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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
Treatment for social phobias
SSRIs
26
Typical antipsychotics (5)
Haloperidol, trifluoperazine, fluphenazine, thioridazine, chlorpromazine
27
Mechanism of typical antipsychotics
Block D2 receptors
28
High potency typical antipsychotics
Trifluoperazine, fluphenazine, haloperidol
29
Neuroleptic malignant syndrome
Rigidity, myoglobinuria, autonomic instability, hyperpyrexia. Seen with typical antipsychotics. Treatment is dantrolene or D2 agonists (bromocriptine)
30
Atypical antipsychotics (6)
Olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone
31
What symptoms of schizophrenia do typical and atypical antipsychotics respectively treat?
Typicals - mostly positive symptoms, atypicals - positive and negative symptoms
32
Side effects of chlorpromazine and thiordazine
Chlorpromazine - corneal deposits, thioridazine - retinal deposits
33
Time course of EPS side effects
4 h - acute dystonia, 4 d - akinesia (parkinsonian symptoms), 4 wk - akathisia, 4 mo - tardive dyskinesia
34
Risperidone side effects
Hyperprolactinemia. May cause amenorrhea
35
Low potency typical antipsychotics
Chlorpromazine and thioridazine
36
Lithium side effects
MNOP. Movement (tremor), Nephrogenic DI, hypOthyroidism, Pregnancy problems
37
Buspirone
Stimulates 5-HT-1A receptors. Use in GAD. Does not cause sedation, addiction, or tolerance or interact with alcohol
38
Tricyclic antidepressants (7)
Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
39
Mechanism of TCAs
Block reuptake of NE and serotonin
40
What is the main cause of death in TCA overdose
TCAs inhibit cardiac fast sodium channels
41
Uses of TCAs
MDD. Bedwetting (imipramine), OCD (clomipramine), fibromyalgia
42
Side effects of TCAs
Sedation, alpha block, anticholinergic effects
43
Toxicity of TCAs
Convulsions, Coma, Cardiotoxicity. Also respiratory depression, hyperpyrexia, hypotension, confusion, hallucinations
44
SSRIs (4)
Fluoxetine, paroxetine, sertraline, citalopram
45
Uses of SSRIs
Depression, OCD, bulimia, social phobia, PTSD
46
Toxicities of SSRIs
GI distress, sexual dysfunction, serotonin syndrome (hyperthermia, myoclonus, CV collapse, flushing, diarrhea, seizures)
47
Treatment for serotonin syndrome
Cyproheptadine (5-HT-2 antagonist)
48
SNRIs (2)
Venlafaxine, duloxetine
49
Uses of SNRIs
Depression, GAD (venlafaxine), diabetic peripheral neuropathy (duloxetine)
50
Toxicities of SNRIs
Increased BP
51
MAOIs (4)
Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline (selective MAO-B inhibitor)
52
MAOIs lead to increased levels of what NTs?
Amines (NE, serotonin, dopamine)
53
Uses of MAOIs
Atypical depression (depression with hyperphagia or weight gain), anxiety, hypochondriasis
54
Toxicities of MAOIs
Hypertensive crisis with tyramine ingestion and b-agonists. Serotonin syndrome if given with SSRIs or meperidine
55
Bupropion
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
Mirtazapine
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
Maprotiline
Blocks NE reuptake. Causes sedation and orthostatic hypotension
58
Trazodone
Inhibits serotonin reuptake. Used for insomnia. Causes sedation, nausea, priapism, postural hypotension

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