Psychiatry Flashcards
mother yells at her child, because husband yells at her
displacement - transferring avoided ideas and feelings to a neutral person or object (vs. projection)
abused child later becomes a child abuser
identification - modeling behavior after another person who is more powerful
a man who wants to cheat on his wife accuses his wife of being unfaithful
projection-attributing an unacceptable internal impulse to an external source (vs. displacement)
after getting fired, claiming the job was not imporatant anyway
rationalization - proclaiming logical reasons for actions actually performed for other reasons
a patient with libidinous thoughts enters a monaster
reaction formation - replacing a warded-off idea or feeling by an (unconciously derived) emphasis on its opposite (vs. sublimation)
teenager’s aggression toward father is redirected to perform well in sports
sublimation (mature) - replacing an unacceptable wish with a course of action that is similar to the wish but does not conflict with one’s value system
mature ego defenses
sublimation (vs. reaction formation), altruism, suppression (vs. repression), humor
guanfacine class of drugs and use
alpha 2 agonist for ADHD and Tourette
guaifenesin class of drugs and use
expectorant
Rett syndrome
XD in girls exclusively. Regression, loss of verbal abilities, ataxia, sterotyped handwringing at early age
length for dx of Tourette
> 1 year
which components of orientation are lost first
first time, then place, then person
EEG changes in delirium
diffuse slowing
dx time for schizophrenia
> 6 months
see brief psychotic disorder and schizophreniform disorder
dx time for brief psychotic disorder
less than 1 month
dx time for schizophreniform disorder
1-6 months
see schizophrenia and brief psychotic disorder
dx time delusional disorder
> 1 month
dx time manic episode
> 1 week
DIG FAST
distractibility, irresponsibility, grandiosity, flight of ideas, agitation, decreased need for sleep, talkativeness
dx time hypomanic
> 4 consecutive days. not as severe as manic
dx time schizoaffective disorder
> 2 weeks with concurrent mood disorder
dx time cyclothymic disorder
> 2 years
dx time MDD
> 2 weeks
SIGECAPS
sleep disturbance, loss of interest, guilt, energy, concentration, appetite, psychomotor, suicidality
changes in sleep during depression
more REM sleep overall, and closer to the beginning of night. also repeated awakening and terminal insomnia
dx time persistent depressive disorder (dysthymia)
> 2 years
dx time panic disorder
attack + > 1 month of distress about future attacks
dx time for general anxiety disorder
> 6 months
dx time adjustment disorder
less than 6 month
dx time PTSD
> 1 month
dx time acute stress disorder
3 days to 1 month
cluster A personality disorders
“weird”: paranoid, schizoid (loner), schizotypal (eccentric)
cluster B personality disorders
“wild”: antisocial (criminal), borderline, histrionic (dramatic), narcissistic
cluster C personality disorders
“worried”: avoidant (wants to be with others but can’t), obsessive-compulsive, dependent
pathogenesis of refeeding syndrome
seen in anorexia. increased insulin causes hypophosphatemia which can lead to cardiac complications
dx time bulimia nervosa
3 months
Russell sign
calluses on hands from induced vomiting
cause of narcolepsy
decreased hypocretin (orexin) production in lateral hypothalamus
tx of narcolepsy
day time stimulants (amphetamines, modafinil) and nighttime sodium oxybate (GHB)
tx PCP overdose
benzo
tx cocaine overdose
alpha blockers
note that beta-blockers are contraindicated
recreational drug that can cause hyperthermia, hyponatremia, and serotonin syndrome
MDMA
CNS pathology in alcohol abuse
periventricular hemorrhage/necrosis of mammillary bodies
preferred drugs for ADHD
stimulants
preferred drugs for alcohol withdrawal
benzos
preferred drugs for bipolar disorder tx
lithium, valproic acid, atypical antipsychotics
preferred drugs for bulimia
SSRIs
preferred drugs for GAD
SSRIs, SNRIs
preferred drugs for OCD
SSRIs, venlafaxine (SNRI) clomipramine (TCA)
preferred drugs for panic disorer
SSRIs, venlafaxine (SNRI), benzos
preferred drugs for PTSD
SSRIs, venlafaxine (SNRI)
preferred drugs for schizophrenia
atypical antipsychotics
preferred drugs for social anxiety disorder
SSRIs, venlafaxine (SNRI)
performance only: beta-blockers, benzos
preferred drugs for tourette
antipsychotics, tetrabenzine
MOA amphetamines
increase catecholamines in synaptic cleft
class of drugs: trifluoperazine, fluphenazine, haloperidol
high potency antipsychotics (typical)
class of drugs: chlorpromazine, thioridazine
low potency antipsychotics (typical)
which antipsychotic causes corneal deposits
chlorpormazine
which antipsychotic causes retinal deposits
thiordazine
which antipsychotic causes neuroleptic malignant syndrome
haloperidol
treat with dantroline and D2 agonists (e.g. bromocriptine)
which antipsychotic causes tardive dyskinesia
haloperidol
class of drugs: clozapine, olanzapine, risperidone
atypical antipsychotics
others included on another card
class of drugs: aripiprazole, ziprasidone, quetiapine
atypical antipsychotics
others included on another card
which atypical antipsychotic causes granulocytosis
clozapine
which atypical antipsychotic causes hyperprolactinemia
risperidone
which diuretic class increases risk of lithium toxicity
thiazide
MOA and use buspirone
5HT-1A agonist for GAD. takes 1-2 weeks to work
class of drugs: sertraline, citalopram
SSRI
class of drugs: desvenlafaxine, duloxetine, levomilnacipran
SNRI
which class of psychiatric drugs can cause SIADH
SSRI
class of drugs amitriptyline, nortriptyline
TCAs
class of drugs: imipramine, desipramine, clomipramine
TCAs
class of drugs: doxepin, amoxapine
TCAs
AE TCAs
3 C’s: convulsions, coma, cardiotoxicity
what can you use to prevent TCA-induced arrhythmia
NaHCO3
class of drugs: tranylcypromine, phenelzine, isocarboxazid
MAOI. others include selegiline
what are the atypical atnidepressants
bupropion, mirtazapine, trazodone, varenicline
MOA and use bupropion
increases nore and dopamine. atypical antidepressant, also for smoking cessation
MOA and use mirtazapine
alpha 2 antagonist (increases NE and 5HT), potent 5HT2 and 5HT3 antagonists.
atypical antidepressant
MOA and use trazodone
blocks 5HT2, alpha 1, and H1
technically an antidepressant, but used primarily for insomnia because high doses are need for antidepressant effect.
MOA and use verenicline
nicotinic ACh receptor partial agonist. atypical antidepressant and also used for smoking cessation
