Psychiatry Flashcards
Is there a critical period to develop attachment between mother and child?
NONNNN
What are the 4 pillars of action on drug-related harm?
- Screening
- Referral to treatment
- Brief interventions
- Harm reduction
What are the types of PD in cluster C?
(Worried Cluster)
- Avoidant
- Dependent
- Obsessive-compulsive
What are the types of PD in cluster A?
(Weird Cluster)
- Paranoid
- Schizoid
- Schizotypal
What is the first line pharmacological treatment of generalized anxiety disorder?
- SSRI
- SNRI
- Pregabalin
What is the second line pharmacological treatment of generalized anxiety disorder?
- Benzodiazepine
- Buproprion XL
- Buspirone
- Imipramine
- Hydroxyzine
- Quetiapine XR
What drugs can have a deathly withdrawal effect?
- Alcohol
- Benzo
What are the screening questions of an alcohol use disorder?
CAGE
- Have you ever felt you should cut down on your drinking?
- Have people annoyed you by criticising your drinking?
- Have you ever felt bad or guilty about your drinking?
- Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (eye-opener)?
What are the 7 reasons to hospitalize someone with an eating disorder?
- Precipitous or extreme weight loss
- Hypokalemia- Hyponatremia –Hypoglycemia
- Pulse (< 40/50 bpm); EKG; Orthostatic hypotension (BP decreases by ≥20/Pulse increases by ≥20)
- Elevated liver enzymes
- Hypothermia ( ≤ 35.0°)
- Weakness; Fainting
- Total fasting; Refusing to drink
What medication can be used for nightmares in PTSD?
Prazosin
Does medication work better than CBT?
They are the same, depends on the patient preference
- CBT: longer to work, lower relapse rate
What are the risks of antidepressent medication during pregnancy?
- Small association with autism
- Miscarriage (3%)
- Neonatal adaptation syndrome
- Persistent pulmonary hypertension (very small)
- Preterm birth (smaller increase)
What are the risks for the child of an untreated postpartum depression?
Neonatal developmental delay
What are the risk of an untreated depression during pregnancy?
- Stillbirth
- Major congenital anomaly
- LBW or SGA
- Preterm birth
- Poor maternal adaptation
- Admission to NICU
- Neonatal developmental delay
What are the 6 symptoms that raise the risk of suicide?
- High Anxiety
- Severe Insomnia
- Panic Attacks
- Low Concentration
- Anhedonia
- Alcohol Abuse
What is the first line pharmacological treatment of PTSD?
- SNRI
- SSRI
What are the hallmark of addiction?
4 “C”
- Loss of CONTROL
- COMPULSIVE use
- CRAVING
- Continued use despite adverse CONSEQUENCES
What are the types of PD in cluster B?
(Wild Cluster)
- Antisocial
- Borderline
- Histrionic
- Narcissistic
What is the second line pharmacological treatment of PTSD?
- Mirtazapine
- Phenelzine
What is the second line pharmacological treatment of social anxiety?
- Benzodiazepine
- Gabapentin
- Phenelzine
What are the criterias BPD?
- Impulsivity in two areas (not self-harm) – ex. spending, sex, drugs, binge eating
- Recurrent suicidality and/or self-harm – suicide attempts, cutting oneself
- Transient paranoia or dissociation – feeling like people are watching or want to hurt the person, feeling disconnected from themselves or reality, like things are a dream
- Affective instability – mood fluctuates quickly, frequently (multiple times per day), and often in response to external cues
- Chronical emptiness – feel completely alone and hollow
- Anger – frequently feels and acts on anger with shouting and fighting
- Identity disturbance – constantly changing goals, values, opinions, preferences
- Frantic efforts to avoid abandonment – afraid of being abandoned, clings on to others
- Unstable and intense relationships – idealize and devalues others, frequently breaking up and getting back together, many short relationships
What medication can be used for flashbacks in PTSD?
Naltrexone
What is the first line pharmacological treatment of social anxiety?
- SSRI
- SNRI
- Pregabalin
What are the risks of antidepressant treatment postpartum on the child?
Little or no evidence of severe side effects
What is the second line pharmacological treatment of panic disorder?
- Benzodiazepine
- Clomipramine
- Imipramine
- Mirtazapine
What is the treatement of a benzo addiction?
- Switching to long-acting benzodiazepine
- Peer support
- Individual or group psychotherapy
- CBT
- Motivational interviewing
What medication can we use for performance anxiety?
Propranolol (3rd line treatment)
What are the adverse effects of benzodiazepines?
- drowsiness
- confusion
- dizziness
- trembling
- impaired coordination
- vision problems
- grogginess
- feelings of depression
- headache
What is the acute treatment of alcohol withdrawal?
- Vital parameters
- Thiamine
- Benzodiazepine
- Beta blockers
- Haloperidol
What is the first line pharmacological treatment of panic disorder?
- SSRI
- SNRI
When is CBT better than medication?
- Health anxiety
- Specific phobia
- PTSD
What is the first step in management of postpartum depression?
Rule-out bipolar disorder (history of mania?)
What are the Educ’alcohol recommendations?
- 2 drinks per day max 10 per week for women
- 3 drinks per day max 15 per week for men
- 3 drinks max per day on special occasions for women
- 4 drinks max per day on special occasions for men
- At least one day per week where no alcohol is consumed
