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USMLE STEP 2 CK RETAKE > Psychiatry > Flashcards

Psychiatry Flashcards

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USMLE® Step 1 flashcards
1
Q

Generalized anxiety disorder Presentation

Dx, Tx

A

constant state of worry about MOST things on MOST days lasting for >6 months
Tx: Psychotherapy and combination with meds SSRIs

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2
Q

GAD symptoms needed for diagnosis

A 
at least 3 or more 
somatic changes 
Sleep changes 
Weight changes 
Irritability 
Concentration changes
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3
Q

Panic Disorder Symptoms

STUDENTS PANIC

A 
Acute, Overt, Catastrophic 
SOB
Trembling 
Unsteady 
Depersonalization 
Excessive HR 
Numbness 
Tingling 
Sweating 
Palpitations 
Abdominal pain 
Nausea 
Intense fear
Chest pain
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4
Q

Panic Disorder

Dx, Tx

A

ECG and troponins
TSH
Asthma
Tx: BZDs

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5
Q

Social Phobia

Tx

A

Usually in the form of public speaking

Non selective beta blockers

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6
Q

Intermittent Explosive disorder
Presentation
Dx, Tx

A

Stressor that leads to violence, Disproportionate to the stressor
Mild: 2x/ week for 3 mo No harm
Severe: 3x/ ever for 12 mo Harm to others

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7
Q

Kleptomania
Presentation
Dx, Tx

A

Steals things, there is rarely any value, patient can usually afford the object
Patient usually has guilt or remorse

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8
Q

OCD
presentation
Dx, Tx

A

made of obsessions and compulsions
obsessions are internal, intrusive and unwanted
Compulsions: reduce anxiety
Tx: SSRI

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9
Q

PTSD

Presentation

A 
Mood Change 
Dissociation 
Avoidance 
Hypervigilance 
Stressor is severe, life threatening
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10
Q

PTSD

Dx, Tx

A

> 6 months duration

Tx: SSRI/SNRI

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11
Q

Adjustment disorder
Presentation
Dx, Tx

A

Stressor is non-life threatening
Mood changes
Dx: Onset >3 days but <1 month
Tx: Usually none

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12
Q

RAD/DSFD
Presentation
Dx, Tx

A 
Abuse/neglect in the family 
RAD=pairs too little  
DSFD=pairs too much
Dx: <5 years old 
r/o Autism
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13
Q

Major Depressive Disorder

Presentation

A 
decreased mood or anhedonia and 
Duration > 2 wks and
5 SIG E CAPS
Sleep decreased or (increased in atypical)
Interest decreased 
Guilt Increased 
Energy Decreased 
Concentration Decreased 
Appetite decreased (increased Atypical) 
Psychomotor retardation decreased 
Suicide
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14
Q

Major Depressive Disorder

Dx, Tx

A

R/o Suicidal ideation

SSRI/SNRI

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15
Q

Suicidal ideation with a plan

A

Hospitalize

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16
Q

Suicidal ideation with no plan

A

Contract the patients safety

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17
Q

Bipolar I

Presentation

A 
Manic predominant 
duration > 1 wk 
E + 3 Sx 
Distractability 
Insomnia 
Grandiosity 
Flight of ideas 
Agitation 
Sexua exploits 
Talkative 
Elevated Mood 
Racing thoughts
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18
Q

Bipolar I

Dx, Tx

A 
r/o Stimulants 
r/o bipolar II, cyclothymia 
Tx: Agitated=BZDs
Mood stabilizer 
1. Lithium 
2. Valproic Acid
3. Lamotrigine 
4. Quetiapine
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19
Q

Bipolar II

Presentation

A

Hypomania with a MDE

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20
Q

Shared features of Grief, PCBD, MDE

A

Dysphoria, Guilt, Anhedonia

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21
Q

Grief Presentation

A 
Onset anytime 
duration <1 year 
focus on the deceased 
Can imagine a happy time
sadness waxes and wanes 
(+) insight
no treatment
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22
Q

Persistent complex bereavement disorder Presentation

A 
Onset > 6 months after 
Duration >12 months 
focus on the deceased 
never happy ever, sadness is persistent 
Hallucinations, no insight 
Tx: SSRI/ SNRI
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23
Q

MDE Presentation

A 
onset at anytime 
duration >12 months 
Focus on themselves
never happy, cannot see an end to sadness 
Hallucinations 
Tx: SSRI/SNRI
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24
Q

Baby blues Presentation

A 
Moms 1st baby and mom cares
onset 2 weeks 
duration 2 weeks 
depressed mood
no treatment
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25
Q

Postpartum depression presentation

A 
second baby, mom doesnt care leading to neglect 
onset within one month
duration-ongoing 
MDD symptoms 
Tx: SSRI
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26
Q

Postpartum psychosis presentation

A 
second baby, mom fears baby 
onset within 1 month 
duration-ongoing 
symptoms of psychosis 
Tx: Antipsychotics
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27
Q

Schizophrenia
Presentation
Tx

A 
(+) symptoms-too much dopamine 
(-) symptoms-too much serotonin 
>2 symptoms one being 1-3
1. delusions 
2. hallucinations 
3. disorganization 
4. disorganization
5. flat affect/poverty of speech/movement
Tx: antipsychotics
28
Q

Brief Psychotic disorder duration

A

> 1 day but <1 month

29
Q

Schizophreniform Duration

A

> 1 month but <6 months

30
Q

Schizophrenia duration

A

> 6 months

31
Q

Schizoaffective disorder Presentation

A

Psychosis and mood symptoms

32
Q

Atypical antipsychotics

Normal patient

A

Quetiapine
olanzapine
risperidol

33
Q

Combative patient which antipsychotic

A

Haloperidol

34
Q

Non-compliant patient which antipsychotic

A

depot form-haloperidol

35
Q

when all other antipsychotics fail what to use?

A

clozapine -can cause agranulocytosis

36
Q

Cluster A personality Disorders

A

Weird
Paranoid
Schizoid
Schizotypal

37
Q

Cluster B personality disorders

A

Wild
Histrionic
Narcissitic
Antisocial

38
Q

Cluster C Personality Disorders

A

Weak, Shy, timid
Avoidant
Dependent
Obessive-compulsive

39
Q

Neuroleptic Malignant Syndrome Presentation

A

Psych Disease
Positive Antipsychotic Medications
autonomic dysfunction- increased HR, BP, Temp

40
Q

Serotonin Syndrome Presentation

A

Psych disease
SSRI
Hypertonicity/Hyperreflexia

41
Q

Treatment durations in MDD

A

> 6 weeks at a single dose
6 months at effective dose
6 weeks of washout

42
Q

SSRI medications

A

(es)Citalopram
Fluoxetine
Paroxetine
Sertraline

43
Q

SSRI Adverse Effects

A

Sexual Dysfunction
decreased libido
Prolonged ejaculation

44
Q

SNRI Medications

A

(des)venlafaxine

Duloxetine

45
Q

Atypical Antidepressants

A

Buproprion
Tx: Smoking
no weight gain
Do not use in bulimia

46
Q

Mirtazapine uses

A

Appetite stimulation

47
Q

Trazadone uses

A

sleep aid

can cause priapism

48
Q

CAGE questions

A

Cut down
Angry
Guilty
Eye opener

49
Q

Alcohol intoxication presentation

Chronic Presentation

A 
AMS
Disinhibition
Slurred Speech 
Cerebellar Dysfunction 
Chronic: Wernicke's
Korsakoff (irreversible)
50
Q

How to treat Alcoholic coma

A
  1. Thiamine

2. D50

51
Q

Acohol withdrawl=BZD withdrawl
Presentation
Tx

A

Diastolic HTN/Tachycardia, Termor, Diaphoresis, agitated, Confusion (delirium Tremens), Seizure
Tx: Long-Acting BZD-Chlordiapoxide, diazepam
and
Short-Acting BZD-Alprozolam/Lorazepam

52
Q

Opiate use
Presentation
Tx

A

Intoxication-euphoria, coma, decreased RR, Constricted pupils
Long-term use-Constipation
Withdrawl-pain, N/V/D, cramping, irritability
Tx: acute-Naloxone

53
Q

BZD
presentation
Withdrawl
Tx

A

Delirium in the elderly, decreased Resp rate, coma, amnesia
HTN, Tachycardia, Seizures, Psychosis
Flumazenil

54
Q

Cocaine
presentation
withdrawl
Tx

A

Psychomotor agitation, HTN, Tachycardia, psychosis, dilated pupils, angina, HTN crisis
depression, cocain bugs
alpha blockade THEN beta Blockade

55
Q

Amphetamines
presentation
withdrawl
Tx

A

dilated pupils, psychosis, overheating (fever/tachycardia), Water intoxication
Crash, Depression
Supportive treatment

56
Q

PCP
presentation
withdrawl
tx

A

aggressive psychosis, vertical and horizontal nystagmus, impossible strength, blunted senses
severe random, violence
haldol, acidify the urine to increase excretion

57
Q

LSD
Presentation
Withdrawl
Tx

A

Rare, hallucinations, flashbacks, increase senses
flashbacks
supportive treatment

58
Q

Marijuana
Presentation
Withdrawl
Tx

A

tired, slowed reflexes, conjunctivitis, munchies, paranoia
no withdrawal symptoms
supportive treatment

59
Q

Barbituates
Presentation
Withdrawl
Tx

A

decreased safety margin, decreased respiratory rate, coma

redistributes into fat

60
Q

OSA
presentation
Dx, Tx

A 
Daytime Somnolence, Obese, snoring, large tongue, short neck 
Dx: Polysomnography 
>15 apnea spells/hr 
>5 apnea + snoring 
Tx: CPAP
Lose weight
61
Q

Narcolepsy Dx test

A

CSF-Hypocretin 1

polysomnography

62
Q

Primary Insomnia treatment

A

Diphenhydramine
Trazadone
Quetiapine
Zolpidem

63
Q

Illness Anxiety disorder

A

previously hypochondriasis
preoccupied with acquiring illness
unwanted
requires reassurance

64
Q

Symptom Somatic disorder

A

Somatic symptoms such as fatigue or pain

unwanted

65
Q

Conversion disorder

A

Neurologic symptom occuring due to some stressor
wont harm self
unwanted

66
Q

Factitous disorder

A

any kind of symptoms
patient wishes to fulfill a role possibly to achieve attention
intentionally deceive

67
Q

Malingering

A

any kind of symptoms
patient is doing due to secondary gain
intentionally deceiving

USMLE STEP 2 CK RETAKE (15 decks)

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