptide.
Factitious d/o (Munchausen syndrome)
Pt continues to use cocaine after being in jail, losing his job, and not paying child support
Substance abuse
Violent pt has vertical and horizontal nystagmus
Phencyclidine hydrochloride (PCP) intox
F who was abused as a child frequently feels outside of or detached from her body
Depersonalization d/o
M has repeated, intense urges to rub his body against unsuspecting passengers on a bus
Frotteurism (a paraphilia)
Schizophrenic pt takes haloperidol for 1 yr and develops uncontrollable tongue movements. Dx? Tx?
Tardive dyskinesia
-Tx: Decrease or d/c haloperidol. Consider another antipsychotic (ex: risperidone, clozapine).
M unexpectedly flies across the country, takes a new name, and has no memory of his prior life.
Dissociative fugue
1st line pharmacotherapy for depression
SSRIs
