Psychiatry Flashcards

Question

what conditions are often comorbid with CD

Answer 1

``` ADHD ODD anxiety depression learning disorder substance related disorder ```

Answer 2

psychotherapy

Answer 3

firearms suicide attempts are more common in females but completed suicide is more common in males

Answer 4

CBT + SSRIs

Answer 5

presence of 1 (or more) of the following symptoms for <1 month 1. delusions 2. hallucinations 3. disorganized speech 4. grossly disorganized or catatonic behavior duration at least 1 day but less than 1 month, with eventual return to pre morbid level of functioning

Answer 6

2 or more of the following for 1-6 months 1. delusions 2. hallucinations 3. disorganized speech 4. grossly disorganized or catatonic behavior 5. negative symptoms (diminished emotional expression or avolition) the episode lasts at least 1 month but less than 6 months

Answer 7

2 or more of the following for AT LEAST 6 months 1. delusions 2. hallucinations 3. disorganized speech 4. grossly disorganized or catatonic behavior 5. negative symptoms (diminished emotional expression or avolition) typically develops between the late teens and mis 30s

Answer 8

1st or 2nd generation antipsychotics

Answer 9

``` contamination thoughts of harming loved ones/oneself washing/cleaning compulsions checking straightening ```

Answer 10

Group A Strep PANDAS pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection

Answer 11

sudden onset or exacerbation of tic symptoms following a recent streptococcal infection

Answer 12

CBT +/- SSRI CBT is the first-line treatment for children with mild to moderate OCD symptoms; SSRI's are used when CBT is insufficient to address OCD symptoms, or when CBT is not accessible or the symptoms are severe.

Answer 13

Noelle's- persistent thoughts that are distressing recurrent and persistent thoughts, urges or images that are unwanted and that in most individuals cause marked anxiety or distress the individual attempts to ignore or suppress such thoughts, urges or images or to neutralize them with some other thought or action (ie by performing a compulsion)

Answer 14

repetitive behaviours (hand washing ordering, checking) or mental acts (praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly

Answer 15

presence of obsessions, compulsions or both that are time consuming (>1h/day) or cause clinically significant distress/impairment half experience remission by early adulthood

Answer 16

``` >50% HAVE A COMORBIDITY ADHD separation anxiety disorder specific phobias agroaphobia multiple anxiety disorders tics ```

Answer 17

Children's Yale-Brown Obsessive Compulsive scale

Answer 18

Conners parent/teacher rating scale

Answer 19

SNAP IV, Conners

Answer 20

MASC | multidimensional anxiety scale for children

Answer 21

1. psychoeducation and support (for all) 2. behavioral management (for most) 3, medications (for some)

Answer 22

Stimulants: methylphenidate, amphetamine atomoxetine- norepinephrine uptake inhibitor (mono therapy) alpha 2 agonists- clonidine, guanfacine (mono therapy or adjunct to stimulant)

Answer 23

age >6 | takes weeks to months to see a response but will have a continuous response throughout the day

Answer 24

sedation stomach upset small increased risk of suicide related events! ``` others: decreased appetite weight loss insomnia irritable mood dizziness increased HR and BP dry mouth ```

Answer 25

CYP2D6 substrate | fluoxetine is a 2D6 inhibitor and will therefore increase the levels of atomoxetine

Answer 26

sedation hypotension bradycardia ``` others: dizziness rebound tachycardia and hypertension headache dry mouth irritability and other emotional changes modest increase in QT (guanfacine) ```

Answer 27

yes!! because it increases its absorption considerably

Answer 28

by CYP3A4 | - inform patients of drug and food interactions (ex: grapefruit)

Answer 29

due to risk of rebound tachycardia hypertension arrhythmias

Answer 30

``` anxiety OCD Depression tic disorders learning disorders substance use disorders * almost 70% of children with ADHD had at least one comorbid condition ```

Answer 31

on AVERAGE stimulants do not cause exacerbation or new onset of tics but they can do so in certain individuals

Answer 32

multi systemic therapy

Answer 33

CD substance use disorder severely delinquent behavior

Answer 34

2/3 | most children with ODD do not go on to develop CD

Answer 35

antisocial personality disorder

Answer 36

early are of onset increased severity increased pervasiveness

Answer 37

psychosocial interventions

Answer 38

medication for ADHD should be used first

Answer 39

risperidone

Answer 40

CAMESA Guidelines | Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children

Answer 41

1. psychoeducation and support (for all) 2. psychotherapy (for most)- primarily CBT 3. medication (for some)- primarily SSRIs

Answer 42

Feelings thoughts behaviours (relaxation/exposure) way to address feelings is by modifying dysfunctional thoughts

Answer 43

Coping Cat

Answer 44

Trauma focused CBT | exposure to memories of the trauma to get desensitized to the memories

Answer 45

exposure and response prevention

Answer 46

1. psychoeducation and support (for all) 2. psychotherapy (for most) CBT with emphasis on exposure and response prevention (ERP) 3. medication (for some)- primarily SSRIs

Answer 47

20-40% | cautious when treating with antidepressants, especially if family history of bipolar disorder

Answer 48

``` older age male sex MDD substance abuse impulsivity/aggression history of suicide attempts presence of suicidal plan/intent stressful life events exposure to abuse/violence access to lethal means (ie firearms) family history of suicide ```

Answer 49

1. Risk assessment and safety planning (for all) 2. psychoeducation and support (for all) 3. psychotherapy (for most)- primarily CBT and IPT-A 4. medication (for some)- primarily SSRIs but most evidence for fluoxetine

Answer 50

``` focus on >/= 1 of the following interpersonal areas: grief role transition role disputes interpersonal deficits ```

Answer 51

most- anxiety | least- MDD (most evidence for fluoxetine)

Answer 52

>12 yo with MDD

Answer 53

The cannabinoid hyperemesis syndrome is characterized by recurrent episodes of vomiting associated with abdominal pain and nausea; patients often find relief by taking a hot shower or bath. Cannabis use has been chronic (>1-2 yr) and frequent (multiple times per week). Treatment includes stopping marijuana use, antiemetics, and topical capsaicin.

Answer 54

CWS is defined by experiencing at least two of five psychological symptoms—irritability, anxiety, depressed mood, sleep disturbance, appetite changes AADIS and at least one of six physical symptoms—abdominal pain, shaking, fever, chills, headache, diaphoresis—after cessation of heavy cannabis use. ACDFHS Heavy cannabis use is defined as daily or near daily use for at least a few months. Withdrawal symptoms commonly occur 24 h to 72 h after last use and persist for 1 to 2 weeks. Sleep disturbance is often reported for up to 1 month.

Answer 55

1. OCD 2. ODD 3. ADHD 4. LD 5. ASD 6. Anxiety 7. Depression

Answer 56

CUD is defined as a problematic pattern of cannabis use leading to clinically significant impairment in areas of function or distress within a 12-month period Usually, adolescents experience the following functional impairments: reduced academic performance, truancy, reduced participation and interest in extracurricular activities, withdrawal from their usual peer groups and conflict with family.