Psychiatry Flashcards
1 month history of delusions; otherwise high-functioning, normal behavior.
Delusional disorder.
Schizophrenic symptoms lasting >1 month but
Schizophreniform disorder.
Schizophrenic symptoms lasting >1 day but
Brief psychotic disorder.
Schizophrenic symptoms lasting >6 months.
Schizophrenia.
Sx of amphetamine intoxication
Agitation, irritability, paranoia, delerium, chest pain, palpitations, tachcardia, hypotension, mydriasis, arrhythmias, seizures, hyperthermia, intracerebral hemorrhage.
Sx of PCP intoxication
Physical aggression, severe agitation, impulsivity, psychosis, paranoia, nystagmus, hypertension, tachycardia, ataxia, dysarthria, muscle rigidity, seizures, coma.
Differences between LSD and PCP intoxication
LSD: visual hallucinations and intensified perceptions.
PCP: agitation and aggression.
Shyness, feelings of inferiority, and a desire to make friends that is overridden by an intense fear of embarrassment or rejection.
Avoidant personality disorder.
First-line treatments for OCD are _ or _.
SSRIs; clomipramine (tricyclic).
Definition of “magical thinking”
The belief that one’s thoughts can control events in a manner not explained by natural cause and effect. It also includes the attribution of casual incidents to supernatural forces.
Definition of perseveration
The repetition of words or ideas during a conversation.
Major risk factors for suicide
SADPERSONS: Sex, Age, Depression, Previous attempts, EtOH (or other substance) use, Rational though loss, Social support (lack of), Organized plan, No spouse or significant other, Sickness or injury.
This atypical antipsychotic is less likely to cause the movement disorders commonly associated with the use of other antipsychotic medications.
Clozapine.
A major side effect of clozapine is _, which means one must _.
Agranulocytosis; monitor WBC count.
Besides agranulocytosis, another major side effect of clozapine is _.
a lowered seizure threshold.
Sx of heroin withdrawal
Muscle spasms, joint pain, nausea and vomiting, diarrhea, abdominal cramps, rhinorrhea, lacrimation, sweating, mydriasis, irritability, autonomic instability (hypotension).
How do antipsychotic medications (risperidone) cause hyperprolactinemia?
Antipsychotics cause dopamine blockade, and dopamine is a prolactin-inhibiting factor. Therefore, they can cause gynecomastia, galactorrhea, menstrual dysfunction, and decreased libido.
Indications for ECT
Severe depression, depression in pregnancy, refractory mania, neuroleptic malignant syndrome, catatonic schizophrenia.
Adverse reactions of ECT
Amnesia (anterograde or retrograde), prolonged seizures, delirium, headache, nausea, skin burns.
These two second generation antipsychotics cause the most weight gain.
Olanzapine and clozapine.
Disorder characterized by a significant mood episode (depressive or manic) with concurrent psychotic symptoms in addition to a period of psychosis without mood symptoms of at least 2 weeks.
Schizoaffective disorder.
_ is a dopamine and serotonin antagonist that can cause weight gain and hyperprolactinemia, the latter of which can lead to amenorrhea and galactorrhea.
Risperidone.
This disorder is characterized by excessive anxiety about multiple events, in conjunction with 3 or more of the following symptoms for at least 6 months: impaired sleep, poor concentration, easy fatigability, irritability, muscle tension, and restlessness.
Generalized anxiety disorder.
A history of _ or _ are absolute contraindications for buproprion.
Seizures; anorexia nervosa/bulimia (due to electrolyte abnormalities).
Is lorazepam or midazolam used for the immediate treatment of panic attacks?
Lorazepam.
A type of extrapyramidal side effect that develops within hours to days of initiation or dose escalation of antipsychotics; characterized by muscle spasms or stiffness in the head and neck, including tongue protrusions or twisting, facial grimacing, torticollis, opisthotonus, and oculogyric crisis.
Acute dystonic reaction.
Treatment of acute dystonic reaction.
Anticholinergic medication (benztropine) and/or antihistamines (diphenhydramine) that have significant anticholinergic activity.
Treatment of choice for OCD.
SSRIs.
Rush of intense fear or discomfort that peaks within minutes accompanied by >=4 cognitive or physical symptoms (e.g., palpitations, lightheadedness, nausea, fear of dying).
Panic attack.
Comorbidities of panic disorder (4).
Major depression, bipolar disorder, agoraphobia, substance abuse.
This medication is unique in that it has shown superiority in treatment-resistant schizophrenia associated with persistent suicidality.
Clozapine.
Serious adverse effects of clozapine.
Agranulocytosis, seizure, myocarditis, and metabolic syndrome.
Recommended treatment for an acutely psychotic patient experiencing command auditory hallucinations but denying suicidal/ homicidal intent.
Voluntary/ involuntary hospitalization.
Difference between conversion, factitious, and malingering disorders.
Conversion: unintentional.
Factitious: intentional, to assume the ‘sick’ role.
Malingering: intentional, with motivation of secondary gain.
Following acute stabilization, patients with bipolar disorder should receive the following maintenance therapy:
1) Atypical antipsychotics are preferred for mild to moderately ill patients.
2) Monotherapy with lithium or valproic acid can be used as alternative therapy.
3) For more severe episodes, combination therapy with lithium or valproate plus atypical antipsychotics is usually preferred over monotherapy.
Hyperkinetic movement disorder that is a side effect of medications; typically presents within 1-6 months after starting the medication.
Tardive dyskinesia.
The most likely atypical antipsychotic to cause EPS.
Risperidone.
The least likely atypical antipsychotic to cause EPS.
Clozapine.
Symptoms include fever, rigidity, altered mental status, and autonomic instability.
Neuroleptic malignant syndrome.
