Psychiatry and Sustance Abuse

Question 1

check what before initiating Li? (two systems it affects)

Answer 1

renal and thyroid - check Cr and Thyroid function tests

Question 2

SIGECAPS - name. dx of MDD?

Answer 2

5/9

depression, sleep, interest, Guilt, Energy, Concentration, appetite, psychomotor, suicidal

Question 3

binge eating v. bulemia

Answer 3

binge eating (no compensatory behaviors) v. bulemia (normal body weight with compensatory
behavior)

Question 4

Naltrexone v. disultram v. naloxone - use when?

Answer 4

NaltREXone = alcohol (still drinking - to reduce cravings) 
Disulfram = alcohol NO DRINKING
NalOXone = bzd od ( think Blue ox)

Question 5

differing factor fo rdementia v normal aging.

Answer 5

dementia - getting lost in familiar surroundings

Question 6

bipolar taking NSAIDs gets: GI sx, ataxia, fasiculations, confusion. what bipolar med is he taking?

Answer 6

Lithium

Question 7

Sudden sustained contraction of neck, mouth, tongue, eyes - dx and tx

Answer 7

acute dystonia - benztropine or diphenhydramine

Question 8

subjective restlessness, inability to sit still - dx and tx

Answer 8

akathesis - propranolol

Question 9

gradual tremor onset, rigidity, bradykinesia - dx and tx

Answer 9

parkinsonism - benztropine or amantadine

Question 10

grimace, >6m therapy - dx and tx

Answer 10

tardive dyskinesia

clozapine can help

Question 11

very HY intervention after schizophrenia diagnosis

Answer 11

family counseling

Question 12

withdrawal with dilated pupils

Answer 12

heroin

Question 13

selective mutism v. normal shyness.

Answer 13

A: Selective mutism is when for one or more months a child refuses to speak in SPECIFIC SOCIAL SITUATIONS (i.e. like at school).

Question 14

displacement -

Answer 14

putting feelings onto a more acceptable outlet (i.e.resident yelled at by attending, so resident yells at med student).

Question 15

projection -

Answer 15

resident is angry with med student and acts accordingly, but the resident rhought student being angry. [putting your feelings into someone else feeling them]

Question 16

Dissociative amnesia =

Answer 16

inability to recall personal infomraiton due to trauma (i.e. divorce, bad news).

Question 17

Dissociative identity disorder -

Answer 17

discontinuity in identity and loss of personal agency with two or more distinct identities alternately ASSUMING CONTROL of behavior.

Question 18

Depersonaliation/derealization =

Answer 18

intact autobiographical memory, but repeated experiences of detachment form self.

Question 19

treat tourettes with?

Answer 19

ANTIPSYCHOTICS or CBT or alpha-2 agonists (clonidine, guanfacine).

Question 20

delerium v psychosis (esp determining medication induced) -

Answer 20

delerium has fluctuating congnitive impariments. psychosis has normal exam - i.e GC-induced psychosis.

Question 21

~tx for catatonia =

Answer 21

BZDs and ECT

Question 22

____ is a first line antidepressant for pt with dperssion with poor sleep and poor appetite ECT is reserved for people who do not respond to antidepresants or whoare acutely suicida, catatonic, psychotic, or refusing po.

Answer 22

mirtazapine

Question 23

trichotillomania

Answer 23

is just the single compulsive act of recurrent hair pulling. (v OCD that has multiple compulsions)

Question 24

Nonstimulants for ADHD

Answer 24

NE-reuptake inhibitors like atomoxetine and alpha-2 agonists.

Question 25

clozapine can cause:

Answer 25

agranulocytosis, SEIZURES, MYOCARDITIS, METABOLIC SYNDROME