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Step 1 > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

Transference

A

Patient projects feelings about formative or other important persons onto physician

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2
Q

Reaction formation

A

Replaced a problematic idea or feeling with its opposite

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3
Q

Mature defenses (4)

A

Altruism, humor, sublimation (replacing unacceptable wish with one that does not conflict with value system), suppression

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4
Q

Retts disorder

A

X-linked seen almost exclusively in girls. Regression characterized by loss of development, loss of verbal abilities, MR, ataxia, sterotype hand-wringing

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5
Q

Time frame form postpartum blues and postpartum depression respectively

A

Blues - resolves within 10 days. Depression - 2 weeks to 1 year or more

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6
Q

Conversion disorder

A

Sudden loss of sensory or motor function (eg paralysis, blindness, mutism) following an acute stressor. Patient is aware of but indifferent towards symptoms

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7
Q

Somatization disorder

A

Variety of complaints in multiple organ systems over a period of years

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8
Q

Schizoid personality

A

Social withdrawal, limited emotional expression, content with social isolation (unlike avoidant)

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9
Q

Schizotypal personality

A

Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness

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10
Q

Schizophreniform vs schizophrenia

A

Schiphreniform is 1-6 months, schizophrenia is 6 months or more

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11
Q

What two effects of opioids do you typically not develop tolerance to?

A

Constipation and miosis

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12
Q

Intoxication with what substance is typically associated with belligerence and what are the other findings?

A

PCP. Impulsiveness, fever, psychomotor agitation, nystagmus, tachycardia, homicidality, psychosis, delirum

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13
Q

What makes methadone useful in heroin treatment

A

It has an extremely long half life

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14
Q

Treatment for alcohol withdrawal

A

Benzos

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15
Q

Treatment for bulimia

A

SSRIs

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16
Q

Treatment for anxiety

A

Benzos, buspirone, SSRIs

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17
Q

Treatment for atypical depression

A

MAOIs, SSRIs

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18
Q

Treatment for bipolar

A

Lithium, valproic acid, carbamazepine, atypical antipsychotics

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19
Q

Treatment for depression

A

SSRIs, SNRIs, TCAs

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20
Q

Treatment for depression with insomnia

A

mirtazapine

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21
Q

Treatment for OCD

A

SSRIs, clomipramine

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22
Q

Treatment for panic disorder

A

SSRIs, TCAs, Benzos

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23
Q

Treatment for PTSD

A

SSRIs

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24
Q

Treatment for tourettes

A

Antipsychotics (haloperidol, risperidone)

25
Q

Treatment for social phobias

A

SSRIs

26
Q

Typical antipsychotics (5)

A

Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine

27
Q

Mechanism of typical antipsychotics

A

Block D2 receptors

28
Q

High potency typical antipsychotics

A

Trifluoperazine, fluphenazine, haloperidol

29
Q

Neuroleptic malignant syndrome

A

Rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Seen with typical antipsychotics. Treatment is dantrolene or D2 agonists (bromocriptine)

30
Q

Atypical antipsychotics (6)

A

Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone

31
Q

What symptoms of schizophrenia do typical and atypical antipsychotics respectively treat?

A

Typicals - mostly positive symptoms, atypicals - positive and negative symptoms

32
Q

Side effects of chlorpromazine and thiordazine

A

Chlorpromazine - corneal deposits, thioridazine - retinal deposits

33
Q

Time course of EPS side effects

A

4 h - acute dystonia, 4 d - akinesia (parkinsonian symptoms), 4 wk - akathisia, 4 mo - tardive dyskinesia

34
Q

Risperidone side effects

A

Hyperprolactinemia. May cause amenorrhea

35
Q

Low potency typical antipsychotics

A

Chlorpromazine and thioridazine

36
Q

Lithium side effects

A

MNOP. Movement (tremor), Nephrogenic DI, hypOthyroidism, Pregnancy problems

37
Q

Buspirone

A

Stimulates 5-HT-1A receptors. Use in GAD. Does not cause sedation, addiction, or tolerance or interact with alcohol

38
Q

Tricyclic antidepressants (7)

A

Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine

39
Q

Mechanism of TCAs

A

Block reuptake of NE and serotonin

40
Q

What is the main cause of death in TCA overdose

A

TCAs inhibit cardiac fast sodium channels

41
Q

Uses of TCAs

A

MDD. Bedwetting (imipramine), OCD (clomipramine), fibromyalgia

42
Q

Side effects of TCAs

A

Sedation, alpha block, anticholinergic effects

43
Q

Toxicity of TCAs

A

Convulsions, Coma, Cardiotoxicity. Also respiratory depression, hyperpyrexia, hypotension, confusion, hallucinations

44
Q

SSRIs (4)

A

Fluoxetine, paroxetine, sertraline, citalopram

45
Q

Uses of SSRIs

A

Depression, OCD, bulimia, social phobia, PTSD

46
Q

Toxicities of SSRIs

A

GI distress, sexual dysfunction, serotonin syndrome (hyperthermia, myoclonus, CV collapse, flushing, diarrhea, seizures)

47
Q

Treatment for serotonin syndrome

A

Cyproheptadine (5-HT-2 antagonist)

48
Q

SNRIs (2)

A

Venlafaxine, duloxetine

49
Q

Uses of SNRIs

A

Depression, GAD (venlafaxine), diabetic peripheral neuropathy (duloxetine)

50
Q

Toxicities of SNRIs

A

Increased BP

51
Q

MAOIs (4)

A

Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B inhibitor)

52
Q

MAOIs lead to increased levels of what NTs?

A

Amines (NE, serotonin, dopamine)

53
Q

Uses of MAOIs

A

Atypical depression (depression with hyperphagia or weight gain), anxiety, hypochondriasis

54
Q

Toxicities of MAOIs

A

Hypertensive crisis with tyramine ingestion and b-agonists. Serotonin syndrome if given with SSRIs or meperidine

55
Q

Bupropion

A

Increases NE and dopamine by unknown mechanism. Depression and smoking cessation. Causes CNS stimulation, headache, and seizure in bulimic patients. No sexual side effects

56
Q

Mirtazapine

A

Alpha-2 antagonist (increases NE and serotonin) and antagonist of 5-HT-2 and 5-HT-3. Causes sedation, increased appetite, weight gain, and dry mouth

57
Q

Maprotiline

A

Blocks NE reuptake. Causes sedation and orthostatic hypotension

58
Q

Trazodone

A

Inhibits serotonin reuptake. Used for insomnia. Causes sedation, nausea, priapism, postural hypotension

Step 1 (21 decks)

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