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Psychiatry Flashcards

1
Q

2 types of bipolar?

A

Bipolar 1 and Bipolar 2

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2
Q

Age of onset of bipolar?

A

20-30

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3
Q

Mania in BP1 or BP2?

A

BP1.

BP2 is hypomania.

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4
Q

Define mania

A

Abnormal and persistently elevated, expansive, or or inappropriate mood at least 1 week with marked impairment of social/occupational function. Sometimes psychotic features.

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5
Q

Abnormal and persistently elevated, expansive, or or inappropriate mood at least 1 week with marked impairment of social/occupational function. Sometimes psychotic features.

A

Mania

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6
Q

Define Hypomania

A

Like mania but no market impairment and no psychotic features

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7
Q

Hypomania in BP1 or BP2?

A

BP2

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8
Q

Which BP has manic or mixed episodes?

A

BP1 only!

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9
Q

Which BP has NO mania or mixed episodes?

A

BP2

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10
Q

Which BP has mania but no marked impairment and no psychotic features?

A

BP2

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11
Q

Define “mixed episodes”

A

Simultaneous occurrance of ≥3 manic or hypomanic sx plus depresson

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12
Q

1st line tx for BP1 and BP2?

A

Lithium

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13
Q

Tx for mania?

A

Haldol or BZD

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14
Q

≥1 HYPOmanic episode + ≥1 major depressive episode

A

BP2

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15
Q

Similar to BP2 but less severe

A

Cyclothymic Disorder

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16
Q

Cyclothymic Disorder for how long?

A

At least 2 y

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17
Q

Cyclothymic Disorder describe

A

Hypomanic symptoms cycling with relative mild depressive episodes for at least 2 years

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18
Q

Cyclothymic Disorder tx?

A

Similar to BP1. Mood stabilizers and neuroleptics (aka antipsychotics)

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19
Q

Persistend Depressive Disorder (Dysthymia) for how long?

A

≥1 year children/adolescents

≥2 years adults

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20
Q

Persistend Depressive Disorder (Dysthymia) milder or more severe than Major Depressive Disorder?

A

Milder than MDD

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21
Q

Persistend Depressive Disorder (Dysthymia) tx?

A

Psychotherapy and SSRIs

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22
Q

Major Depressive Disorder for how long?

A

≥2 weeks

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23
Q

How many Sx for Major Depressive Disorder?

A

≥5 symptoms

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24
Q

Major Depressive Disorder tx?

A

Psychotherapy and SSRIs

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25
Q

How long to let SSRIs work?

A

3-6 weeks minimum

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26
Q

When to consider ECT in Major Depressive Disorder?

A

If other tx fail

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27
Q

How long goes General Anxiety Disorder have to last for?

A

≥6 months

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28
Q

Excessive worry or excessive anxiety about various aspects of life for a majority of days for more than ≥6 months

A

General Anxiety Disorder

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29
Q

General Anxiety Disorder TX?

A

SSRIs (ex paroxetine/Paxil, escitalopram/Lexapro)
Buspar
psychotherapy

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30
Q

Panic Disorder definition

A

≥2 Recurrent and unexpected panic attacks, last <60 min, peak at about 10 min

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31
Q

When to panic attacks often occur?

A

Followed by concern for future attacks

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32
Q

Panic Disorder tx

A

SSRIs, CBT, BZDs for acute attacks

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33
Q

PTSD in who?

A

MC young adults who have experienced trauma (war, sex abuse)

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34
Q

PTSD is when you re-experience the trauma for how long?

A

More than 1 month (less than 1 month is acute stress disorder)

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35
Q

PTSD tx?

A

SSRI, CBT

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36
Q

Tobacco withdrawal sx?

A

Restlessness, anxiety, irritabiity, sleep abnormalities, depression, nicotine craving

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37
Q

Mainstay of tobacco withdrawal?

A

Nicotine tapering therapy

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38
Q

Anti-depressant used with tobacco withdrawal?

A

Bupropion (Zyban)

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39
Q

Which med blocks nicotine receptors and reduces anxiety from tobacco withdrawal?

A

Chantix

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40
Q

Opioid intoxication sx?

A

Euphoria, sedation, pupils constrict (miotic), resp depression, bradycardia, hypotension

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41
Q

Opioid withdrawal sx?

A

Pupila dilate (mydriasis), piloerection (goosebumps), flu-like sx, rhinorrhea

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42
Q

Opioid intoxication tx?

A

Narcan

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43
Q

Opioid withdrawal tx?

A

Clonidine, loperamide, NSAIDS, Suboxone, Methadone taper

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44
Q

Alcohol intoxication sx

A

Disinhbition, depression, labile mood

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45
Q

Alcohol intoxication tx?

A

Observe. Haldol for psychosis or severe aggression. IV Thiamine and Folate.

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46
Q

Alcohol withdrawal begins how long after the last drink?

A

6-24h

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47
Q

Alcohol withdrawal does what to CNS activity?

A

INCREASES it

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48
Q

Alcohol withdrawal sx?

A

Tremors, anxiety, diaphoresis, palpitations

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49
Q

When can seizures occur from Alcohol withdrawal?

A

6-48h

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50
Q

When can DT occur from Alcohol withdrawal?

A

2-5 days after last drink

51
Q

DT in Alcohol withdrawal sx?

A

Delerium, tachycardia, hypertension, diaphoresis

52
Q

Alcohol withdrawal tx?

A

IV BZS, fluids, thiamine, magnesium, B12, and Folate IV

53
Q

Korsakoff’s Syndrome due to what?

A

Major thiamine deficiency during alcohol withdrawal

54
Q

Describe Korsakoff’s Syndrome?

55
Q

Korsakoff’s can happen when what is given before Thiamine?

A

Glucose given before Thiamine (no real proof of this but it can show up on tests)

56
Q

Schizophreniform Disorder lasts how long?

57
Q

Schizophrenia lasts how long?

A

≥6 months

58
Q

Schizophrenia lasts how long and what declines?

A

≥6 months with functional decline

59
Q

Define hallucination

A

Sensory perception w/o physical stimuli

60
Q

Define delusion

A

Fixed belief with strong conviction despite evidence to contrary

61
Q

What is Schizoaffective Disorder?

A

Schizophrenia + mood disturbance (mania, major depressive)

62
Q

Schizphrenia requires which of the following: hallucinations, delusions, or disorganized speech

A

At least one of them

63
Q

Which generation anti-psychotics first-line for psychotic disorders like schizophrenia

A

Second-line. Does D4 and 5-HT2 antagonism.

64
Q

Which generation anti-psychotic better for positive symtpoms of psychotic disorder?

A

1st gen (Haldol, Thorazine) but many extra-pyramidal symptoms (D2 receptor antagonist)

65
Q

Schizophreniform vs Schizophrenia

A

Less than 6 months in duraiton, more than 6 months in duration

66
Q

What happens to brain gray matter in schizophrenia?

A

Less of it

67
Q

What happens to brain ventricles in schizophrenia?

68
Q

What happens to CNS dopamine receptors in schizophrenia?

69
Q

How long does Delusional Disorder last for?

A

≥1 month

70
Q

How many delusions in Delusional Disorder

71
Q

Does Delusional Disorder have other psychotic symptoms?

72
Q

Delusional Disorder delusions likely?

A

Possible but highly unlikely

73
Q

Delusional Disorder has impairment of function

74
Q

Facitious Disorder

A

Falsified general medical or psych symptoms uwsually after psychosocial stress

75
Q

ADHD dx before what age?

76
Q

ADHD in how many settings?

77
Q

ADHD sx?

A

Hyperactive/impulsive/inattentiveness

78
Q

Tx of choice for ADHD?

A

Sympathomimetic meds (Ritalin, Adderall)

79
Q

Difficult social interactions, impaired communication, restricted/repetitive behaviors in which condition?

A

Autism spectrum disorder

80
Q

Conduct Disorder most common in who?

81
Q

What percent Conduct Disorder develops into Antisocial Personality Disorder?

82
Q

Behavior that deviates sharpy from age-appropriate norms and violates the rights of others

A

Conduct Disorder

83
Q

Violations of law, cruel to animals, defeitculness, destruction of property in which childhood condition?

A

Conduct Disorder

84
Q

Oppositional Defiant Disorder can progress into what other disorder?

A

Conduct Disorder

85
Q

Defiant behavior toward adults in which disorder?

A

Oppositional Defiant Disorder

86
Q

How many months for Oppositional Defiant Disorder?

A

> 6 months

87
Q

Angry/ittirable mood, argumentative/defiant behavior, vindictiveness in which childhood disorder?

A

Oppositional Defiant Disorder

88
Q

Aneroxia Nervosa in which sex 90% of time?

89
Q

Aneroxia Nervosa is when person refuses to do what?

A

Maintain minimally normal body weight

90
Q

What sort of behaviors in Aneroxia Nervosa?

A

Behaviors toward maintaining low weight

91
Q

Aneroxia Nervosa when BMI below what?

92
Q

Aneroxia Nervosa when Ideal Body Weight below what?

93
Q

What ideal weight to hospitalize Aneroxia Nervosa?

94
Q

Tx for Aneroxia Nervosa?

A

CBT, weight monitoring, monitored meals. SSRIs, atypical anti-psychotics.

95
Q

Bulemia Nervosa weight normal?

A

Normal weight. Sometimes even overweight.

96
Q

Bulemia Nervosa binge eating when?

A

Weekly for 3 months+

97
Q

Bulemia Nervosa binge eat when?

A

Stress/mood changes

98
Q

Bulemia Nervosa compensate for binge eating how?

A

Vomiting (aka purging)

99
Q

What happens to teeth in Bulemia Nervosa?

A

Teeth pitting and enamel erosion

100
Q

Electrolytes in Bulemia Nervosa?

A

HypoK

HypoMg

101
Q

What kind of acidosis from vomiting in Bulemia Nervosa?

A

Metabolic acidosis

102
Q

Tx for Bulemia Nervosa?

A

CBT, SSRIs

103
Q

Which SSRI helps with purging in Bulemia Nervosa?

A

Fluoxetine but my have cardiac problems

104
Q

Illness Anxiety Disorder aka?

A

Hypochondriac

105
Q

Fear or belief one has or will contract serious disease or has undiagnosed disease?

A

Illness Anxiety Disorder

106
Q

Illness Anxiety Disorder definition

A

Fear or belief one has or will contract serious disease or has undiagnosed disease

107
Q

Are somatic symptoms usually present in Illness Anxiety Disorder?

108
Q

Tx for Illness Anxiety Disorder?

A

Regularly scheduled appointments with provider for reassurance

109
Q

Somatic Symptoms Disorder most commonly in which sex?

110
Q

Somatic Symptoms Disorder describe

A

Physical symptoms involving ≥1 part of body but NO PHYSICAL CAUSES FOUND

111
Q

Facitious Disorder aka

A

Munchausen Syndrome

112
Q

Intentional falsification or exaggeration of s/sx of medical or psych illness for primary gain is which disorder?

A

Facitious Disorder

113
Q

Facitious Disorder patient is trying to get which gain?

A

Primary Gain (being sick/injured for their benefit such as sympathy)

114
Q

OCD made up of what two parts?

A
  1. Thoughts (obsessions)

2. Behaviors (compulsions)

115
Q

Define Obsessions in OCD?

A

Recurrent or persistent thoughts/images which are inappropriate and unwanted

116
Q

Define Compulsions in OCD?

A

Repetitive behavior which person feels compellet to perfrm

117
Q

Which SSRI for OCD?

A

Fluoxetine

118
Q

Describe Obsessive Compulsive Personality Disorder?

A

Perfectionist who required ORDER AND CONTROL. Preoccupied with minute details.

119
Q

Overly emotional, dramatic, seductive, sexually inappropriate

A

Histrionic Personality Disorder

120
Q

TOC for Histrionic Personality Disorder?

A

Psychotherapy

121
Q

When to use activated charcoal in anticholinergic intox?

A

<1hr since ingestion

122
Q

Antidode for anticholinergic?

A

Physostigmine

123
Q

When to use sodium bicarb in TCA overdose? (hint: EKG)

A

QRS above 100ms

124
Q

When to use charcoal in TCA OD?

A

If less than 2h since ingestion

EORE (10 decks)

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